1. AN AGILE JOURNEY IN HEALTHCARE Alston Hodge, Enterprise Agile Coach A presentation at the 2012 Cincinnati Day of Agile (University of Miami) May 19,2012

2. AGENDA History Assessment Findings Anti-Scrum Patterns Root Causes Impacts to the Healthcare company Fixing the Problems Lessons Learned 3. HISTORY Nov 2007 IT dept established Agile charter Feb 2008 IT dept created Agile implementation plan, training campaign, pilot projects Oct 2008 IT dept created Agile Community of Practice Oct 2009 consulting firm recommended coaches Apr 2010 IT dept created Agile Maturity Model Oct 2010 BP survey highlighted Agile issues Apr 2011 hired first Agile coach, conducted organizational assessment Oct 2011 BP survey highlighted Agile issues 4. 2011 ORGANIZATIONALASSESSMENT 5. ASSESSMENT FINDINGS 53% of projects use Scrum 55% of people trained (mostly IT) 70% global partner utilization Sampled 35% of Scrum teams (47/136): Only 13% (6 teams) practice true Scrum 87% (41 teams) struggle with 4 or more key Scrum principles and practices 6. ANTI-SCRUM PATTERNS Scrum-> Scrum-lite-> O-gile Mini-waterfall approach Multiple concurrent projects in Sprints 83% have 3 ormore projects Teams with few or no retrospectives Risks not being identified and managed 7. LowestLower Higher Highest Attribute RiskRiskRisk RiskTeam Collocated Distributed Distributed Distribution Collocated Part-time OverlapNo Overlap Product Lead multiple POsOwner1PO2(no lead) ProductComplexity 1 system2 systems3 systems 4+ systemsTrue SprintLength 2 wks 4 wks6 wks 8+ wksProjects per Team1 23 4+Scrum AdvanceExperienceExpert Proficient BeginnerNoviceXPAdvanceExperienceExpert Proficient BeginnerNoviceTeamTruly cross-SpecializedStructurefunctional roles 8. MORE ANTI-SCRUM PATTERNS SM assumes some responsibilities of PO Stakeholders not attending demos Inconsistent use of VersionOne New teams adopting anti-Scrum habits of early adopters IT PM, Business PM No lead Product Owner 9. Product OwnerTeam Scrum MasterSimple Scrum 10. ProductOwner 4ProductOwner 3Business PMProduct ScrumOwner 2 TeamIT PMScrum SME/ArchMasterProductOwner 1 11. AND SOME MORE. Individual performance measures Workload exceeds capacity Start most/all stories at same time No sprint goals No tracking velocity Teams larger than 12 members Separate testing from development 12. Sprint ModelsModel SDEV-SIT-UATDEV-SIT-UAT DEV-SIT-UAT.Model DS-UDEV + SITUATDEV + SIT UATDEV + SIT UAT Model D-D-D-S-U DEV DEVDEV.SITUATModel D-S-U DEV SITUAT DefectsDefects DEVSITUATDefectsDefects DEV SITUAT 13. ROOT CAUSES 14. ROOT CAUSE 1:ADAPTING VS. ADOPTING SCRUM We need your help to adapt Scrum to fit our culture PMO Program Manager Perhaps we need to adopt the Values and Principles, and adapt the techniques and practices instead. Alston 15. AGILE VALUES AND PRINCIPLES Already complement our corporate values and principles. Guide us in our daily decisions. Are foundational, the core of what we believe to be true about us. Generally accepted Scrum practices are based on Agile values andprinciples Changing the values and principles de-stabilizes our Scrum framework. 16. EXAMPLE Choosing to not have retrospectives hampers: Continuous improvement Transparency Sustainable development Not tracking velocity hampers: Continuous improvement Transparency Sustainable development 17. ROOT CAUSE 2:ADOPTION VIEWED AS AN IT CAMPAIGN, NOT ACOMPANY CAMPAIGN Initiated and supported as IT campaign Business partners not fully understanding the implications: PO develops the backlog PO prioritizes based on business value PO approves story completion PO decides when to release With Agile, the Business is in the drivers seat! 18. IT LEFT WITH UN-ANSWERED QUESTIONS Service Provider vs. Business Partner IT projects vs. Business projects What to do with PMs? Scrum-> Scrum-lite-> O-gile? 19. ROOT CAUSE 3:ACCELERATED OFFSHORE UTILIZATION 2008 60% company, 40% contractor 2011 30% company, 70 % contractor Source of business innovation cut in half 20. LOOK AT THE NUMBERS US health care insurance experience 160+ years as an industry Over 80% of Americans with healthcare insurance today Indias health care insurance experience 12 years experience in industry Less than 6% with healthcare insurance (as of 2010) 21. ROOT CAUSE 4:ADD AGILE DEFICIT DISORDER Symptoms Difficulty in focusing Hard to develop self-discipline (team & organizational) Commitment issues Scrum Buts Resistance to Transparency 22. IMPACTS TO HEALTHCARE COMPANY 23. COLLABORATION CHALLENGES Agile Community of Practice stalled Increasing collaboration issues Increase turnover (company, vendors) in some areas Decline in Partnership survey scores Innovation Communications Ownership Increased use of PMs (IT and Business) 24. FIXIN THE PROBLEMS 25. UPDATE THE TRAINING Use experienced SMs and POs Lots of new resources available now Address the common Anti-Scrums Introduce eXtreme Programming Continuous integration Paired programming Automated testing Focus more on the Why of key Scrum concepts 26. KEY CONCEPTS OF SCRUM Transparency Prioritize Business Value Commitment Incremental development Continuous Improvement Minimal documentation Collaboration Sustainable pace Discipline Iterative development Stop.Inspect.Adapt Swarming Cross-functional teams Sprint planning Retrospectives Product Demos 27. RE-BUILD THE AGILE COMMUNITY Coachs Corner BUZZ Tips and Tricks (12 guidelines) Agile tract in Learning Week Monthly Corporate Scrum Gatherings Agile Team of the Year Award Louisville Agile Forum Partner with regional Agile groups 28. Coaches CoachesCoaches Coaches CoachesCoachesCoaches 29. PROMOTE VALUE OF COACHING organizationally agnostic - not subject to the same peckingorder, enabling them to tell the hard truths that may need tobe said Help teams develop self-discipline and good habits provide needed on-the-job learning and mentoringopportunities soon after training 30. Training with Coaching Coaching 31. PROMOTE VALUE OF COACHING Challenge teams to address the difficulties they face rather thansweep them under the rug. bring both tried and new practices and processes to the teamand organization reducing the degree of trial and error. bring an outside view of the organization, team and individualsand remove intrinsic bias and interpersonal issues. 32. GROW YOUR OWN COACH Internal coach program 6 months to coach the coach Full time commitment Workload of 12-15 teams Already knows the business Limitations Agile experience limited to one company Not organizationally agnostic No previous coaching experience 33. EDUCATE BUSINESS LEADERSHIP Find the champions Educate top down and bottom up 30 minute intro to Scrum Provide Product Owner learning map Solicit their help to champion Scrum Sell the idea of external coaches Help Business take back the reins. 34. EDUCATE IT LEADERSHIP Find the champions Provide Agile PM learning map Address the unanswered questions: Are we a Service Provider or Partner? How to develop Agile PMs? Do we understand and accept the risk of offshoring? Are we serious about Scrum adoption? 35. TREAT THE ADD Guidance of prioritizing projects/features Help teams develop self-discipline Educate on myth of multi-tasking 36. ADDRESS COLLABORATION ISSUES Lack of trust - team building exercises Triangulation Painters Pyramid Matthew 18 360 Surveys Monthly joint meetings 37. ADOPTION LESSONS LEARNED 38. Involve the Business from beginning Utilize external coaches for first year Honor Scrum values & principles Be transparent Be honest 39. MOST IMPORTANTLY: MAKE A DECISION Do you want to be a Guppy or an Olympic Swimmer? 40. Product Owner 4ProductOwner 3 Business PMProductScrumOwner 2TeamIT PMScrum SME/ArchMaster Product Owner 1 41. Product Owner 4Product OwnerProduct 3Owner 2Business PM Lead Product OwnerScrumTeamScrum MasterSME/ArchIT PM 42. QUESTIONS? 43. CONTACT ME alstonehodge@gmail.com Alstons Awesome Agile Blog www.alstonhodge.com (free coaching and advice!) Twitter: @alstonhodge Join me each month at the Louisville Agile Forum meetup Farm Credit Services office (1601 UPS Drive, Louisville, KY) 4th Wednesdays (6:30PM) Call me at 309-531-0611