The Need For Agile Healthcare

Adopting agile can help healthcare organisations adapt to the changing needs of patients, regulations and technology without the need for organisation-level restructuring

In this era of ever-changing external

factors, such as regulatory guidelines and new emerging technologies, healthcare organisations need to be responsive, nimble and able to seize the opportunity more than ever to be able to provide the highest level of patient care while staying in profitable business.

Being agile will be an increasingly critical capability moving forward, considering the industry’s turbulence, complexity and accelerating speed of change. In this environment, healthcare leaders must choose to lead the pursuit of greater agility or risk being left behind.

WHAT IS AGILE/AGILITY?

Agility is our ability to respond to change. The world around us is changing faster

than ever. For a business to succeed, what is often known as ‘business agility’ is most important. Business agility is responding to changing customer demand, market conditions, new technology entrants and even legislation or customer perceptions.

Keeping one step ahead of the game requires the ability to respond swiftly to the changes when needed. There’s a fine line between chaos and carefully deviating from the plan in a considered way to meet changing demands. This is where agile comes in.

Agile is a bunch of tools and techniques that help us achieve agility Agile is not a new term, it’s just the extension of the way organisations have worked in the past. For example, planning

is an agile tool, we would always plan whatever we did, but like all agile methods the key difference is that the agile planning session would be short, focused and done as a team.

Putting people at the centre is at the heart of every agile method and we can probably spot any agile technique in the wild quite easily – if it involves a cross section of skills and disciplines collaborating, it’s likely to be agile in action.

Agile frameworks like Scrum and Kanban are a good place to start if you’d like to start being agile or introduce agility in to your organisation.

THE AGILE MANIFESTO

According to the agile manifesto, agile is summed up as 'uncovering better ways of developing software by doing it and helping others do it'. Through this work we have come to value:

• Individuals and interactions over processes and tools

• Working software over comprehensive documentation

• Customer collaboration over contract negotiation

• Responding to change over following a plan.

That is, while there is value in the items on the right, we value the items on the left more. This might seem to be more focused on software development, but the core values hold true for any industry.

THE HEALTHCARE SECTOR NEEDS AGILE

Many healthcare organisations have struggled to keep pace with an everchanging business landscape. Thus, the pursuit of being agile – an organisation’s ability to adapt quickly and successfully in the face of rapid change – has taken on increased importance. In numerous industries, the companies thriving most have managed to crack the paradox of agility, balancing a stable foundation of core processes and capabilities with the ability to dynamically redeploy those capabilities to address emerging challenges and opportunities.

Both stability and dynamism are needed to excel – organisations that get the balance wrong can find themselves either

struggling to keep up or burdened with a bureaucracy that leaves them unable to respond to changing market conditions. The concept of agility is especially relevant to healthcare, which has endured tremendous upheaval in recent years. The industry continues to see strong growth. Financial and regulatory pressures have grown. With the immensely increasing pressure on the healthcare services, there is a dire need to move towards becoming agile to efficiently and effectively manage existing resources and services.

CONSEQUENCES OF NOT BEING AGILE

The concept of agile and agility stretches back more than a century, with organisations from the US military to Japanese manufacturers serving as evangelists. More recently, the software development industry started focusing on agile methodologies, and the concept has spread to application development functions within more traditional industries. In some companies, bureaucracy had so slowed product development cycles that businesses

were investing hundreds of millions on major IT applications only to find that evolving customer needs had rendered the applications obsolete by the time of release.

An agile development process has enabled companies to work faster and more collaboratively to reduce the time to market for new products; hence making sure that companies respond swiftly to the changing external factors and customer needs.

Organisations that are not agile are often so slow to adapt to changes they find they must pursue a fairly disruptive organisational restructuring every two or three years, just to keep up with changes in the market – costing them a lot of funds, resources and efforts which are detrimental to the long-term goals of the company.

Considering the growing pressure on the healthcare services, organisations need to be more efficient in delivering their services and, considering the shortage of clinical staff and ageing population, organisations need to be able to utilise their resources effectively, in fact more so than ever.

HOW CAN AGILE BE INCORPORATED?

At the heart of agile is the concept of small groups self-organising and working on agreed-upon priority tasks. This iterative component thus defines and directs the work, rather than a big project plan created at the beginning of the initiative. Scrum adds a component of time, the ‘sprint’ concept during which teams commit to a certain set of deliverables.

Below are some of the key learnings the healthcare sector can take from other agile organisations:

Creating cross functional teams and increasing communication and engagement Healthcare organisations should look at moving away from a hierarchical structure towards having cross-functional teams. Cross-functional teams usually consist of colleagues with different areas of expertise and discipline. There will be a product owner of the team who takes care of the backlog items and priorities, depending on the project or the goal. The cross-functional teams can be ramped up, ramped down or reconfigured depending on the need. The team members can be co-located as this will increase the communication and engagement in the team.

"Considering thegrowing pressure onthe healthcare services,organisations need tobe more efficient indelivering their services"

In the field of healthcare, members from different departments in the hospital can be included to create cross-functional teams depending on the need.

For instance, several shared services for functional areas (e.g., HR, claims) and ‘centres of excellence’ in specialised areas (e.g., quality, compliance). The business lines can draw on these shared services as necessary for resource-intensive but infrequent efforts, and then set priorities and direct activities for the shared staff assigned to their projects (an example of such an effort would be the need to develop the approach for responding to a large request for proposal). This agile setup allows the company to quickly develop and scale capabilities that can then be rapidly deployed as needed.

Increased customer collaboration The hospitals can look at collaborating more with the patients on getting a regular feedback on services received. Involving them into the pilot for new applications or services and getting the feedback can help in continuous learning and follow on improvements which are the very important part of agile.

Using agile as an alternative to traditional ‘waterfall’ management Waterfall project management involves all the planning in advance before any work is started. That’s how the traditional healthcare organisations have been working.

To begin with healthcare organisations can look at the departments which might already be agile, like IT or the healthcare innovation department, and if not then start adopting agile from those departments where it’s easier to follow. Then, step-by-step, launch agile in other areas where it can be used as an alternative to the traditional waterfall project management or as a peer to it.

HEALTHCARE CAN BECOME MORE AGILE

Healthcare organisations can become more agile by the following steps:

• Define the strategic objectives and identify how agile can benefit towards them (e.g. increased patient care, enhanced care models)

• Assess the departments which might be already using agile like the IT and healthcare innovation departments in the organisation

• Identify the areas where there is scope to pilot the agile model and prepare a road map to implement it

• Define the stable backbone for the organisation and the dynamic areas can be handled by agile teams

• Launch agile based models, iterate and keep evolving with regular feedback from the teams

• Create scalability by moving the targeted departments to become more agile over time

• By implementing by departments, the organisation will eventually reach the point where agile becomes selfsustainable.

THE BENEFITS OF ADOPTING AGILE

Agile has been widely adopted by many industries because of the benefits it provides. Some of the key benefits healthcare organisations can achieve from using agile are as follows:

• Engaged staff: empowering staff by allowing them to work in selfmanaged teams makes them more engaged in their work and therefore they produce a better quality of patient care and minimal errors

• Customer focused: agile emphasises focusing on customers and regularly getting feedback so healthcare organisations can benefit from constant improvements

• Lowered risks: using agile, risks can be assessed very early in the process because of the iterative approach

• Faster ROI: as results are delivered quicker with each iteration, benefits can be seen in the early stages

• Agility: adopting agile empowers the organisations to quickly respond to changes

• Improved performance transparency: adopting agile helps in improving performance transparency in both clinical and non-clinical areas.

PALLAVI KUMAR SENIOR ANALYST PROGRAMMER NHS

Pallavi is a senior software development professional and certified Scrum Master. She is passionate about learning new technologies and challenging and improving existing processes to enhance their efficiency