Seeking the approaches that enable faster change in the complex world of health and social care
We all need to speed up change.
Generally, change happens far too slowly, resulting in overwhelming pressure to compromise to meet time pressures. I have seen this happen again and again, and when it does, the greater the perceived time pressure the greater the chance of senior interference, slowing progress down further.
In the complex world of Health and Social Care much of the complexity comes from people, but responding to this with linear and process heavy methodologies designed for engineering, misunderstands the nature of change in the sector. Responding to complexity and accelerating in this environment requires an adaptable approach that engages people, the concept of a ‘Sprint’ is one approach that can help to accelerate in this environment.
What is a sprint?
The basic concept of the sprint is stolen from ‘Agile Project Management’, is consistent with the acceleration enablers, and is simple. Essentially, it brings together a group of people (sprint team) with the right capabilities to undertake the delivery of an output(s) in a defined period of time. This might sound familiar, however there are some key concepts that differ. The key features of sprints are:
The success I’ve had from some sprints, has been astounding. In one case a high priority complex set of outputs had failed to even begin for over 9 months, pulling together a small sprint team from different disciplines for two weeks achieved 75% of the outputs, and 6 weeks later a further sprint completed them. Another sprint stopped half way through, having identified a previously unknown but significant barrier, although seen as a failure by some, the identification of the barrier allowed focus to shift and has ultimately accelerated change.
So why are they successful? It’s simple, in a complex world, the interactions people have are more important than process, having early visible outputs that people can see, produces significantly better quality outputs, and finally, adapting to a situation through flexible planning is more effective than being a slave to a plan.
The message is clear, to accelerate change, bring people together to collaborate and develop outputs, enabling them to adapt their approach as they go. Sprints are a simple and effective way to do this.
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I’ve seen people struggle with ‘sprinting’ outside of software development and I think you’ve captured some of the key reasons here. In your first point “No one is in charge, people involved are there because of skills or knowledge not their position” this is a hard one for people used to traditional approaches to get used to. They’re used to being ‘directed’ and it can take time for them to shift culturally. I’ve had the same experience trying to move software development teams to agile practices.
And this point “Early versions of outputs are generated to allow wide input and adaption.” we all suffer from not wanting to share what we’re doing until it’s ‘finished’. It’s much better, when trying to adapt to change, to share often and build solutions together.
Finally, I’ve found the daily standup a difficult thing for people to accept. Team members often consider regular meetings to be about tracking progress and therefore the more time they spend ‘reporting’ the less time the spend ‘delivering’. It’s important to show them how the standup is about helping them remove barriers to their work and create rituals around which they can organise their day.
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Craig, thanks for your comment. I would agree with all your points, embedding agile and sprinting is far more complex than teaching people how to follow a methodology. The rewards are spectacular when it happens. This is probably why there are so many Agile coaches around.
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