Sprints; an approach to accelerate change

Genuine change in health and social care is complex, unpredictable, time consuming and very difficult to achieve. As outlined in a previous post on Sprinting, sprints are an approach  that embraces the characteristics of complex change and can be very valuable approach in your armoury and key to accelerating change.

A Sprint can be described as an exercise that 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, usually 1 or 2 weeks.

The concept of sprinting comes from the software industry and is encapsulated within Agile Project Management. The approach is based on a number of key principles designed to reduce development time and cost, and develop better software. In developing sprinting within health and social care, we have adapted the key Agile Manifesto principles from the agile movement  for Health and Social Care and the current iteration of the adapted underpinning principles are:

• Individuals and interactions over processes and tools
• Working solutions over comprehensive documentation
• Stakeholder collaboration over contract negotiation
• Responding to change over following a plan.

These have wider application, but when relating to a sprint these principles are important to ensure that the focus remains on people, being flexible and production of a working output within the timescale.

The software industry has since taken the concept and embedded detailed processes and methodologies, which for me, seems counter to the ’embracing complexity’ approach that saw its birth. Indeed, experience of using the approach clearly demonstrates that the ability to improvise within the constraints of the key principles is required, wrapping this into a methodology would have been unhelpful and have lead to changing the environment to match the methodology rather than embracing and working with the complexity. To illustrate how this improvisation is important and how it responds to the environment, I will outline a number of examples and situations.

•  In my current role the first sprint I was able to initiate, focused on the development of a specification for an integrated care model and was halted halfway through, as the sprint group encountered an information governance blocker that couldn’t immediately be overcome. The group acknowledged the sprint as a success, despite its premature end, as otherwise it may have taken months to find and understand the information governance blocker.
• Another sprint, seeking to develop a multi organisation, Organisation Development Strategy split the sprint into two shorter sprints (perhaps dashes!), with a gap of around 3 weeks between them. This was the only way we could secure the right people and capabilities to be part of the sprint. Successful outcome, an initial multi organisation OD Strategy developed within 4 weeks.
• Using a series of sprints, end to end, a small team was able to build a large complex business case in iterations. For each iteration, different people/capabilities were added to the team, from the wider design and modelling work. This allowed 8 iterations to be developed, aided the socialisation of the case with senior leaders, and more effectively and predictably used scarce capabilities.
• For a piece of work to develop a strategic plan, based on a series of high level Models of Care, a sprint approach was established. However, the large team running this highly complex work, generated a rolling sprint that lasted for around 3 months. Within a framework of milestones, the team generated objectives for the week and setout the activities to achieve these, rolling any outstanding activities into the following week. This approach achieved an incredible level of pace into the work and achieved what many had thought impossible. One senior leader commented that although the overall programme was behind schedule, this process had caught up 3 months within 3 months (i.e. 6 months work in 3 months). Additionally, the positivity and shared commitment from the team around this adaption and the sense of achievement has been greater than I’ve seen for sometime.
• The most successful sprint I’ve been part of to date, sought to resolve a long standing inability to deal with a backlog of 50+ guidelines (develop or review) that had been a problem for 9 months or more. By drawing the right people into a sprint, the key guidanelines were resolved within a week and the remainder 6 weeks later, when some consultant time could be scheduled.
• Another sprint sought to pull together a key project approval document to outline a service change, capturing the vision and agreements, and seek wider support, in 2 weeks. The sprint ended up being extended and extended until it fizzled out. All of the document had been pulled together, except for the benefits section, within the original sprint period. The blocker here was the availability of key staff to help with the modeling to describe these benefits. Rather than halting the sprint to seek the right resources, it kept going as the key objective hadn’t been met.

From the adaption of the concept outlined above, it is clear that there is no single way in which to approach sprints and whilst I and my colleagues have learnt a lot through trial and error, there is still much to learn. Many people I’ve introduced to the approach, although skeptical initially, have really started to embrace and adapt the approach, but not the 4 principles, as the acceleration benefits have been evident.

It is clear from the sprints I’ve undertaken and seen that they really do accelerate change in a complex world, to do this, however they do need to be adapted to meet the specific circumstances, but they always stay true to the key principles.

2 comments on “Sprints; an approach to accelerate change”

1. Pingback: The Delay Eliminator (Sprint Story 1) | Accelerating Change Programmes

2. Pingback: Create Pace, Sweat the Small Stuff | Accelerating Change Programmes

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