Post on 05-Apr-2020
Adventures in Agile Coaching:
A Case Study in
Healthcare Support Services
AgileIndy Conference 2019
Presenter: Alston Hodge, CEC
About the Speaker
• Alston Hodge is a Certified Enterprise Coach with proven experience in a variety of industries including Insurance, Financial Services, Information Technology, Energy, Government, Healthcare and Hospitality. His extensive experience includes 15 years of enterprise, portfolio and team-level coaching and training for executives, senior leaders, scrum masters, and product owners.
Alston currently serves as a Business Agility coach at SolutionsIQ, a group within Accenture.
About the Client
• One of the largest non-profit faith-based Healthcare systems in the world.
• Facilities in 23 states and the District of Columbia.
• Collaboration of hospitals, medical practices, and innovators that shares best practices
• Objective of developing healthier communities through community outreach and researching means of reducing the cost of healthcare.
Electronic Health Management Systems
The Focus of this Study:
Allscripts Teams
About the Teams
2nd Level Support Team
3rd Level Support Teams
• Meds Management
• Clinical Documents
• Surgery Scheduling
• Orders (Labs, Radiology, etc.)
• Order Sets
• Customization
• Technical
• Security
• Others
• Not really software development - - more support and services for the Allscripts platform
Coaching Approach
2 Weeks prior to training teams
Prepare Leaders for Change
Prepare SM and PO for new role
Understand workflow, impediments
3 days of Agile Fundamentals for teams -
Scrum and Sprint Zero
10 weeks of intensive team and leadership coaching
Preparing Leaders for Change
Leadership Transitions
Managing & Directing People
Defining/enforcing policies and rules of engagement
Making project decisions
Managing to the project portfolio
Designing organizational environments where team can be self-directed
Establishing objectives; keeping attention to what’s happening; keeping transparent
Pushes decision-making into the teams, and build the team’s ability to make good decisions
Collaboratively establishing broad business goals and objectives
Command & Control Management Trust & Empower Leadership
Leadership Transitions
Coordinating project implementation details with business
Managing systems and processes
Solving problems
Building trusting relationships with business, allow teams to work out details
Designing organizational environments
Understanding what problems reveal about underlying organizational dynamics/structures; let
people close to the problem solve problems
Command & Control Management Trust & Empower Leadership
Preparing Teams for Change
Team Training
2 days of basic Scrum training
Coach and trainer present
Tweaked basic training
Sprint Zero
Typical Sprint Zero activities, like Scrum tool training and creating initial backlog
Also worked with teams to understand:
Role of a coach
Value stream maps
Impediments
Create a Coaching Agreement
Discuss the role of a coach with the team and leaders
1
Let them share their expectations first
2
Create a coaching agreement
3
The Role of the Coach
Value Stream Mapping
Value Stream for support services are simple - - they already use Service Now tool.
Facilitate team discussion of work intake and deployment process
Challenges though - - different ministries, different states, different deployment processes
Keep Value Stream Mapping Simple
Let the PO and SM facilitate the discussion of value stream
Document a simple flow diagram (high-level) of current state
Estimate volume and priority of work intake
Intake
Output(Deliver)
Service/Support
Team
Prioritize the Intake sources
Managing Impediments
Brainstorm with team• Review impediments that surfaced
during training
• Dot voting the Agile Principles
• Compile master list and prioritize impediments
• Share with others
#1 Impediment: Multi-tasking
• Shoulder taps
• Working on multiple tasks, projects, assignments
• High pressure work environment
• Everything is important!
Addressing Multi-taskingthru the Name Game
The Name Game
NiCoLe
EdWaRd
HaRlEy
AlStOn
Ten Weeks of Coaching
Sprint 1 –Common Observations
• Highly specialized skills
• Perfectionism
• Super Heros
• Resistance to Change
How can we address these?
Pair Sharing
Pick a topic below and share for 1 minute with a neighbor how you might address this issue:
• Highly specialized skills
• Perfectionism
• Super Heros
• Resistance to Change
Creating Cross-functional teams• Skill survey
• Recognize the experts
• Address the question - WIIFM?
• Create Training/Development stories in each sprint
“When dealing with
people’s health, our
solutions must be perfect!”
Perfectionism - But at what cost?
• Perfection: the enemy of Progress
• Delays due to scope creep
• Testing delays due to end users not readily available
• Months to deliver solutions
• Big Bang releases
Dealing with Super Heros
• Recognize the experts
• Address their fears of giving up control
• Funnel all work request through PO
• Address the shoulder taps
• Create a Super Hero Team instead
But be prepared…not everyone likes being a team player.
We have resistors…By 2019, if your company is just starting its Agile journey, you are already a late adopter.
Pair Sharing
Pair up and discuss your thoughts on how to address resistors.
How do you address
Resistors?
Consider the root causes
The # 1 root cause?
Fear.
• Fear of losing control
• Fear of losing my job
• Fear of change
• Fear of failure
Addressing Resistors
• Explain the WHY
• Let’s experiment!
• Recognize their expertise and value in building a team
• Its OK to fail; in fact:
• F – First
• A – Attempt
• I – In
• L - Learning
• If we’re not failing, we’re not trying hard enough!
• Engage leader support
• You’re not alone (COPs)
Pair Sharing
Have you experienced this mind set before?
Share a story with your neighbor how you can relate to this experiment.
Sprints 2-3: Agile Acceleration
• Gradually getting all work into a sprint backlog
• Shoulder taps diminish
• Realizing work-life balance
• Less multi-tasking
But what about dependencies between teams?
Managing Dependencies
Identify potential dependencies during Refinement sessions
POs & SMs meet weekly to finalize dependencies and schedule work
Tagging stories with “Dependency”
Re-align sprint start dates if needed to reduce overall development time
Sprint 4-6:Sharing with others
• Bi-weekly PO/SM meeting• share tips and tricks
• Drive toward some minimum level of consistency between teams
• Escalate environment impediments common between teams
• Explore Portfolio management
Managing conflicts between teams
Remember, we have the same customers, the same stakeholders, the same mission. We’re all on the same Allscripts team.
5 Dysfunctions of a Team
Remember Tuckman’s Model of Team Development
Matthew 18
Conflict Management Styles Assessment
What did I learn?
Coaching Support Services teams is a bit different than software teams.
Non-profit companies have different challenges than for-profit companies.
Faith-based companies are great clients to work with!
Agile principles and practices can easily be used by non-software products and services.
Support Services vs Software Development
Attribute Support Services Software Development
Team Maturity Fast (within 3 sprints) Moderate (within 6 sprints)
Size of Stories Mostly 0.5 to 1 day complete 2-5 days to complete
Complexity Little Moderate to high
Predictable work Minimal (on-call) Moderate