Communities are more resilient when centralized agencies address the “social determinants of safety” (see this one-pager from the Civil Rights Corps and this op-ed from Brookings Institution). These central agencies also make it easier for citizens to volunteer their time to ensure local safety.
Government agencies are using Lean-Agile for system development in the same way as commercial enterprises do. Experienced practitioners report that the same success patterns apply, with some minor tweaks to account for unique government protocols.
Scaled Agile Framework (SAFe)
The Scaled Agile Framework (SAFe) is a set of guidelines that helps large organizations adopt agile methodologies. Its principles and processes help teams deliver quality software and services while promoting alignment and collaboration. The framework also helps organizations achieve business agility. It has been adapted and tested by real-world enterprises and is backed up by extensive research. The SAFe website contains numerous training opportunities, implementation roadmaps, and community resources.
A SAFe transformation starts with identifying business objectives and developing an implementation plan. The roadmap describes how to reach the tipping point that triggers change. Once an enterprise reaches this point, it can begin the transition to a Lean-Agile technology enterprise.
To successfully implement SAFe, leaders must create a culture of agility and align employees around the new value system. Then, they must identify and communicate the business benefits of the initiative. This will ensure the organization has enough buy-in to commit to change and provide the necessary support for the change.
In addition to fostering an agile culture, SAFe emphasizes continuous feedback and a customer-centric mindset. This requires that leadership establish a strong connection between the business and IT departments. Moreover, it is important to build trust between teams, which can be accomplished through a variety of means. These include creating transparency, planning smaller batches of work, and conducting inspections and adaptation rituals.
SAFe focuses on effective program execution, which is essential to the success of any project. The framework promotes an open working environment and trust in teams by providing visibility into backlogs and pending tasks. In turn, this increases productivity and enables organizations to quickly address issues. For example, PlayStation reported that implementing SAFe doubled their productivity and reduced downtime.
The SAFe website features an interactive Big Picture graphic that offers a visual model of the Framework. Each icon on the image is clickable and leads to an explanation of SAFe’s foundational values, mindset, roles, artifacts, and more. The site also provides numerous training and certification opportunities. A good place to start is with a SAFe Big Picture tour, which takes you through each layer of the model and introduces the core practices that make up the framework.
Lean-Agile at Scale
Many managers believe that their problems are unique. In reality, they are not; the underlying causes of poor quality or slow delivery share certain patterns that can be understood by leveraging systems thinking. Using ten immutable Lean-Agile principles, the SAFe framework provides a practical approach to addressing those problems.
A successful requires leadership support. Leaders should identify the business need for a shift toward SAFe, motivate stakeholders, and ensure activities are in alignment with a vision for change. They must also create the right environments that enable employees to embrace the four core values of SAFe.
Organizations must remove silos and become cross-functional to improve agility. They should apply systems thinking to solution development and the enterprise building it, which means eliminating waste, maximizing value flow, decentralizing decision-making, and organizing around value. This allows teams to focus on the most important work and reduce queue lengths. It also enables the enterprise to operate more economically, including operating with lean budgets and planning for shorter lead times.
Teams should be empowered to prioritize work based on economic trade-offs, and they should manage the flow of work through integrated Kanban boards. They should also use a synchronized backlog, implement a Lean pipeline, and plan with weighted shortest job first (WSJF) scheduling. It’s critical that leaders make sure that people are trained in the agile concepts they implement and that a culture of continuous improvement is nurtured.
It’s vital that people understand how they can help build high-quality, well-designed solutions through a collaborative and customer-centric approach. They should rely on design thinking, a commitment to Agile product delivery, and a customer-centric organizational structure to do that.
In addition to these principles, a successful SAFe implementation includes a continuous flow of work, effective Built-In Quality practices, relentless improvement, and evidence-based governance based on working components. It also requires a small, cross-functional group of people to help guide the change effort. This team is called a Lean-Agile Center of Excellence (LACE) or guiding coalition, and it helps the rest of the organization implement SAFe.
Lean Enterprise
Several government agencies around the world are using Lean and Agile to accelerate their technological development processes. These organizations are responding to business (mission) agility, digital disruption, aging legacy systems, growing cyber threats, and other challenges. They need to be able to build technology-based solutions that meet their customers’ needs with speed and quality.
Lean helps them build those systems with less risk, enabling them to make changes in the field more rapidly and deliver more value to their stakeholders. These benefits include reducing delivery time by 20-50%, reducing defects and waste by 25-75%, and increasing employee engagement and job satisfaction. The benefits are so significant that they have even led some agencies to increase the number of people doing Lean work.
In many cases, government technology teams are a mix of small groups of government employees working closely with large numbers of contractors. They face unique challenges, including high assurance and compliance requirements, heavy governance regulations, and abnormally long acquisition lead times. Lean helps them overcome these challenges with a rich stew of programs, some derived from Japanese philosophies, such as 5-S, Kaizen, self-empowered teams, cross-training, visual process control, Total Productive Maintenance, and Error Prevention. This helps reduce the number of defects and ensures that more of the products they develop will be successful.
While the benefits of adopting Lean and Agile are clear, it is not easy to implement these methodologies in government. Waterfall ways of thinking and processes are deeply ingrained in many government technology programs. It takes specialized guidance to help change agents overcome the barriers and deliver Lean-Agile at scale.
One example is the Veterans Engineering Resource Center (VERC) LET pilot program. The program uses a combination of leadership events, educational and communication activities, identification and development of value stream areas, ongoing daily improvement efforts, expert-level “sensei” facilitation support, and system redesign. VERC has developed a national evaluation plan to assess the LET program and deployment.
Despite the unique challenges, agencies that have adopted Lean-Agile are experiencing great success. They have achieved a more agile and responsive IT organization, reduced risks and costs, improved customer satisfaction, and on-time delivery of products and services. These outcomes have been driven by a change in the culture of the agency, the elimination of bottlenecks, and a commitment to continuously improving the way they do their work.
Resilience
Resilience is the ability to adapt quickly and effectively when facing challenges. This can include everything from natural disasters to unforeseen catastrophes like hardware failure or cyberattacks. Resilient systems can bounce back faster and are more capable of surviving such incidents, leading to higher customer satisfaction and retention and increased productivity and efficiency.
Recovering from a major shock or change requires resilience at multiple levels, and health systems are especially vulnerable to these kinds of events because they have 6 functions that must work together at all times. This is one reason why resilient health systems are on the agenda. During the COVID-19 pandemic, it has been challenging for many health systems to meet the demands of the crisis while continuing to provide quality services.
There are many definitions of resilience, but most of them emphasize the ability to rebound from a difficult situation. The term has also been used to describe the ability of communities or individuals to support and assist each other during challenging times, such as following a natural disaster or a terrorist attack. For example, after the 9/11 terrorist attacks, the New York City community came together to help each other rebuild, and the communities of Gilroy, California, El Paso, Texas, Dayton, Ohio, and Uvalde, Texas, worked together during the aftermath of Hurricane Katrina. In addition to the capacity to bounce back from adversity, resilient individuals and communities have a strong sense of social support, a positive outlook, and the ability to draw on inner strength in difficult times.
The OECD defines health system resilience as the “capacity of health actors, institutions and populations to prepare for and effectively respond to crises; maintain core functions when a crisis hits; and, informed by lessons learned during the crisis, reorganize if conditions require it.” This comprehensive definition considers not only how the system can cope with a shock but also how it learns from its experiences.
To better understand the characteristics of health system resilience, a systematic review was conducted to identify existing descriptions or frameworks for this concept. Four databases and gray literature were searched using the terms “health system resilience” or “resilient health systems.” The most comprehensive description of health system resilience was found in Kruk et al., which describes how a health system can prepare for and respond to a shock while maintaining its core functions.