Anything that was written in a ski lodge draws a certain amount of skepticism. Despite this, the “Agile Manifesto,” created in 2001 and intended as a set of principles for creating a better software design process, has permeated business and other efforts worldwide. In fact, we find “agile” taught in the Carlson School of Business, Continuing and Professional Studies, and Software Engineering to name only a few places within the University. And like any good thing, there are things that we in the health care sciences can learn from and use from it as well.
When we are faced with enormous problems and limitations of resources, it can be difficult to start setting a course forward. Especially when we are working with constraints of time and money, we tend to want to perfect the approach first and act second. As you well know, there are problems with this approach in health care, not least of which is the speed and unpredictability with which the landscape around it is changing. How many of us have worked on carefully crafted strategic plans that were outmoded by the time we were ready to implement them?
What an “agile” approach gives us is the assurance that we can start right away, start simple and know we plan to reassess, add to, and adapt our plans as we go forward.
What an “agile” approach gives us is the assurance that we can start right away, start simple and know we plan to reassess, add to, and adapt our plans as we go forward. By launching small efforts, we are using mini-models of what we are working toward.
An example of this is the BOLD Ideas grants. Short timeframes, quick bursts of creative thinking and concrete application--then evaluation, analysis, revision—and repeat the cycle. We don’t have to find the perfect solution, we just have to start. In health care, because we know the problems are going to change anyway, it allows us to shift our strategies as the endpoint(s) shift.
In an “agile” environment, everyone has the opportunity and responsibility to make the project successful, regardless of their official role or job title. Everyone contributes, even people operating outside of their core competencies―because multiple viewpoints and the ability to do what needs to be done are key to success. It’s about bringing the problem together with the people who can help solve it without needless restrictions.
When you use “agile” project management ideas, the problem changes as much as the solution. In other words, just acting on the problem helps define and refine it.
Another useful thing about using “agile” development is that you don’t need to build the infrastructure to support the solution first. You don’t create the system to solve the problem. You build the system (and the infrastructure) by solving the problem (which may actually be a quite different problem than the one you started out to solve).
I hope that all of us can find something useful in an “agile” approach by giving ourselves permission to look at our own tasks without the limitations of administrative (and sometimes intellectual) clutter. I also hope you will share your experience with “agile” and tell us about new areas where you think we could use this approach. As always, your feedback is what helps us start forward, helps us evaluate the work we have in progress, and points us toward necessary additions and improvements.
Jakub Tolar, MD, PhD
Vice President for Clinical Affairs