TP479: Agile in a Waterfall World (or Don’t Go Chasing Waterfalls)

Running sprints inside an organization that hasn't changed anything else isn't transformation. It's double the work. Chris Boyer and Reed Smith examine what isolated Agile adoption actually produces in health systems — and what it exposes about the organizational infrastructure no methodology can fix on its own. Mentions from the Show: Only 23% of Agile-experienced executives say their org can shift resources quickly; only 34% say culture naturally enables Agile: Bain & Company, "How Agile Is Powering Healthcare Innovation" — https://www.bain.com/insights/how-agile-is-powering-healthcare-innovation/ Siloed structures as primary barrier to Agile at scale in large enterprises: Agility at Scale research review, 2025 — https://agility-at-scale.com/implementing/transformation-leadership/ 55% of organizations cite poor leadership as top barrier to cross-functional OKR alignment (prerequisite for Agile): Hyperdrive Agile OKR research, 2024 — https://hyperdriveagile.com/articles/breaking-silos-how-advanced-okr-cross-functional-performance-drives-unprecedented-growth-83 CEO "follow me, I'm just behind you" case study — management stuck in old-fashioned way while development teams ran Agile: Bain & Company, "Agile Innovation" — https://www.bain.com/insights/agile-innovation/ Healthcare structural and cultural barriers to Agile implementation: Rahman et al., SSRN, August 2024 — https://papers.ssrn.com/sol3/papers.cfm?abstract_id=5041524 Real Agile blockers: decisions, load, trust, habits — finance and HR structural changes required: Bee'z Consulting / Scrum Alliance, 2025 — https://www.beez-consulting.com/blog/adopting-an-agile-culture-and-practices-in-healthcare-challenges-and-solutions Agile at scale requires finance, HR, and governance to shift — not just team-level training: Scrum Alliance, Coaching for Transformation microcredential framework — https://www.scrumalliance.org/microcredentials/coaching-for-transformation-sustaining-change Reed Smith on LinkedIn: https://www.linkedin.com/in/reedtsmith/ Chris Boyer on LinkedIn: https://www.linkedin.com/in/chrisboyer/ Chris Boyer website: http://www.christopherboyer.com/ Chris Boyer on BlueSky: https://bsky.app/profile/chrisboyer.bsky.social Reed Smith on BlueSky: https://bsky.app/profile/reedsmith.bsky.social Learn more about your ad choices. Visit megaphone.fm/adchoices