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

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