White Paper: Scaling Agile in Healthcare Domain

Executive Summary

In a complex, hybrid global healthcare organization, world leader in simulation and clinical education, was facing challenges in coordination, delivery and realisation of business goals, caused by distributed teams struggling with inconsistent agile maturity, waterfall processes, and slow delivery cycles. Benzne Agile Consulting helped in setting up the scaling agile framework inspired by SAFe, unified the diversified group by launching Agile Release Trains (ARTs) and stabilising them, standardizing engineering practices and onboarding multiple supporting teams to bring end to end harmony. The transformation delivered faster release cycles, improved visibility, stronger collaboration between multiple contributors (business, architects, security, DevOps, SRE, Customer Support teams, Engineering etc), and self-organizing teams operating with execution certainty.

1. Problem Definition

• Global organization in healthcare training technology: Serving hospitals, Emergency response teams, educational institutions, and public-sector clients worldwide.
• Unorganized and Inconsistent approach to end to end product delivery: Teams were maintaining a common solution for different geographies which was resulting in multiple patch works and complicated delivery, applying Scrum approaches casually; underlying approach was pretty waterfall-ish and a huge resistance to change.
• Challenges:
  • Delivery inconsistency and poor visibility
  • Lack of cross-functional alignment and engineering discipline
  • Unpredictable release cycles and unrefined backlog prioritization
  • ‘Divisional’ mindset
• Business demands:
  • Build one-team mindset
  • Establish a common development cadence and pipeline
  • Incremental feature delivery aligned with business needs
  • Bring predictability, stakeholder transparency, and continuous improvement
  • Data driven decision making through effective prioritisation and other measures

2. Approach & Methodology

2.1 SAFe Introduction & Pilot Launch

• Performed As-Is analysis to clearly understand the challenges and opportunities
• Conducted Agile awareness and SAFe training for executives and pilot teams
• Standardized PI (Program Increment) cadence: planning, execution, review
• ART launch & first PI readiness
• Set shared ART rituals to synchronize across value streams

2.2 Role-Based Coaching & Team Integration

• Coached 90-95 professionals across product and engineering roles
• Expanded Agile practices (Scrum, PI practices) across additional ARTs over months
• Developed capabilities in backlog refinement, estimation, and PI ceremonies
• Team formation with varied skillsets to bring cross-functionality

2.3 Engineering Practices & Tool Integration

• Instituted & refined pair programming, CI/CD automation, and BDD principles
• DORA ( DevOps Research and Assessment) maturity at team levels around 4 metrics – Deployment Frequency, Lead Time for Changes, Change Failure Rate, and Time to Restore Service
• Redesigned Jira workflows, ROAM boards, PI dashboards, and roadmaps
• Implemented retrospective and metrics review practices for continuous improvement

2.4 Data-Driven Transparency & Metrics Culture

• Designed dashboards tracking capacity, scope creep, estimation variance, and dependencies
• Shared executive summaries and PI status updates to align leadership with outcomes
• Introduced PI planning using Mural, JIRA, Physical instruments like visual boards
• In Inspect & Adapt week, learn both qualitative & quantitative aspects, few are mentioned below –
  • ART Predictability Measure (comparing the actual business value delivered to the planned business value for each team’s PI objectives)
  • Actual Business Value Delivered
  • Cumulative flow diagram to check continuous delivery and track changes
  • Deployment and Release Metrics

2.5 Coaching Sustainability & Leadership Enablement

• Conducted regular retrospectives and leadership briefs
• Established LACE (Lean Agile Center of Excellence) to track progress within ART and across multiple ARTs
• Embedded coaching within teams and at program level to maintain maturity
• Scaled Agile mindset from pilot to enterprise-wide through hands-on support
• Launched VMO (Value Management Office) to bring portfolio agility along with leaders and key contributors to strategic decisions

3. Solution Summary

Benzne agile consulting solution combined SAFe training, practical coaching, and agile tooling into an integrated transformation journey. It ensured distributed teams adopted lean practices aligned with business priorities, enabling end-to-end collaboration and steady value delivery.

4. Outcomes & Impact

• Organizational Alignment: Unified SAFe adoption across all ARTs, replacing waterfall silos with synchronized workflows
• Enhanced Agility: Introduced engineering practices that enabled incremental delivery and higher product quality
• Operational Transparency: Dashboards and reporting tools provided real-time insights into progress, dependencies, and risks
• Execution Certainty: With prioritized backlogs and staged PI planning, product release cycles became consistent and predictable
• Team Maturity: Over time, teams became self-organizing—taking ownership of planning, estimation, and continuous improvement
• Backlog Efficiency: Improved requirement clarity and scope estimation led to reduced scope creep and increased forecasting accuracy
• Stakeholder Trust: Executives and cross-functional leaders gained confidence through regular demos, progress reports, and outcome-based reviews
• Self-sufficiency: Ensuring that the client organization should be able to sustain without our support on already established elements and also have team of experts to navigate way forward

5. Key Takeaways & Recommendations

1. Start with pilot ARTs and scale gradually for early wins and broader organizational adoption
2. Role-based coaching embeds behavioral change, cascad­ing Agile practices across functions
3. Tooling and metrics architecture drive transparency, enabling leadership to lead with data
4. Engineering practices accelerate team’s delivery confidence like automation, estimation disciplines, collective code ownership, CI/CD, continuous refactoring and more
5. Continuous alignment of business and delivery during PI cycles shifts teams from output focus to outcome focus

6. Conclusion

This healthcare case study exemplifies how Benzne Consulting’s agile transformation approach is built on its SAFe adoption expertise, coaching-led maturity, and engineering discipline, to deliver consistent business outcomes and operational excellence. By aligning distributed teams, divisional mindset, implementing required Agile practices, and institutionalizing feedback loops, Benzne enabled the client to confidently deliver value continuously, reduce risk, and build a scalable Agile culture.

Interested in applying similar agile transformation success to your organization? Schedule a call with India’s best agile consultants at Benzne Consulting to explore how we can help your teams drive execution certainty, cross-functional transparency, and high-performance collaboration.

Anuj Ojha

Anuj Ojha is Co-Founder & Consulting Head at Benzne. Anuj has designed & led multiple turnkey transformation journeys across industries, domains & geographies and has 16+ years of experience as an agile practitioner. He has worked with CXOs, CTOs & Key Leaders to translate their business objectives on the ground, contextualizing org transformations and creating buy-in across level, leading a team of coaches/consultants to implement agility across 150+ teams & trained more than 12k team members. Anuj’s core area of interest is business agility & working with leaders & teams to achieve long term sustainable, Agile culture & mindset.

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