The Scrum methodology in the hospital sector

The Scrum methodology ensures that the company focuses on what is most important at all times and as quickly as possible.


When launching a project, any organisation, in our case any healthcare centre, must ensure that the team involved knows its tasks and deadlines. Scrum is a framework that helps us to achieve this and, at the same time, speed up the delivery of value to the client. 



What is SCRUM?

Scrum is a framework or process that enables collaborative work, on a regular basis, between teams. In this process, a set of best practices are regularly applied to work together as a team in order to achieve the best possible outcome of a project.


“Scrum, in practice, encourages teams to learn through experiences, to self-organise while tackling a problem, and to reflect on their victories and defeats in order to continuously improve.”


The beauty of this methodology is that, while it has always and most often been used by software development teams, its principles and lessons can be applied to all types of teamwork. This is one of the reasons why it is so popular, and why it is making such a big splash in healthcare.





What is Scrum really about?

Although often thought of as an agile project management framework, Scrum includes a set of meetings, tools and roles that, in a coordinated way, help teams structure and manage their work.

With this tool, regular, partial deliveries of the final product are made, prioritised by the benefit they bring to the recipient of the project. Therefore, Scrum is particularly suitable for projects in complex environments, where results need to be obtained quickly, where requirements are changing or poorly defined, where innovation, competitiveness, flexibility and productivity are essential. This is the case in the healthcare industry and the operation of hospitals.





So, what is the Scrum framework based on?

Being framed within agile methodologies, Scrum is based on aspects such as:

  • Flexibility in the adoption of changes and new requirements during a complex project.
  • The human factor.
  • Collaboration and interaction with the client.
  • Iterative development as a way to ensure good results.




What are the fundamentals of Scrum?

Scrum is based on:

  • The incremental development of project requirements in short, fixed time blocks (iterations of one calendar month and up to two weeks if necessary).
  • Prioritising requirements by customer value and development cost in each iteration.
  • Empirical control of the project. The team is synchronised on a daily basis and makes the relevant adaptations.
  • Empowerment of the team, which is committed to delivering requirements and is given the necessary authority to organise its work.
  • Systematising collaboration and communication both between the team and with the client.
  • Timeboxing of project activities, to help decision-making and achieve results.




What are the benefits of Scrum?

The benefits of Scrum are wide-ranging and have an impact on the team, the stakeholders and the organisation as a whole.

First of all, teamwork is encouraged, focusing all efforts on achieving a common goal. Stakeholders have greater control and transparency over the project, allowing for better organisation. And the client can monitor what is happening more closely, without having to wait for a final result that does not convince them. 

In addition, it allows for a reduction in product development time, more adaptability and flexibility in the face of a changing environment and requirements, increasing the value provided to customers. Not to mention other benefits such as:

  • Monthly or fortnightly) delivery of results
  • Regular management of customer expectations based on tangible deliverables
  • Anticipated results
  • Flexibility and adaptation to customer needs, market changes, etc.
  • Systematic management of Return on Investment (ROI)
  • Systematic mitigation of project risks
  • Productivity and quality
  • Alignment between client and development team
  • Motivated team




Roles in SCRUM teams

With Scrum, the team is focused on delivering value and quality results to meet the customer’s business objectives.

To this end, Scrum teams are self-organising and cross-functional, i.e. each team member is responsible for specific tasks and for completing them within the agreed timeframe. Thus, there are 3 crucial roles in a Scrum team.

  • Product owner: Responsible for maximising the value of the work. The Product Owner is the only profile that talks constantly with the customer, which requires him/her to have a lot of knowledge about the business.
  • Scrum Master: Responsible for ensuring that Scrum techniques are understood and applied in the organisation. He/she is the Scrum leader and manager.
  • Development Team: Responsible for carrying out the tasks prioritised by the Product Owner. 





Applying the SCRUM methodology to the hospital sector

The million dollar question is: can SCRUM be applied to healthcare? The answer is clear and simple: YES. Not only can it be done, it should be done. 

Let’s take a simple look at why. It is common knowledge that the Spanish public health system, like the British, among others, has a serious problem of sustainability in the medium and long term. If we look at the Spanish population pyramid and its expected evolution in 2030 and 2050, with the low birth rate and the increase in life expectancy, the health spending that is more and more concentrated from the age of 65 onwards, we realise that a new paradigm is needed that must include different and modern methods such as Scrum. Why? To take advantage of the opportunities of digital health, as part of the solution, together with decisive action by public administrations to save our healthcare system.

In addition, Scrum also allows improving Information Technology (IT) systems, providing faster and more efficient services without compromising quality; and offers immediate attention in the emergency, diagnosis, treatment and recovery of patients.

Thus, as a general rule, in some agile clinics, interactions are valued more than processes, using real-time feedback as an opportunity to learn, improve and deliver wellness and health tailored to each patient and/or staff. 





LEAN tools

On the other hand, we also find the application of LEAN tools as a way of working similar to SCRUM. This is based on the philosophy or methodology that seeks to reduce the waiting times of the total process of patient care health services, considering as such the time that elapses from the time the patient comes to the centre until the end of the care process. 

In order to achieve these objectives, we first need to train the teams in the basics and tools of the Lean Healthcare Management System. Once trained, they will be applied to the day-to-day work of the teams, to generate new routines.

A successful case of Lean applied to the healthcare environment is that of Sts. Mary and Elizabeth Medical Center. This centre is a benchmark in the application of Lean tools such as the systematic review, standardisation and simplification of processes, which they call a breakthrough rapid improvement event.





SCRUM case studies in the health sector

It is time to see, on a practical level, what Scrum methodology is currently being used in the healthcare system. 

For example, Futurs, the technology division of the Ribera Salud healthcare group, announced this year the renewal for two years of its Scrum Level certification, which it has had since 2019 and which does so with a higher level of adaptation of its practice to this methodology, which accredits that its software development department is fully aligned with its philosophy. 

This is a team in which most of its professionals are certified as Scrum Masters, thanks to the internal training plan that the aforementioned company offers its employees to improve their skills and advance in their professional development.

On the other hand, there are different innovative clinics that have already started to use agile methodologies to save the lives of their patients in a more strategic way. This is the case of the mental health clinic, Monash Health, in Melbourne (Australia), where since 2017, doctors have adopted agile practices to tackle complex diseases. Melissa Casey, director of psychology at the clinic, also indicated that since adopting agile practices, there has been a 46 per cent improvement in care measures and job satisfaction. 


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