1. Reach the Tipping Point

• Recognize when current ways of working reach their limits
• Identify pain points in digital initiative delivery
• Build awareness of need for new approach
• In hospitals: Often triggered by multiple KHZG or other digital transformation projects that can't be managed effectively with traditional methods

2. Train Lean-Agile Change Agents

• Identify internal champions who will drive change
• Provide SAFe Program Consultant (SPC) training
• Create initial transformation expertise
• In hospitals: Often IT project managers, process improvement specialists, or clinical informatics leaders

3. Train Executives, Managers, and Leaders

• Ensure leadership understands Lean-Agile principles
• Conduct Leading SAFe (SAFe Agilist) training
• Secure active sponsorship from top management
• In hospitals: Critical to include both IT and clinical leadership

"Leadership engagement is crucial - transformation must be modeled 'from the top down' with executives actively demonstrating commitment to new ways of working."

4. Create a Lean-Agile Center of Excellence (LACE)

• Form an interdisciplinary transformation team
• Coordinate all SAFe implementation activities
• Provide internal consulting and coaching
• In hospitals: Include representatives from IT, clinical departments, and administrative functions