Top Management Commitment

• Hospital leadership must actively support the transformation
• Leaders need to promote cultural change
• Open up rigid hierarchies for cross-functional collaboration
• Visibly model new behaviors and decision-making approaches

Investment in Training

• Budget for comprehensive training programs
• Ensure all roles receive appropriate SAFe training
• Create a common understanding of terminology and practices
• Develop internal training capabilities over time

Capacity for Change

• Allocate dedicated time for staff to learn new ways of working
• Consider dedicated resources for transformation (e.g., full-time coaches)
• Acknowledge that initial productivity may dip during transition
• Create space for experimentation and learning

Culture of Learning

• Foster an open error culture within patient safety boundaries
• Encourage experimentation and innovation
• Move from blame to learning when issues arise
• Celebrate learning and improvement, not just success

Technical Infrastructure

• Select appropriate tools for backlog management
• Establish collaboration platforms for distributed teams
• Consider DevOps automation needs early
• Ensure infrastructure supports transparency and visibility

Change Management and Communication

• Develop comprehensive change strategy
• Communicate regularly about goals, progress, and wins
• Address concerns and resistance constructively
• Use multiple channels (town halls, newsletters, intranet)