SAFe draws from four established knowledge domains to create a comprehensive framework:

1. Lean Product Development

   • Eliminate waste and optimize value delivery
   • Focus on the economics of decisions
   • Create flow across the entire value stream

2. Agile Development

   • Iterative, incremental delivery of working solutions
   • Customer collaboration and responding to change
   • Cross-functional teams with a focus on outcomes

3. Systems Thinking

   • Optimize the whole system, not just parts
   • Consider interdependencies between components
   • Focus on end-to-end value creation

4. DevOps

   • Continuous delivery and deployment
   • Automation of the technical value stream
   • Shared responsibility across development and operations

These foundations make SAFe uniquely suited for complex healthcare environments, where coordination across departments, regulatory compliance, and patient-centered innovation must coexist.