Attempting Too Much Too Soon

• Pitfall: Attempting to implement all levels of SAFe simultaneously
• Solution: Start with Essential SAFe (Team and Program levels), then extend progressively
• Hospital Context: Begin with a single ART focused on a critical digital initiative

Insufficient Training

• Pitfall: Rushing implementation without proper training
• Solution: Invest in comprehensive training for all roles
• Hospital Context: Ensure clinical stakeholders receive role-appropriate training

Mechanical Implementation

• Pitfall: Implementing SAFe as a rigid process without understanding principles
• Solution: Focus on Lean-Agile mindset and principles, not just practices
• Hospital Context: Adapt ceremonies to clinical workflow realities

Unstable Teams

• Pitfall: Frequently changing team composition
• Solution: Maintain stable teams for at least the duration of a PI
• Hospital Context: Plan for clinical staff availability and use stable representatives

Neglecting Technical Practices

• Pitfall: Focus on process while ignoring engineering excellence
• Solution: Include Built-in Quality practices from the start
• Hospital Context: Incorporate compliance requirements into Definition of Done

Poor Tool Implementation

• Pitfall: Over-reliance on tools without understanding the practices
• Solution: Focus on principles first, then select supporting tools
• Hospital Context: Evaluate tools for integration with hospital systems

Insufficient Executive Sponsorship

• Pitfall: Transformation without active leadership support
• Solution: Secure and maintain visible executive commitment
• Hospital Context: Engage both clinical and administrative leadership