For more than $50$ years, Hospital El Pilar has been providing the highest level of comprehensive care to patients in

Guatemala City, Guatemala. The private hospital $$ which offers a range of medical services including pediatrics,

intensive care, oncology, cardiology and outpatient care $$ is now one of the best hospitals in the country, thanks to its

commitment to quality care and continuous improvement.

As part of this commitment, Hospital El Pilar is focused on driving innovation by investing in the latest technology to

better serve both patients and staff.

$$ Challenge

$$ Solution

$$ Results

Challenge:

The hospital$$s application development team, which works within the technology department to build solutions and

strategies that aid hospital operations and outcomes, was experiencing stalled progress on projects due to several

obstacles, including:

$$ Unclear priorities. Every project was defined as urgent, which ultimately left the team unsure of how to focus its efforts

and prioritize needs.

$$ A lack of visibility. $$We had little visibility into the progress of projects and requirements, which led us to try to cover a

lot and, in the end, there was no progress at all,$$ said Adolfo Enrique Gal$$n Paz, manager of IT$.$

$$ Little interaction with users. $$We only had interaction with users at the beginning and end of projects,$$ Gal$$n said.

$$That caused us not to deliver what the client really required and drove errors in production when publishing

developments.$$

$$ Competing demands. The application development team also served as user support, which hindered the progress of

coding and development since the process was constantly interrupted to help users troubleshoot.

To improve how projects were being managed and how key stakeholders and users were involved in the process, the

team $$ made up of a development manager and five developers $$ selected Disciplined Agile$($DA$)$ as the best path

forward.

Solution:

To improve project outcomes, the development team ultimately needed to improve how their projects were being

managed without recreating the wheel. Project efforts had to continue even as the team worked to improve its processes.

This journey began by separating the support functionality from the application development team in order to allow the

team to better focus on their core purpose.

From there, the team $$ which was using what Gal$$n describes as $$some form of Scrum$$ began learning and applying

DA$.$

$$The advantage of Disciplined Agile is that you can start at the moment exactly where you are,$$ said Miguel Angel Garcia

Trujillo, PMI Disciplined Agile$$ Coach $($DAC$)$ and instructor, and CEO of Ditrats, Aguascalientes, Mexico, who provided

DA training and certification to Gal$$n and his team. $$This way they can start where they are with the technologies and

systems that are already part of the hospital and still create an immediate impact. In general, Disciplined Agile can

optimize anything that can be managed.$$

As part of their DA adoption, the application development team made some key changes, including:

Prioritizing user stories. Before using DA$,$ the team did not have documentation of user stories, which meant they did not

have properly defined user criteria or a definition of done $($DoD$)$ for the project. In addition, they decided to include

stakeholders in the team. According to Gal$$n$,$ this promotes transparency, makes the work more focused, and ultimately

makes the user feel like part of the team that is building the solution.

Implementing a monitoring dashboard. This dashboard provides the team greater visibility into:

$$ Working speed.

$$ Average days to complete stories.

$$ Number of tasks and stories pending in an iteration.

$$ Burndown iterations.

Redefining the way of working $($WoW$).$ The application development team ultimately selected the DA Agile life cycle as its

WoW, which they broke down further to include:

Holding daily coordination meetings

$$ Improves task tracking

$$ Enables the team to be flexible with priorities as needed

$$ Serves as a renewal of the team's commitment on a daily basis

Scheduling retrospective meetings

$$ Captures minutes with solutions to reported problems

$$ Takes self$-$assessments and prioritizes a positive attitude

$$ Improves how the team works together for future iterations

Taking requirements

$$ Ensures the team understands stakeholder objectives

$$ Allows project teams to more deeply understand the whole process to design a better product

$$ Establishes a relationship of trust with the hospital staff

$$ Prioritizes communication with the hospital staff

Organizing planning meetings

$$ Helps gain agreement on the effort required for each user story

$$ Assists the team in improving iteration planning. Project failure is typically a result of the absence of success factors. Use the theory on the causes of project failure and

advise how the project in the case study could have proactively considered this theory to good use.