Health Center News, Uncategorized

Agile Scrum Framework 101: Driving Change by Improving Process

Project management flow chart graphic

by Camila Silva and Efe Omadevuae

This post is the second in NACHC’s Innovation Blog Series. This series is hosted monthly by our Center for Community Health Innovation.

If you are trying to implement a new idea or look at better ways to manage your existing work, you might utilize or consider several project management techniques and approaches.  You may have heard buzzwords such as Waterfall, Agile, Scrum, Kanban, Lean, Extreme Programming, etc. But what do these mean for the Community Health Center movement?

The interview below features a conversation with Efe Omadevuae, Scrum Master with NACHC’s Informatics team. Efe started out working in a bank, became an IT specialist, and is now acting as the scrum manager for the NACHC Informatics Team who are using Agile processes to make things happen at NACHC and in its work with community health centers.

Photo of Efe Omadevuae

Driving Change – Inspiring Community Health Centers

Given the pandemic and the rapid rate of change in technology, many industries are in an increasingly unpredictable environment, and health centers are no exception. With the ever-changing landscape, organizations need frameworks to implement new ideas while still being able to quickly respond to the changes happening around them. This is where Agile project management comes in. Agile methods are adaptable, allowing for rapid decision-making and near-instant responsiveness to changes in the industry.

Q: Let’s start from the beginning, what is a Scrum Master?

Efe: An Agile facilitator that enables processes that are tailored in a scrum framework.

  • Agile is a Lean planning tool that focuses on an iterative approach to break down larger projects into more manageable tasks and allow maximum flexibility to modify solutions and optimize staff time. When using Agile you are working hand in hand with the customer to understand their needs while iteratively developing artifacts to meet those needs which gives your team the ability to quickly respond to change. There are most two well-known Agile methodologies: Kanban and Scrum.
  • Scrum is the most used framework within Agile. It is popular with almost all kinds of industries, such as health care, informatics, agriculture, and manufacturing. The role of a Scrum Master is to make sure that the project allows continuous improvement but still is accountable to an end goal using feedback, objective metrics and continuous process refinement.

Q: For those new to project management, what is the difference between the Waterfall and Agile methodologies?

Efe: Waterfall is about the approach of traditional project management—it plans the project from beginning to end as though nothing will change and evaluates the output after it is completed. Waterfall requires a lot of early design before stakeholders are engaged and changes are hard to implement, while feedback is not given in a timely manner. So, there was a need to make the process more responsive and flexible, and that’s the goal of Agile.

Here’s an example: When we think of putting 10 buildings in the marketplace, if we build all 10 buildings at the same time, we will presumably get 10 identical buildings, without the opportunity to reduce waste, reduce time to build or improve on design. However, if we put our resources into completing one building first, we can immediately consider opportunities for improvement and can use that to improve the process of creating the second and third buildings and so on. This is the essence of Agile, to do things in short bursts or sprints, get feedback, and improve the overall process. This systematic approach can be deployed across many different types of projects.

Q: How can this framework relate to community health centers?

Efe: A project which is mission critical and in need of continuous improvement could benefit from using Agile. Scrum was designed for software development but can be used in any industry including in complex settings. Specifically for the community health movement, it can be implemented in projects that improve day-to-day care processes, seek to improve patient and staff engagement or focused on effectiveness of operations.

Scrum will help bring awareness and engagement to the project management process. You can see the result if there’s an improvement from your starting point, and this allows you to measure the impact of smaller initiatives as opposed to waiting for the entire project to see if it is successful or not. This will allow you to create a tailored process that can be helpful not only to you but to the organization.

Q: What can we expect of an Agile framework?

Efe: You start by breaking larger projects or processes down into smaller components and work at each one before moving to the next. Start small and be open to feedback, then it will create the opportunity to implement any changes. Early changes can lead to improvement before the project is too far along. The framework of Agile Scrum involves frequent communicate across project stakeholders to reduce miscommunication and smooth transitions in the work.

Q: Any advice for those starting with Agile?

Efe: The birth of Agile is about the need to understand what the challenges are and be flexible in engaging the team in developing an approach that works for the current people and process. Creating a shift in the culture and mindset isn’t a quick shift—it takes months to years to truly become ingrained. The team must throughout the entire process to be ready for change and track what is working and what isn’t and pivot towards what does. The health center landscape is changing, and we need to welcome change and look for the value of what is working and reconsider what is not. It’s not about getting everything right, it’s about consistency and continuous improvement.

To summarize, the Agile process is an incremental model, which develops collaboration within the team and continuous planning. Its foundation is dynamic interaction that allows constant delivery – focused on “near-shore” visibility but never losing the long-term product goal in the distance.

Please share how your organization has used different project management techniques by writing to NACHC’s Center for Community Health Innovation at or commenting below.