Harrisburg University GRAD 695: Research Synthesis - Agile Healthcare

This assignment, completed for a GRAD 695 course at Harrisburg University, focuses on synthesizing research related to applying agile principles within the healthcare industry to improve the quality of care. The student provides examples of paraphrasing research findings, demonstrating agreement and consensus among authors, highlighting ongoing debates, and explaining the importance of certain claims. The assignment includes citations in APA format, showcasing the student's understanding of research synthesis techniques. The first part of the assignment focuses on providing citations by paraphrasing what researchers say, showing agreement and consensus, ongoing debates, and why claims matter. The second part includes a reference list of all sources used in APA format. The assignment also includes a short outline of the student's research paper, demonstrating a strong understanding of the research topic.

ASSIGNMENT 5: RESEARCH SYNTHESIS
Name:
Research Topic: Applying Agile Principles in the Healthcare Industry to improve the Quality of Care
PART 1: CITATIONS
Converso, G., Improta, G., Mignano, M., & Santillo, L. C. (2015, September). A simulation approach for agile
production logic implementation in a hospital emergency unit. In International Conference on
Intelligent Software Methodologies, Tools, and Techniques (pp. 623-634). Springer, Cham.
For a very long period, healthcare has been regarded as the most complex system in society, and healthcare has
continued to expand in scope as well as complexity, which means that the challenges to manage the system are
also increasing. The current healthcare delivery is described by the concepts that has interconnected medical
practitioners instead of individual clinicians in providing care to patients. In this essence, it means that the
success or failure of healthcare delivery is in the end determined the capability of those medical practitioners by
coordinating their practices. However, with the upsurge in healthcare complexity these previously dissimilar
care processes and healthcare providers becomes challenging to manage and align, leading to heightened risk to
patient and inefficient use of system resources. On the same note, the rise in competition and increase in public
health challenges with the decline in resources calls for a necessity to delivering healthcare services in a more
efficient manner (Converso, Improta, Mignano, & Santillo, 2015). In this sense, the ability to understand and
quickly get used to the ever-changing patient requirements as they pass through the systems of healthcare
practitioners is vital for the successful healthcare delivery system. In order to ensure that well-structured and
organized delivery of care should be synchronized to achieve the up and downs of demand is of great relevance
in offering high quality and affordable healthcare.
GRAD 695 Citation & Formatting Assignment JAN 2019 1

Flood, D., Chary, A., Austad, K., Diaz, A. K., García, P., Martinez, B., & Rohloff, P. (2016). Insights into
global health practice from the agile software development movement. Global health action, 9(1),
29836.
Flood et al. (2016) argue that the aged solutions of lowering costs by reducing the workload of healthcare
providers are short-sighted at best. Moreover, other solutions borrowed from the manufacturing sector like lean
have not been fruitful to provide the anticipated improvements. In addition to that, healthcare has been reluctant
to embrace the service supply chain management practices, which have proved to be lucrative in other sectors.
At the same time, research and development in the supply chain principles utilized in healthcare environments
is still at its infancy, thus there are no clear operational-level procedures for healthcare directors yearning to
hone system-wide service delivery. In this sense, to address this gap, this paper will investigate the usage of a
relatively novel management paradigm in the healthcare industry. The management paradigm has been taken
from the custom manufacturing and service delivery “agile”, which is a collection of organization-wide
approaches that optimize the delivery of services in an unpredictable demand setting that has highly variable
client needs. Agile work to increase the responsiveness of the system to customers by enhancing the flexibility
and coordination of resources through the redesigning of organizational structures, logistic procedures,
management of decision heuristics and information systems (Flood et al., 2016).
McCaffery, F., Trektere, K., & Ozcan-Top, O. (2016, June). Agile–Is it Suitable for Medical Device Software
Development? In International Conference on Software Process Improvement and Capability
Determination (pp. 417-422). Springer, Cham.
Agile software development is a design approach that address adaptability and flexibility, close association
between developers and end users. Indeed, agile design ties various related software production strategies
(McCaffery, Trektere, & Ozcan-Top, 2016). In the recent past, agile model development has proved to be
GRAD 695 Citation & Formatting Assignment JAN 2019 2

successful beyond the anticipated expectations. The emergence of agile software development originated from
the frustrations experienced by engineers with the traditional design approaches regarded as cumbersome,
bureaucratic and inflexibility. The traditional approaches were extensively variations on the waterfall model, in
which the project is developed using structured stages of product development, analysis, design, execution and
testing. However, waterfall model uses wide-ranging up-front strategies, deliver functional product at the end of
the project lifestyle and only involves end users response in the last stage of the project. As a result, waterfall
model is not suitable for addressing unpredictability and changes in the design due to its assumption that
problems are predictable and can only be resolved through planning.
Jamot, M., & Pettersson, M. (2016). Agile challenges within regulated healthcare environments.
To the contrary, agile model restrict the amount of upfront planning (Jamot & Pettersson, 2016). The objective
of agile model is to generate usable software early during the project life cycle. Therefore, this model then
makes incremental improvements by using numerous iterative testing cycles, redesign, and feedback. In this
sense, the contribution of the end user is given priority with focus placed on physical communication between
the software developer and the end users. Additionally, instead of trying to solve all problems and unforeseen
events that can arise in a complex system through advanced planning by embracing redesigning the
requirements. Consequently, to agile model fosters flexibility and adaptability approach by decentralizing the
style of management.
Agreement and Consensus
Provide two examples from your research where more than one author concurs or supports a certain claim
including appropriate APA in-text citations. Template suggestions:
Tolf, S., Nyström, M. E., Tishelman, C., Brommels, M., & Hansson, J. (2015). Agile, a guiding principle for
health care improvement?. International journal of health care quality assurance, 28(5), 468-493
GRAD 695 Citation & Formatting Assignment JAN 2019 3

According to Tolf, Nyström, Tishelman, Brommels, and Hansson, (2015) the acceptance of agile in the
healthcare sector can aid healthcare businesses to adopt to the rapidly changing patient needs, technologies as
well as regulations without the need for organisation-level organization. In the modern age of ever-changing
external aspects like emerging technologies, and regulation guidelines should be responsive to seize
opportunities in the sector and be able to offer the best patient care level (Tolf et al., 2015). Therefore, by
healthcare organizations going agile they will be able to critically increase their capability moving forward,
regarding the sector’s complexity and turbulences and hasten accelerating speed of change. As a result,
healthcare managers should choose the pursuit to greater agility not to be left behind. Research has shown that
most healthcare organizations are struggling to keep pace with the rapidly changing patients requirements;
hence, the most appropriate approach is going agile, which is the ability to quickly and successfully adapt to the
rapidly changing business landscape. In many industries, most of the thriving corporations have managed to
crack the agility paradox to balance a stable base of central abilities and processes with the capacity to
dynamically redeploy these abilities in addressing the evolving opportunities and challenges.
Tolf, S. (2017). Lean, agile, and lean and agile hospital management: responses to introducing choice and
competition in public health care.
According to Tolf (2017) the excellence of an organization calls for dynamism and stability since organizations
that get it wrong with balance often end up struggling to keep up with the bureaucracy, which could make them
not able to respond to transforming market requirements. The concept of agility is specifically significant in the
healthcare setting that has endured much disturbance in the recent years. The healthcare industry has continued
to grow strong but the regulatory and financial pressure has also increased. The immense and rising pressure in
the healthcare industry calls for the need to advance toward becoming agile to effectively and efficiently
manage the existing services and resources.
Ongoing Debates
GRAD 695 Citation & Formatting Assignment JAN 2019 4

Provide two examples from your research where more than one author disagrees or proposes and opposite view
of another researcher. Template suggestions:
Kannan, V., Fish, J. C., & Willett, D. L. (2016, February). Agile model driven development of electronic health
record-based specialty population registries. In 2016 IEEE-EMBS International Conference on
Biomedical and Health Informatics (BHI) (pp. 465-468). IEEE.
Utilizing agile as an alternative management approach to traditional waterfall: Waterfall management model
entail all planning initially before commencing any work, which is the way traditional healthcare organizations
have been operating. As a start, healthcare organizations should consider departments that can be agile like
healthcare innovative department (Kannan, Fish, & Willett, 2016). However, if not the organization can start to
embrace agile model by departments that are easier to implement. Thereafter, the organization can then launch
sequential agile process in other departments where it can be utilized as an alternative to the traditional waterfall
management.
Duffau, C., Grabiec, B., & Blay-Fornarino, M. (2017, October). Towards embedded system agile development
challenging verification, validation and accreditation: Application in a healthcare company. In 2017
IEEE International Symposium on Software Reliability Engineering Workshops (ISSREW) (pp. 82-85).
IEEE.
Similarly, Duffau, Grabiec, and Blay-Fornarino, (2017) assert that agile creates a cross-functional teams and
increasing involvement and communication. Therefore, it is high time that healthcare organizations should
consider shifting from the hierarchical structure to ensuring that they have cross-functional teams. Generally,
scoss-fuctional teams comprise team members from dissimilar fields of expertise and discipline. The cross-
functional teams can be reconfigured based on the end user requirements. These teams can be co-located to
improve the engagement and communication among the team. In the healthcare field, members from different
departments in the organization can be engaged to create cross-functional teams based on the requirements
GRAD 695 Citation & Formatting Assignment JAN 2019 5

(Duffau, Grabiec, & Blay-Fornarino, 2017). For example, different shared services for functional areas such as
human resource to concentrate on excellence to provide quality. As a result, the healthcare organization can
base on these shared services for resource-intensive efforts by setting priorities by directing activities for the
shared staff assigned to the project. The agile model enables the business to quickly develop and scale up
abilities, which can be developed rapidly as required.
Establishing Why Claims Matter
Provide two examples from your research explaining the importance of certain claims. Template suggestions:
Maijala, R., Eloranta, S., Reunanen, T., & Ikonen, T. S. (2018). Successful implementation of lean as a
managerial principle in health care: a conceptual analysis from systematic literature review.
International journal of technology assessment in health care, 34(2), 134-146.
Maijala, Eloranta, Reunanen, and Ikonen, (2018) claim that agile has been embraced in different sectors due to
the benefits that it offers. These benefits include:
Enhanced transparent performance: The adoption of agile is significant to healthcare organizations because it
improves performance transparency both in clinical and non-clinical fields.
Client driven: Agile focuses on clients and constantly receiving feedback, hence healthcare organizations can
significantly benefit from the continued improvements.
Lennerz, J. K., McLaughlin, H. M., Baron, J. M., Rasmussen, D., Shin, M. S., Berners-Lee, N., &
Schmahmann, J. D. (2016). Health care infrastructure for financially sustainable clinical genomics. The
Journal of Molecular Diagnostics, 18(5), 697-706.
Similarly, Lennerz el al. (2016) through his study on healthcare infrastructure for financially sustainable clinical
genomics provide additional benefits of using agile model in healthcare. These benefits include:
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 Lower risks: The use of agile helps to minimize risks because risks are addressed early during the
iterative approach.
 Agility: The adoption of agility empowers the organizations to respond quickly to changes.
 Engaged staff: agile empowers employees by allowing them to work in self-managed teams, which
makes them more involved in their work thus produce better quality services to patients and minimize
errors.
PART 2: REFERENCES
(List all references used above in APA format. A minimum of five sources should be cited)
Converso, G., Improta, G., Mignano, M., & Santillo, L. C. (2015, September). A simulation approach for agile
production logic implementation in a hospital emergency unit. In International Conference on
Intelligent Software Methodologies, Tools, and Techniques (pp. 623-634). Springer, Cham.
Duffau, C., Grabiec, B., & Blay-Fornarino, M. (2017, October). Towards embedded system agile development
challenging verification, validation and accreditation: Application in a healthcare company. In 2017
IEEE International Symposium on Software Reliability Engineering Workshops (ISSREW) (pp. 82-85).
IEEE.
Flood, D., Chary, A., Austad, K., Diaz, A. K., García, P., Martinez, B., ... & Rohloff, P. (2016). Insights into
global health practice from the agile software development movement. Global health action, 9(1),
29836.
Jamot, M., & Pettersson, M. (2016). Agile challenges within regulated healthcare environments.
Kannan, V., Fish, J. C., & Willett, D. L. (2016, February). Agile model driven development of electronic health
record-based specialty population registries. In 2016 IEEE-EMBS International Conference on
Biomedical and Health Informatics (BHI) (pp. 465-468). IEEE.
GRAD 695 Citation & Formatting Assignment JAN 2019 7

Lennerz, J. K., McLaughlin, H. M., Baron, J. M., Rasmussen, D., Shin, M. S., Berners-Lee, N., ... &
Schmahmann, J. D. (2016). Health care infrastructure for financially sustainable clinical genomics. The
Journal of Molecular Diagnostics, 18(5), 697-706.
Maijala, R., Eloranta, S., Reunanen, T., & Ikonen, T. S. (2018). Successful implementation of lean as a
managerial principle in health care: a conceptual analysis from systematic literature review.
International journal of technology assessment in health care, 34(2), 134-146.
McCaffery, F., Trektere, K., & Ozcan-Top, O. (2016, June). Agile–Is it Suitable for Medical Device Software
Development?. In International Conference on Software Process Improvement and Capability
Determination (pp. 417-422). Springer, Cham.
Tolf, S. (2017). Lean, agile, and lean and agile hospital management: responses to introducing choice and
competition in public health care.
Tolf, S., Nyström, M. E., Tishelman, C., Brommels, M., & Hansson, J. (2015). Agile, a guiding principle for
health care improvement?. International journal of health care quality assurance, 28(5), 468-493.
GRAD 695 Citation & Formatting Assignment JAN 2019 8

PART 3: PAPER OUTLINE
Introduction
In the present age where regulations and standards are continuously evolving and emerging, distaste to
technological revolution is futile. This is applicable particularly in the digital healthcare instruments being used
by medical providers in their daily service delivery. Therefore, using agile model to plan, build and execute
incremental service delivery in the modern healthcare will be most effective and relevant approach to delivering
high quality care.
Problem Statement
Healthcare organizations have in the past been relying on exclusively digital development of products using
waterfall model that provides a final product at the end of the development. However, waterfall approach does
not allow for testing and assessment of the product to detect possible defects of the product during development.
While this approach is effective in other fields, in healthcare it is not the best because of the rapid changes taken
place.
Literature Review Outline (Review of the major themes that emerged from your literate research)
 Introduction (3-5 sentences explaining overall topic, its importance to project management and how the
literature review is organized – i.e. sequential, topical, methodological, theoretical, etc.)
The acceptance of agile in the healthcare sector can aid healthcare businesses to adopt to the rapidly changing
patient needs, technologies as well as regulations. To ensure that well-structured and organized delivery of care
should be synchronized to achieve the up and downs of demand using agile. Agile work to increase the
responsiveness of the system to customers by enhancing the flexibility and coordination of resources through
GRAD 695 Citation & Formatting Assignment JAN 2019 9

the redesigning of organizational structures, logistic procedures, management of decision heuristics and
information systems. The literature is categorized into three parts: summary of different authors’ argument
about the research, consensus regarding the research, ongoing argument and significance of the research.
 Use of agile will increase the responsiveness of the system to customers by enhancing the flexibility and
coordination in healthcare service delivery.
 Acceptance of agile in the healthcare sector will aid healthcare businesses to adopt to the rapidly
changing patient needs.
 Agile approach allows the developer to receive feedback regarding the functionality of the developed
products early because it delivers products iteratively unlike waterfall model.
Conclusion
According to the arguments by different authors it shows that acceptance of agile approach in healthcare
industry will brings significant improvements particularly in response to the rapid changes in patients’ needs.
The challenges facing healthcare sector is the use of waterfall model which only involves end users late in the
development of the project hence the reason for the numerous challenges in terms of service delivery.
Healthcare organizations should adopt agile approach gradually starting with information technology
departments and then eventually move to other departments.
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