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Making Connections Visible: How to Defrag your ...

Making Connections Visible: How to Defrag your Value Stream

This talk addressed 3 things:
Complexity drives necessary specialization
Specialization causes expensive disconnects
How to deal with the resulting communication debt

Dominica DeGrandis

December 06, 2018
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  1. @dominicad © Tasktop 2018 Making Connections Visible: How to Defrag

    your Value Stream . Dominica DeGrandis Director, Digital Transformation
  2. @dominicad © Tasktop 2018 3 THINGS • Complexity drives necessary

    specialization • Specialization causes expensive disconnects • How to deal with the resulting communication debt
  3. @dominicad © Tasktop 2018 WHAT’S THE POINT? A defragged value

    stream improves flow Value Stream: all activities done to plan, design, build & deliver items that provides biz value The hardest thing we do is communicate across teams.
  4. @dominicad © Tasktop 2018 • Speech therapist • Physical Therapist

    • Occupational therapist • Neurologist Primary care physician is just the first stop.
  5. @dominicad © Tasktop 2018 To defend the network & assets

    from cyber threats, we bolt on more & more security layers & policies. This increases complexity. Different expertise is required for each vendor. 95% of organizations use network security devices from multiple vendors. https://www.wired.com/insights/2013/01/uncovering-the-dangers-of-network-security-complexity/
  6. @dominicad © Tasktop 2018 Forbes article predicting global shortage of

    two million cyber security professionals by 2019. https://www.forbes.com/sites/jeffkauflin/2017/03/16/the-fast-growing-job-with-a-huge-skills-gap-cyber-security/#32c6bb455163
  7. @dominicad © Tasktop 2018 “Code will be used in ways

    we cannot anticipate, in ways it was never designed for, and for longer than it was ever intended.” ~ Joshua Corman https://www.iamthecavalry.org/about/overview/
  8. @dominicad © Tasktop 2018 https://www.reuters.com/article/us-hospira-fda-cybersecurity/fda-warns-of-security-flaw-in-hospira-infusion-pumps-idUSKCN0Q52GJ20150731 BOSTON (Reuters) - The U.S.

    Food and Drug Administration on Friday advised hospitals not to use Hospira Inc’s Symbiq infusion system, saying a security vulnerability could allow cyber attackers to take remote control of the system. The agency issued the advisory some 10 days after the U.S. Department of Homeland Security warned of the vulnerability in the pump, which is used to deliver medications directly into the bloodstream of patients
  9. @dominicad © Tasktop 2018 “The more we scale, the more

    we need specialized people. The growing division of labor in IT results in the specialization” ~ Mik Kersten With scale comes complexity which drives specialization
  10. @dominicad © Tasktop 2018 Adenosine* heart stress test Healthcare costs

    from disconnect workflow Dr’s orders: “No caffeine 24 hours prior to test.” Nurse: “Would you like some coffee?” https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us US medical errors cause > 250k deaths/yr, 3rd leading cause of death * pharmaceutical used to assess blood flow to the heart. Pharmacy tech handed nuclear medicine tech wrong stuff. Instead of heart tracker injection the Dr ordered, my mom was injected with a bone tracker. oops! oops!
  11. @dominicad © Tasktop 2018 Dependencies have high coordination costs The

    more teams, the higher probability of more dependencies.
  12. @dominicad © Tasktop 2018 • Unhappy employees • Unhappy customers

    • Things take too long! • Where’s my thing? • Inaccurate estimates • You want what when?!?!? IT costs from disconnected workflow Cost center or profit center?
  13. @dominicad © Tasktop 2018 How to deal with the communication

    debt related to complexity & specialization Thing #3
  14. @dominicad © Tasktop 2018 Jan. 30. Amazon announces collaboration with

    Berkshire Hathaway & JPMorgan to launch a company aimed at cutting healthcare costs for their U.S. employees. Shares of other healthcare companies plummet shortly after the announcement. Feb. 13. Sources familiar with Amazon's plans say it is pushing to turn its medical supplies business into a major supplier to U.S. hospitals and outpatient clinics. The idea is to establish a one-stop-shop for health systems. March 21. The U.S. Patent and Trademark Office grants Amazon a new patent for a delivery drone that can respond to human gestures. This is not Amazon's only patent to expand its air delivery service. Experts say this delivery service may disrupt supply chains across all industries. https://www.beckershospitalreview.com/finance/amazon-jpmorgan-and-berkshire-hathaway-to-launch-healthcare-company-6-things-to-know.html https://www.beckershospitalreview.com/healthcare-information-technology/here-s-what-we-know-about-amazon-s-foray-into-healthcare.html Healthcare Disruption - integrated view of patient
  15. @dominicad © Tasktop 2018 consolidation, replication, and strangle approach. epics

    reqs features stories defects test cases incidents problems vulnerabilities Rfc’s gantt charts ryg rpts time sheets Tool fights break out due to inability to share knowledge, understand work capacity and improve workflow.
  16. @dominicad © Tasktop 2018 “Things take too long” is a

    universal problem work request Disconnects in communication interferes with collaboration & delays delivery
  17. @dominicad © Tasktop 2018 • Improve flow time • visibility

    of progress • Traceability of info from handoffs • Communication debt relief BENEFITS
  18. @dominicad © Tasktop 2018 Email: [email protected] Subject: flow To receive:

    • copy of this presentation deck • excerpts of Making Work Visible • Flow 101 workshop - Fundamentals of Flow