Medical Laboratory Project Management Series – Part 4 – Agile Methodology

In this final installment of the project management series, the Agile methodology will be examined. This is the most fluid of all the methodologies. Steps can be interchanged and updated as needed. In the laboratory, this methodology would most likely be used for LIS implementation.

Agile Explained

Agile project management is defined as a collaborative, iterative project management approach that incorporates continuous testing and responsiveness to change. Agile was developed in the 1990s by software developers that found more structured methodologies too constraining.

As discussed in previous blog posts, critical path and waterfall methodologies require extensive planning and do not allow for much deviation. Using the agile method allows for quick changes when something is not working the way it should or when a lab’s needs change. Agile relies on short bursts of development called “sprints” rather than sticking to a fixed process.

Core Values

Agile methodology has four (4) core values.

  • Individuals and interactions over processes and tools.
  • Working software over comprehensive documentation.
  • Customer collaboration over contract negotiation.
  • Responding to change over following a plan.

Agile’s goal is to create the best possible product for the end-user.

12 Agile Principles

While Agile doesn’t have a fixed set of steps like other methods, it does have a set of 12 guiding principles listed below.

  1. The number one priority is customer satisfaction through the early and continuous delivery of valuable software.
  2. Welcome changing developments, even late in development. Agile processes harness change for the customer’s competitive advantage.
  3. Deliver working software frequently, from a couple of weeks to a couple of months, with a preference to the shorter timescale.
  4. Business people and developers must work together daily throughout the project.
  5. Build projects around motivated individuals. Give them the environment and support they need, and trust them to get the job done.
  6. The most efficient and effective method of conveying information to and within a development team is face-to-face conversation.
  7. Working software is the primary measure of progress.
  8. Agile processes promote sustainable development. The sponsors, developers, and users should be able to maintain a constant pace indefinitely.
  9. Continuous attention to technical excellence and good design enhances agility.
  10. Simplicity — the art of maximizing the amount of work not done — is essential.
  11. The best architectures, requirements, and designs emerge from self-organizing teams.
  12. At regular intervals, the team reflects on how to become more effective, then tunes and adjusts its behavior accordingly.

NOTE: The lists of Core Values and 12 Agile Principles were taken directly from the following website.

Agile Example: LIS Implementation

The most likely scenario where Agile will be used in the clinical laboratory is during a LIS build and implementation. Let’s take a look at how the core values of Agile align.

Individuals and interactions over processes and tools.

When a build for a new LIS begins, the first thing that happens is an analyst is paired off with each department supervisor. The analyst and the supervisor then discuss the needs of the department and the ability of the LIS to fulfill those needs. The analysts will gather information regarding what kind of testing is performed, which tests should be interfaced, which test results need to have reflex testing, and which specimens are shared with other departments.

Working software over comprehensive documentation.

Once the analyst has established the laboratory’s needs they begin to build the tests. As each test is built the laboratory staff then tests out the finished product in a test environment. The testing environment is an isolated computer system that allows the IT department and lab staff to test out the new LIS without the worry of results crossing into the EMR. As each component is tested the laboratory staff will provide feedback regarding what works and what needs to be changed. Any changes can be made in real-time as the project is in progress. Working a piece at a time allows for this flexibility.

Customer collaboration over contract negotiation.

The analyst and the laboratory staff have a collaborative relationship. Rather than viewing each other as adversaries, they should be working to figure out the best way toward project completion. For example, the analyst needs to understand that the laboratory staff’s primary function is patient testing. Any work being done on the new LIS needs to be done around the laboratory’s schedule. The laboratory staff member in charge of the LIS implementation needs to be able to communicate when it is best to perform certain functions. An example would be instrument testing. When performing testing on an instrument to ensure it interfaces with the new LIS properly, it needs to be taken offline. This means that patient tests can’t be run on the instrument at that time, so it follows that this should be done during a slow time.

Responding to change over following a plan.

Because Agile puts such an emphasis on flexibility it’s easy to pivot when a problem is encountered or something unexpected pops up. To give an example let’s say during LIS testing the chemistry lab realizes that syphilis screens need to be reflexed to micro for confirmatory testing. However, at the time of the test build the chemistry department did not communicate this to the analyst and it was not accounted for. Due to the nature of Agile methodology, it is not hard to modify the test to accommodate for this compared to other project management methods.


Agile methodology is the best methodology to use when a project needs to move quickly and requires flexibility. There is little upfront planning. The emphasis is on collaboration and delivering a finished product that is exactly what the end-user wants. This type of methodology will only be used in the lab for specific types of projects, such as a LIS implementation. It is not likely that laboratory staff will be in charge of a project that uses this methodology but it is important that this method is understood.

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