Out of Bounds Growth While Saving the Culture

Out of Bounds Growth While Saving the Culture

 |  Vicki Muscarella

CoverMyMeds has been growing at an unbelievable rate.

In the past two and a half years, what was 100 people is now 450 people. And it is not unusual on Mondays to see 10 or more new associates running through our training and orientation program.

We’ve got out of bounds growth, but with it comes big challenges. Here’s a few for starters.

  • Organizational challenges
  • Workflow challenges
  • Process challenges
  • Cultural challenges

How do we keep the great aspects of a small company, the agility with which it can operate, and the speed at which it can deliver value, while expanding the impact we have to help patients get the meds they need to live healthier lives?

We talk about scaling systems and writing software that scales easily, but we don’t talk or think about what it takes to scale our teams. As our organization grows, we must evaluate how it operates.

  • Are we still efficient and effective in getting our work done?
  • What can we do to be more efficient?

One thing we know for sure: What got us this far won’t necessarily take us to where we want to go.

Break the Organization Into Smaller Components

One way we have tackled our growth is to break the organization into smaller components and give them the autonomy to work as if they are independent entities. This approach is not a silver bullet. We are still one company and there are still interdependencies between the teams.

Add Lightweight Processes

To help resolve the team interdependencies,we added some lightweight processes to facilitate work that crosses the boundaries. This means that the teams are optimized for work that remains within the team and there is some extra work required when other teams must be involved. Dividing into smaller teams has been a valuable thing for most work and it is the first technique we use to scale while protecting our culture.

Create a Nexus Team

What happens when projects get into that grey area between the teams? When there is no clear owner for the work. When priorities between the teams are conflicting? In our Shared Technology organization, this describes much of our work. We needed another solution to incorporate the good practices of our small, effective, agile-oriented teams with the recognition that cross-team work presents different challenges, and therefore, requires another layer of coordination.

After thinking through the problem internally and looking externally to see what others have done, we landed on our own version of a scaled agile approach, which is loosely based on the Nexus Framework from Scrum.org.

In a nutshell, we created a Nexus team that consists of members from each of the eight teams within Shared Technology. We identified a product owner who is responsible for prioritizing work across the larger team. The team meets once a week to review the shared work and alternates the meeting’s focus on in-progress work and backlog work. The team is responsible for bringing the status of the relevant work from their local team to the Nexus meeting and for taking the Nexus priorities back to their team.

The team makes sure that:

  • Work on the Nexus board is understood and ready to be worked
  • Team dependencies and modes of collaboration are clear
  • There is a common understanding for when an work item is done

We hold working sessions to refine the work items, but make sure to include necessary team members to be respectful of everyone’s time. We also hold retrospectives to ensure that we are continually improving our processes and working agreements.

Protect the Culture

The Nexus team has existed for about four months within the Shared Technology team at CoverMyMeds. It took a month for the team to feel functional and another month or so for everyone to see the benefits. Every week we adjust and tweak to find the right balance between process and autonomy, between regulation and freedom.

We still don’t have all of the answers, but the time we spend together is starting to feel beneficial. The work is starting to flow more naturally and the cross-team challenges are easier to overcome.

Most importantly, we are forging ahead, preparing for more growth, while protecting the one thing we hold so dear: Keeping CoverMyMeds the best place to work in Ohio.

Share this article on Facebook Share this article on Twitter Share this article on LinkedIn Share this article via email
Stay up to date on what's trending in healthcare