Multiple clinic and queue shipments taught us that estimation accuracy improves when we timebox discovery on the hospital floor and cap MVP scope in writing. Verbal agreements do not survive week 4 of a busy outpatient rollout.
On-site delivery worked best with shared checklists and live demos for reception and nursing leads — not handoff documents left unread in email.
Clients who joined weekly demos had fewer change requests late in the project than clients who only reviewed async recordings.
We are carrying three habits into 2025: weekly demo recordings for async stakeholders, mandatory peak-hour dry runs before go-live mornings, and blameless postmortems within 48 hours of any sev-2.
The biggest redo: starting queue load simulations earlier — morning peaks are predictable when the hospital shares historical footfall.
