Charter every active initiative

Scope-creep guardrails on every project before the first sprint.

Stand up the Data Thread

Charter → Goals → RACI wired across the portfolio.

Baseline your key metric

First SPC chart live for your top clinical or operational measure.

Close the top 5 failure modes

FMEA RPNs driven down; high-risk items sent to RCA.

HIPAA / FERPA pre-audit

Privacy Proof SRA complete; BAAs and data agreements verified.

Change readiness > 70%

ADKAR scored on every go-live; resistance caught early.

Ship 3 PDSA cycles

Gemba walks logged; good ideas becoming standard work.

Value stream redesign

VSM complete on the slowest workflow; lead time cut.

Board scorecard live

Score Sense rolling up the Quintuple Aim as gauges.

Standard work adopted

Reinforcement plans active; adoption measured, not assumed.

Financial case proven

COPQ savings reported to the CFO; ROI documented.

Plan next year's portfolio

Roadmap refreshed; new charters scoped from this year's data.