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Two-Speed Workgroups

Intent

Separate a small delivery core from a broader review ring to balance velocity and legitimacy.

Structure

Two-speed workgroups separate fast delivery from broad review. Structurally, you establish a small decision-making core plus lightweight, scheduled review rings with explicit decision rights.

  • Delivery core: owns backlog, PR triage, and day-to-day authoring decisions
  • Review rings: clinical, terminology, and implementer bodies with clear scopes
  • Cadence: predictable meeting/review rhythm aligned to shipping increments
  • Decision rights: documented RACI-style expectations (decide/advise/inform)
  • Escalation: a single, named path for conflicts and high-risk decisions

Two-Speed Workgroups Structure Diagram

Key Components

Delivery core

  • Small group empowered to decide and ship
  • Owns backlog, triage, and day-to-day authoring decisions
  • Maintains the release plan and PR review velocity
  • Keeps decisions aligned with the thin slice
  • Escalates only when needed

Clinical council

  • Reviews clinical intent and usability (not syntax)
  • Provides acceptance criteria and examples
  • Helps identify risk areas requiring stricter constraints
  • Ensures narrative matches real workflows
  • Meets on a predictable cadence

Terminology authority

  • Owns CodeSystem/ValueSet/ConceptMap governance
  • Reviews bindings, expansions, and mapping policy
  • Sets release process for terminology artifacts
  • Ensures terminology tests are realistic and reproducible
  • Coordinates with implementers for adoption

Implementer roundtable

  • Provides feasibility feedback and edge cases
  • Reviews examples and test vectors
  • Identifies ecosystem variance early
  • Advises on migration and compatibility expectations
  • Helps ensure constraints are implementable

Escalation path

  • Defines what issues require escalation (breaking change, safety, policy)
  • Names the escalation owner/body
  • Sets time-boxes for resolution
  • Records outcomes in ADRs
  • Prevents endless re-litigation

Behavior

How work moves

The core ships continuously, while rings review in batches on a cadence. The key behavior is preventing the review ring from becoming an approval bottleneck.

Two-Speed Workgroups Flow Diagram

Delivery loop

  1. Core groom backlog and define what’s in the next increment.
  2. Core authors changes in small PRs with executable validation.
  3. Core merges when gates pass and review requirements are satisfied.

Review loop

  1. Rings get a hosted preview and a short agenda (what decisions are needed).
  2. Feedback is captured as issues with clear acceptance criteria.
  3. Only high-impact disagreements escalate; everything else routes back to the core backlog.

Benefits

  • Decisions stay fast
  • Reviews predictable

Trade-offs

  • Needs clear decision rights

References

Example

Weekly core squad; fortnightly review ring; monthly release train.