Though the origin of the phrase likely dates back centuries, boxer Muhammad Ali is widely known to have said, “It isn't the mountains ahead to climb that wear you out, it's the pebble in your shoe.”
It’s an apt metaphor for the challenges facing frontline workers in pediatric health care today and the essence behind an initiative at Children’s Hospital of Philadelphia (CHOP) to improve employee well-being and satisfaction. CHOP launched GROSS (Getting Rid of Senseless Stuff) in 2020 to empower staff to address items that can enhance the organization by removing non-value-added work or processes.
“This program is all about taking those pebbles out of our shoes,” says Sarah Johns, MHRIR, principal strategy integration partner at CHOP. “It was initiated based on employee feedback that we heard in our engagement survey, and it’s all about getting rid of those pebbles and making room for the things that matter—patient care, research and education.”
How it works
The process begins with an employee submission originating via an online portal. The submission is reviewed by the GROSS team, made up primarily of strategy integration partners, who are internal consultants providing project management and business process improvement services. From there, the idea is routed to a “quarterback,” someone within the organization more familiar with the day-to-day operations of the department or function where improvement is recommended.
The quarterback then has four options to explore with the submission:
- Just do it.They may determine the best champion for this project is the staff member who submitted the idea. That employee is empowered to move forward with the proposed improvement with the support of the GROSS team.
- (Re)communicate. If the idea submitted is already being addressed by another department or initiative within CHOP, GROSS works with human resources and internal communications to ensure employees are aware of the solutions available to them.
- Project work. These submissions may tie into an existing governance structure, or a new governance structure is required to move the work forward.
- Deferred. “The promise of our GROSS program is not necessarily that every single idea automatically goes to the top of the line and we work every single one,” Johns says. “We rely on our quarterbacks to take a look at ideas amid their existing portfolio of work and help us connect to their roadmap.” Johns adds that deferred ideas remain on the team’s radar and may be ultimately moved forward as circumstances and priorities in the organization shift.
In its first two years in existence, the program has removed a substantial number of “pebbles.” Johns says her team has received more than 420 submissions over that time period—with nearly 300 having been resolved.
GROSS has high engagement from frontline staff and receives ideas across all levels of tenure. And although the program has resolved hundreds of submissions, Johns says three stand out as prime examples of the program’s success:
- Employee parking. Situated in a concentrated urban setting, parking has always been a challenge for CHOP staff members—it wasn’t uncommon for workers arriving 45 minutes early to still be late for their shifts. GROSS analyzed the pain points and decreased employee frustration by developing a system that texted staffers with parking lot capacity notifications, added more shuttles to the hospital and streamlined payment options to speed workers through the queue.
- Lactation rooms. Breastfeeding mothers would often spend their entire break periods searching for an available room to express milk. The GROSS team scaled a text-based lactation room reservation system to streamline the process, getting these staff members back to the bedside or their workstation more quickly. “It was an incredible moment when this was launched at an all-employee town hall to hear the feedback from people who recognized the importance of this issue,” Johns says.
- Excessive printing. Frustration over massive amounts of paper waste noticed by hospital staff led to restructuring the way patient family information packets were distributed. Systems were reprogrammed to allow a print-optional feature and providers could direct families to online instructions, as appropriate.
Johns says the program continues to evolve, and her team is working on ways to source and implement ideas more effectively, as well as celebrate program victories with those who have spearheaded them. But it all always comes back to empowering the employee voice.
“This program is really rooted in embracing the ‘people’ pillar of our overall strategy,” Johns says. “The objective here is to include employees’ voice and perspective and involve them in creative ways so that they're really plugged into our improvement efforts.”