value culture header
Benjamin Wright and Kristen Martinez
Shayma Salih, University of Utah Health
This Is What I See, What Do You See?
Continually speaking up is one of the most challenging things an employee does, and making it safe to speak up takes consistent supportive leadership. Members of the patient support services team share how to empower employees to highlight issues and provide solutions.

t University of Utah’s hospital information desk, we focus on warmly greeting patients and their visitors to help them find their destination. For hospitalized patients, we provide various amenities like reading glasses and books in an effort to make our patient’s experience more comfortable. Getting to know our patients as they heal and sometimes build a new life is incredibly rewarding.  

Supporting our patients remains our constant priority, but other aspects of our work fluctuate. This job changes so much. We’re regularly asked to do and learn new things, so we must be flexible and receptive to our leadership’s guidance. But in order to improve and evolve, we have to be able to raise issues and questions. 

Speaking up in a fast-paced environment  

For years, our Information Desk employees felt uncomfortable bringing up issues. If instructions came down from leadership, we didn’t question them. I (Kristen) remember when I initially started, I brought up a problem I’d experienced with some of our processes. I was told, “Well, that’s just how we’ve been told to do it." I felt uncomfortable making suggestions after that because I felt like I wasn’t being heard. 

In the past, I was often hesitant to question authority figures, especially at work. I never wanted to seem unappreciative of my job. It wasn’t until an old boss reminded me that just because I’m grateful for an opportunity doesn’t mean I should be scared to speak up if I see a problem that needs to be addressed.

Introducing Value Culture and “Rocks in Your Shoes” 

Value Culture is a way of thinking and acting. It is supported by two pillars: systemic respect and continuous improvement. It’s about clearing the path and supporting frontline workers to identify and solve workplace process issues. 

When the "Rocks in Your Shoes" program was introduced, our team was so excited to participate. Value Culture enables teams to speak up on issues, big or small, that leaders might not even realize exist. It also gives us a chance to propose solutions to those problems that, although small, ultimately cause us frustration at work.  

Submitting and working on “rocks” 

We have a white box and a pile of sticky notes in our office. Employees can submit their written “rocks” or concerns to the box. Employees decide if the “rock” is a P1 problem – a top priority that impacts safety, or a P2 problem – an issue that impacts patient's quality, service, or cost. When problems are discussed in a huddle, the team decides if a problem is a P1 or P2. The team then decides on what they would like to address. 

Initially, team members felt nervous stepping forward. The mentality of, “Will I even make a difference? Can anything really be done?” left many feeling hesitant. But once our team nominated somebody to take charge of the first "rock", and came up with a fix, we started seeing positive changes. It was like opening the floodgates.   

I (Ben) actually stepped up as one of the leaders on the first project. It became an example for how to successfully lead a "rocks" project. The project I was working on examined a vast number of logs we used to track information. I asked myself, “Are these things we need to track, or are these unnecessary?”  

For example, we were tracking every phone call, which was a very tedious pebble on the pile of rocks we were already trying to manage. I realized that, since the telephone operators also track those calls, we could just pull the information from them. Removing the stress of remembering to log calls and simplifying that part of the job felt incredibly rewarding. 

This program has given us free rein to bring our concerns to light, work through our frustrations, and make suggestions. Even if we can’t resolve every issue, we now have a platform to speak our minds and be heard.  

Support to continue speaking up 

On my (Ben) first day, my manager Mary Lynne Cortez instantly made me feel supported and safe. She willingly listened as I explained some of my health problems and went out of her way to accommodate my needs. She’ll still check in and say, “How can I help? What can I do to make this more manageable for you?” To this day, her active support always makes me feel comfortable going to her with questions or concerns.   

Our info desk’s growing culture of support has helped our staff flourish. Being in an environment now where we’re encouraged to respectfully question leadership’s decisions feels incredible. Building trust between our leadership and our employees has probably been our team’s biggest accomplishment, and we’re seeing the effects of that open communication and support trickle down.  

Overall, the project provides the Information Desk team with the tools needed to work with each other in a supportive environment to make our jobs less stressful and more enjoyable. 

When leadership offers their support, it infiltrates your day-to-day interactions with your co-workers. You feel like you can give them support, too. I’ve (Ben) noticed my team members are more willing to help out their colleagues and say, “Hey, I know you’re feeling a little under the weather today. How can I help?”  

Encouraging employees to speak up

From Rob Kistler: 

When I realized that employees found something I implemented years ago as a "rock in their shoes," I felt embarrassed and a little stunned as it became crystal clear that something askew had happened: we hadn’t created a safe place for our staff to say, “Why do we need to do this?” 

Certain employee groups are very talkative and others take a while to warm up. This is when you practice being patient and communicate that we have all the time they need. Because this is a culture, not a program, rest assured we consistently talk about providing a space for employees to be creative and contribute. My job is to hold up a mirror and say, “This is what I see; a person who is the expert in their role and has much to offer. What do you see?” Encouraging people to speak up requires endurance and a never-ending commitment to incremental improvement over time. 

From Mary Lynne Cortez: We also recommend an open-door policy, because sometimes people just want to talk. Create that safe space where they can discuss frustrations. They know nothing can be changed immediately, but it’s a way to feel heard. As leaders, we must remember we’re not there to solve every problem. Let’s help our employees become more engaged by encouraging them to become the problem solvers. Providing a sounding board for each other allows all of us to be more effective at our jobs.


Kristen Evans Martinez

Patient Relations Specialist, Customer Service, University of Utah Health

Benjamin Wright

Patient Relations Specialist, Customer Service, University of Utah Health

Mary Lynne Cortez

Supervisor, Information Desk, University of Utah Health

Rob Kistler

Senior Director, Patient Support Services, University of Utah

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