Small Changes. Meaningful Impact.
The UW Medicine Well-Being Team is piloting Pebble Projects across clinical spaces to identify and address the small frustrations that add up over time and contribute to burnout.
Modeled after the American Medical Association–endorsed GROSS initiative, Pebble Projects focus on removing unnecessary, inefficient, or redundant tasks – our “pebbles” – that make daily work more difficult than it needs to be.
What Are Pebbles?Pebbles are small obstacles in everyday work that may seem minor on their own but can have a significant cumulative impact on employee well-being. Examples include:
By addressing these challenges, we can make meaningful improvements to the work environment and support a healthier, more sustainable workplace.
Why It MattersSmall frustrations can accumulate over time and contribute to stress, inefficiency, and burnout. Pebble Projects create a structured way for frontline staff to identify those challenges and help shape solutions. Together, we can improve workflows, reduce unnecessary burdens, and make it easier to focus on what matters most: delivering exceptional patient care. |
How the Pebble Project Works
Each Pebble Project follows a 12-week rapid improvement cycle designed to gather feedback, implement solutions, and keep teams informed throughout the process.
Phase 1: Feedback
Employees submit pebbles through a feedback form and are encouraged to share potential solutions or ideas for improvement.
Phase 2: Triage
The Well-Being Team partners with local project champions to review and categorize submissions based on feasibility, scope, and area of impact.
Some pebbles may be too large or complex to address within the Pebble Project framework. Categorization helps identify the right stakeholders to engage during the next phase.
Phase 3: Solutions
The Well-Being Team collaborates with project champions and departmental leaders to implement practical solutions and test improvements.
The goal is rapid action, continuous learning, and meaningful change.
Phase 4: Close-the-Loop Communication
Participating units receive updates on:
- Pebbles that were successfully addressed
- Solutions that were implemented
- Pebbles that were outside the project’s scope
- Opportunities for future improvement efforts
Closing the loop ensures transparency and demonstrates how employee feedback drives positive change.
Frequently Asked Questions
What teams are participating in the Pebble Projects?
The Well-Being Team is launching with the UW Medical Center Northwest Emergency Department. Near-term pilot sites have also been identified at Harborview Medical Center and UW Medical Center Montlake. If you’re interested in serving as a champion for a Pebble Project in your unit, please contact uwm-wellbeing@uw.edu.
How can I submit a Pebble?
At this time, submissions are limited to the three identified pilot sites. Once we’ve evaluated the outcomes, we hope to expand the Pebble Project across UW Medicine. If you’d like to champion a Pebble Project in your unit, please reach out to uwm-wellbeing@uw.edu.
What happens to Pebbles that are out of scope or too large for the project to address?
We refer to those as boulders and mountains. The Well-Being Team documents all submissions through the feedback form, and items that fall outside the scope of the project are organized and shared with leadership.
How are the solutions funded?
The Pebbles model does not depend on dedicated funding to be successful. We work closely with department leadership to help identify solutions using existing resources. In many cases, the best fixes won’t require new funding at all – they may involve process improvements or organizational changes.
Stay Connected
This pilot is just the beginning. Check back regularly for updates, success stories, and progress reports from Pebble Projects across UW Medicine. Questions? Contact us at uwm-wellbeing@uw.edu.