Getting rid of stupid stuff (GROSS) at scale – Jennifer Bissram, MS, MBA, and Emily Kertcher, PhD, OTR/L

Episode 110 | Duration: 42:20

“Getting Rid of Stupid Stuff,” or GROSS, is a healthcare improvement approach first introduced by Dr. Melinda Ashton at Hawaii Pacific Health in a 2018 New England Journal of Medicine article. Originally focused on empowering clinicians to identify and eliminate unnecessary EHR tasks to reduce administrative burden and improve joy in practice, GROSS has since gained momentum as a broader movement to improve care team safety and wellbeing.

At UNC Health, Jennifer Bissram, MSIS, MBA, and Emily Kertcher, PhD, OTR/L, are members of a team focused on ease of practice for clinicians. They took the idea of GROSS, which is often applied in a single unit or department, and scaled it across the organization. They also expanded it beyond the EHR and technical issues to allow clinicians to identify pebbles, rocks and boulders (small irritants to major obstacles) anywhere in their workflows or work environments that cause distraction, create inefficiencies or reduce clinical effectiveness.

In this episode of Caring Greatly, Emily and Jennifer talk about the inspiration behind their team’s efforts to scale GROSS across the health system, as well as the steps required to make the scaled-up program work. They also discuss why it’s necessary to focus on building trust and relationships to drive program success well beyond operational excellence.

Emily Kertcher is the Program Manager for UNC Health’s GROSS Program. Her work is rooted in the intersection of occupational therapy, human factors engineering, and teammate wellbeing, specifically focusing on improving operational efficiencies to enhance the workplace experience. In her role, Dr. Kertcher is dedicated to scaling the program’s reach across the healthcare system and amplifying frontline voices to implement sustainable solutions that support both professional satisfaction and institutional excellence.

Jennifer Bissram is an Operational Project Manager with UNC Health and holds an adjunct faculty position within the University of North Carolina at Chapel Hill School of Medicine’s Division of Healthcare Engineering (DHE). She co-leads the GROSS program with Dr. Kertcher. In her role, Jennifer focuses on the design and scaling of the GROSS program across the healthcare system, building the infrastructure needed to support intake, triage and resolution of workflow inefficiencies. She works to translate insights from clinical teams into sustainable, system-level solutions that reduce administrative burden and address drivers of burnout. Her background is in academic health sciences librarianship. She transitioned into healthcare operations through her work in DHE, where she received training and mentorship in systems thinking, Lean management and process improvement. She is particularly interested in how thoughtful system design can better support the daily experiences of clinical care teams to create more sustainable healthcare environments.

Jennifer Bissram and Emily Kertcher are leaders who care greatly.

Related links:

• AMA Steps Forward Getting Rid of Stupid Stuff: Reduce the Unnecessary Daily Burdens for Clinicians
• NEJM Getting Rid of Stupid Stuff