It's in the details: How a fitted sheet spurred hospitalwide change at Tampa General

I spend several hours each month working on the frontlines of Tampa General Hospital. Over the last two years, I've transported patients — taking me back to my first job in the healthcare industry — delivered meals, cleaned rooms, greeted guests, and shadowed nurses, doctors and residents. I think of these hours as some of my most essential and critical work. 

Frankly, there's no better way to understand what works — and what doesn't — in the hospital than this. Walking in another person's shoes provides me with a new level of insight and appreciation for the work they do and the challenges that come with each role. It also allows me to collaborate with frontline team members to solve problems — problems which might on the surface seem small or insignificant, but when addressed, can have a dramatic effect not only on patients but also on the team’s ability to do their jobs well.

Here's an example. A few months ago, I was working with the amazing team of nurses in our ICU who have an incredibly demanding job. As I shadowed one of our team members, Jordan, she alerted me to what she labeled as a "small problem" on her floor — the fitted sheets on our beds. The sheets were not particularly soft, which made them difficult to get on the bed. But more importantly, they popped off the bed corner's anytime she moved or repositioned a patient.

As I observed when shadowing Jordan, the ill-fitted sheets would become tangled in the patient's leads and lines, creating further discomfort for the patient and an added challenge for Jordan and her colleagues. As Jordan observed, the patients under her team's care are very sick, and it can be scary for family members to see them in that condition. Providing the patient with a clean, well-made bed not only creates some comfort for the patient, but it makes a difference to the family as well. They want their loved ones to feel as safe and comfortable as possible.

Listening to Jordan and seeing it for myself first-hand, I knew we needed to find a solution. If we could put a man on the moon, there had to be a fitted sheet that could stay on a hospital bed. 

We connected our linen provider with Jordan and our ICU Nurse Manager, Linda. Together, they worked with fellow team members across the hospital to "test drive" multiple sheet options until they settled on a softer, more substantial, and much more compliant fitted sheet that better served both staff and patients. With the new sheets in place, patients are more comfortable, and our team can focus more time on patient care and less on remaking beds. 

I now realize that what was perceived to be a small problem — a sheet on a bed — when multiplied by over a thousand beds, was a big problem — a problem whose solution made a significant impact across the entire hospital.

I share this story to not only illustrate the importance of not overlooking the "small stuff" but to demonstrate the positive effect of creating a culture where employees feel empowered to be part of the change. Here are some ways you can do this in your own organization:

Create a space to listen to team members: It's critical to create an environment where team members feel comfortable in not only sharing problems but helping to find solutions. Without Jordan feeling empowered to speak to me about the issue, I might never have known about the problem.  

Let the team be part of the solution: Instead of purchasing sheets recommended by the linen providers, we gave the team the power to choose. They tested three types of sheets, surveyed colleagues, and determined which type of sheet worked best for TGH. This approach resulted in a greater sense of ownership and investment in both their work and TGH. Jordan has seen that her action can result in positive change, making her more inclined to speak up and find solutions.

Give team members the tools they need to do their best work: Here, the little and not so little things can make all the difference. If it's important to a team member, it must be important to you. From sheets to technology, it's critical to listen to your team and provide them with what they need to do their jobs in the most effective way possible. Don't put roadblocks in their way. Instead, give them the extra gas to get moving.

And so as we embark on a new year, I encourage you to seek out new opportunities for change — of all shapes and sizes — and work collectively with your team to find new ways of doing things. A "small problem" often comes with a solution that adds up to a big difference in the lives of so many. 


John Couris is the president and CEO of Tampa General Hospital. You can read more from John at


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