Frontline Workers as the Recipe for Innovation and Improvement

By Mallory Bouwman, LMSW, CAADC

The name Ruth Wakefield is not likely one that you recognize, but you most certainly know the invention she is credited for.

Ruth and her husband Kenneth owned a toll house in Whitman, Massachusetts in the 1930’s. Toll houses operated in the 1700-1800’s, serving not only as a building for which to collect tolls, but also as a haven for travelers to rest and enjoy a home-cooked meal. Ruth and her husband converted their toll house into a lodge, naming it the Toll House Inn.

True to the tradition of serving home-cooked food, Ruth baked for guests of the Inn. One of her favorite recipes to make was the Butter Drop Do cookie, and one day while she was making them, she decided to mix up the recipe by breaking a Nestlé chocolate bar into bits and adding them to the cookie. The delicious result was a cookie with soft, creamy chocolate morsels. Her recipe gained fame at the Inn and found its way into regional newspapers, exploding the sale of Nestlé chocolate bars.

Ruth’s innovation of tiny pieces of chocolate led to the creation of packages of chocolate morsels, or what we have come to call chocolate chips1.

Innovative ideas, like the chocolate chip, don’t always come from those in senior positions. Great ideas can—and should—come from those doing the work, like the baker. In behavioral healthcare this means that CEOs, directors, supervisors, and managers don’t possess all the solutions to the challenges their workforce faces. As leaders our charge is to empower direct care workers, peer support specialists, case managers, nurses, and other frontline workers to leverage their knowledge, experiences, and perspectives to challenge the status quo, make work easier, and serve people well.

To empower innovation on your team, consider the following:

  • Establish an Innovation Process—Establish a process for the flow of innovative or improvement ideas from theory to reality. Structure the process so that staff know where to go with an idea and what it looks like to take that idea through the stages of development. This could look a number of different ways. Maybe it works best for your program to have an ‘innovative idea box.’ Much like a suggestion box, an innovative idea box would sit in a common staff space, available for staff to slip ideas into (anonymously if desired). These ideas could then be read aloud at staff meetings as a standing agenda item. Following the reading of each idea, staff would be invited to volunteer to participate in a workgroup to flesh out that idea, with the ultimate goal of the workgroup being the development of a proposal for how to make that idea come to life. Program leaders could then discuss the proposal and determine the next steps.
    Alternatively, this process could involve the submission of an innovative idea request form. The form would ask staff to identify their innovative idea, how it would benefit the program’s staff and/or persons served, and the time and resources it would take to develop their idea. The staff’s supervisor would review the form to determine if time and resources to develop the idea would be approved. If approved, the supervisor would support the staff in scheduling uninterrupted time to work on it independently or with peers. This time would be during their shift, with shift coverage established, or outside of their shift, as focused time without the responsibilities of their day-to-day job to create the greatest opportunity for success.
  • Make Innovation a Competition—Friendly competition is a motivating factor in the generation and development of innovative ideas. Start by asking staff to submit innovative ideas. Meet as program leaders to narrow down the submitted ideas to the three or four with the most potential value and feasibility. Divide the team into multidisciplinary groups to each workshop an idea for an hour or two. At the end, bring the team together for a “shark tank” idea pitch. The pitch would include a description of the innovative idea and the purpose it would serve, the associated benefits and risks, and the resources (i.e. time, money, materials, staff) it would require to bring the idea to fruition. Program leaders would have the opportunity to ask the group questions to better understand the idea and what it would take to develop, and the best idea would be selected for implementation.
  • Name Innovation as a Program Value—To foster innovation, innovation must be perceived by staff as something of value. Staff must know that innovative ideas are desired and that those ideas will be welcomed with the attention and consideration they deserve. Say ‘yes’ to piloting innovative ideas, no matter how big or small, as often as possible. Name innovation as a program value, broadcast the value of innovation through orientation, training, staff meetings, and purposeful signals like repeated catchphrases or an object on display, and promote innovation ten times more often than you think you need to. Make innovation so routine that it is a part of program culture.
  • Celebrate Innovation—Recognize staff for their contributions to the betterment of program procedures, workflows, and service. Shoutout staff for innovative ideas in staff meetings, offer incentives like program swag, gift cards, cash bonuses, or paid time off for ideas that go live, or spotlight innovative ideas in your program newsletter or social media. Make staff feel seen and valued for their ideas. Make small telling connections between the past, present, and a vision of the future by telling stories of how three years ago a certain idea wasn’t in place, now it is and it’s working great, and in the future things could be even better with their contributions.

Ruth was able to create the chocolate chip because she was directly involved in baking for the Toll House Inn. Because she was directly involved, she could see the challenge and solution to making Butter Drop Do cookies. Ruth was also empowered to try new ideas, free to explore cutting a chocolate bar into tiny pieces to see what would happen. And finally, Ruth had the time and resources available to set aside her other responsibilities and dedicate her attention to perfecting her recipe.

Direct involvement in the day-to-day work, empowerment, and the gift of time and resources are the recipe for innovation for frontline workers. Consider ways your program can bring innovative ideas to fruition through a thoughtful process, friendly competition, or the broadcasting and celebration of innovation.

*The invention of chocolate chips story was adapted from the History of Nestle Toll House.

1 History of Nestle Toll House. (2009, February 23). History of NESTL� TOLL HOUSE – NESTLÉ (