The Greater Baltimore Medical Center (GBMC) is a hospital located in the Baltimore suburb of Towson, Maryland. The Performance Improvement & Innovation (PII) is a donor-funded initiative to infuse innovative thinking, lean principles, & human-centered design into the GBMC healthcare system through program development and targeted design interventions. 
The primary challenge of the PII team can be summarized with:
How can we engage the GBMC Healthcare workforce in systems thinking based problem solving
As a Social Design Fellow, I worked with the PII team to develop a rewards & recognition program. The program encouraged behaviors integral to Lean management, as well as promoted an encouraging working environment. 
Social Design Fellow
Sasha Avrutina 
Performance Improvement & Innovation Team
Rhonda Wyskiel, Makensey Schuchart, Erin Hudson
Michele Patchett, Monica Goetz, Sarah Lefebvre
The work described in this document was conducted as part of a Social Design Fellowship and accomplished from November 2019 - April 2020. 
Lean Management System (LMS)
Lean Management is a model that combines six unique elements including Visual Management, Self-Accountability, Observation, Problem Solving, Coaching and Structured Time to form Standard Work. 
Lean management provides a method to making continuous improvement. This is done through reducing inefficiencies by analyzing and adjusting workflows.
Process
Several brainstorming sessions with the PII team resulted in the idea of a coin-based reward system. Employees would be awarded coins for specific skills based on Lean management. 
What skills should be recognized?
GBMC employs approximately 3,900 people that work in both clinical and non-clinical areas. In order to create consistency in assessing recognition, it was best to list specific skills that are integral to the functions of the medical facility. 
How will it be determined when teams receive rewards?
It was taken into consideration how often rewards would be given out. Prizes given out too freely would reduce their impact.

A list of all the rewards and their corresponding coin worth. This list went through a series of renditions. 

Systems Change: GBMC Rewards & Recognition Currency​​​​​​​
Systems Change Tracker Board
The ultimate goal of the Lean Management System is to provide infrastructure to develop system wide change. In order to prioritize this the concept of achieving a gold coin was created. Teams would aid to work closely with the PII team to develop a systems wide change to achieve a gold coin. 
Training Material
Since the rewards program was intended to be systems-wide all the employees would need to understand how it words. The PII team did not have the capacity to train the entire healthcare center, therefore print and online material was developed to enable hands-off training. 

Guide to Giving
An instructional booklet was created so that it could be easily accessible to employees. Staff would each receive a personal copy of the booklet and one would also always be available near the systems change tracker board. 

Overview Video
A video providing an overview and detailed instructions on how to participate in the rewards program. This was intended to be the primary training resource and available online for staff. 

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