Frontline employees shape the customer experience, spot operational friction first, and determine whether new tools improve work or simply create more of it. Their motivation, judgment, and skill are mission critical for any change—large or small, tech-based or not.

Yet large organizations often fail to harness the inherent power of their frontline workforce. In our research and advisory work, we have seen one major reason: flawed systems for listening to frontline workers and working with them to address the obstacles they face in carrying out their jobs. We have observed the same pattern repeatedly: Companies carry out broad engagement surveys that don’t adequately capture those obstacles. They result in well-intended but incomplete fixes, employees see little change, and trust erodes further.

One effective remedy is a disciplined process for listening to employees and engaging them in cocreating solutions to the challenges they face. We saw the power of this approach at a major pharmaceutical company, which built on previous initiatives led by the BCG Institute (formerly the BCG Henderson Institute) in retail, manufacturing, and professional services as part of its knowledge-development work.

The Institute for Leadership & Work at the Boston University Questrom School of Business teamed up with the BCG Institute to put this approach into practice. The project—which was guided by a group of frontline workers as well as leaders from HR and data science—focused on the company’s Patient Service Group, which consisted of about 100 representatives and 10 district leaders.

Each representative spoke daily with dozens of patients about a groundbreaking medication used to treat a serious medical condition, answering their questions, helping them navigate insurance issues, and nudging them to refill their prescriptions so there was no interruption in treatment. This daily contact with patients was crucial to the company’s mission of delivering lifesaving medicines to chronically ill individuals.

Originally, representatives would start their days formulating their call plans, prioritizing patients and topics based on the notes in their files—steps that could take an hour or more. Two years before our project, the company introduced an AI-powered dashboard to automate the call-planning process. Based on the company’s algorithm, each representative was given a specific set of calls to make each day.

The company wanted to understand the impact of this technological innovation and how it could be improved. The company also wanted to enhance the overall design of the work, give these employees more of a voice, and increase their empowerment, because the group had reported lower-than-average scores in these areas on recent pulse-check surveys. A single phrase that we heard repeated in our initial interviews captured their prevailing sentiments: They felt “behind the glass.” The phrase was both literal and symbolic. Because they handled private health information, these frontline employees sat in a separate area of headquarters behind a locked glass barrier. The barrier was for compliance reasons, but it also represented how disconnected and overlooked they felt inside the organization.

Over the course of five months, the company successfully adopted a more employee-centered approach. Here is the six-step approach to introducing it that worked.

Step 1: Conduct structured interviews to engage and learn.

The project team began with confidential, hour-long interviews with roughly 20% of the Patient Service Group. Employees were asked what made work meaningful, what made it harder than it needed to be, and when they felt most proud or most frustrated. To make them feel psychologically safe so they would speak up, the team explained that the conversations would be kept confidential.

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