Hospital leaders face a constant challenge in balancing day-to-day operations with the pursuit of long-term strategic initiatives. This balancing act becomes even more critical as hospitals strive to maintain quality care, adopt new technologies, and respond to evolving patient needs. One of the most effective frameworks for managing time and resources is identifying and budgeting for "big rocks"—those essential but non-differentiating tasks that consume significant organizational bandwidth.

Hospital leaders face a constant challenge in balancing day-to-day operations with the pursuit of long-term strategic initiatives. This balancing act becomes even more critical as hospitals strive to maintain quality care, adopt new technologies, and respond to evolving patient needs. One of the most effective frameworks for managing time and resources is identifying and budgeting for "big rocks"—those essential but non-differentiating tasks that consume significant organizational bandwidth.