At Sharp Grossmont Hospital in La Mesa, Calif., everybody from the custodial staff to the transplant surgeons is expected to come up with ideas for making the patients feel more welcome, engaged and at ease. For Andy Grossman, the engineering operations manager, this was a particularly tall order. Grossman manages the landscape crew who, until recently, had the distinction of being perhaps the most invisible five men on the hospital campus, their days spent outdoors tending to 300 rose bushes and mowing vast lawns with protective headphones clamped over their ears.

How was he going to get them into the ebb and flow of the hospital? How was he even going to get them in the hospital without getting lost? Though each had worked at the hospital for years, "all they knew was how to get to a bathroom and the cafeteria," Grossman says.

Even more challenging, one of the men, Arturo Reyes, is hearing-impaired and can't speak. He came to California from Mexico as a young man and never learned formal sign language of any kind.

But then Grossman circled back to the flowers. He'd seen the men spontaneously cut and hand out single roses to patients, visitors and employees who happened to be strolling through or simply enjoying the gardens.

"He noticed how people would be smiling, being grateful for the roses, and he said, 'You know, we can take that power and bring it inside the hospital,' " recalls Rudy Sanchez, the lead landscaper.

Grossman and Sanchez came up with a plan. The crew would hand out roses inside the hospital. "At first it was just the employees," says Sanchez. "Nurses, secretaries, anybody who needed cheering up during the week."

When the men started receiving thank you cards, Grossman suggested bringing bouquets to the patients. The idea eventually turned into a program called "This Bud's for You."

"We went to the 99-cent store and picked up some vases, and we worked on designing a card that could be handed out," Grossman says. The card is decorated with photographs of the hospital's seven rose gardens. It also explains who the crew is and what they're doing, eliminating the need for any actual words to be exchanged.

"It's a great way for Arturo to actually go inside the hospital, say [via the card], 'Here's a bouquet of roses, I just want to bring a smile to you,' and see expressions change right away," says Sanchez. "He's been here for over 25 years. He's outside working hard. Finally, he gets to see how much his work changes people's lives."

The rest of the crew look forward to Thursdays, too — their official bouquet day. Sanchez recalls visiting a heart-transplant patient who was so thrilled to receive a bouquet, she asked the men to autograph a heart-shaped pillow that her surgical team also had signed.

"She'll have that pillow forever," figures Sanchez. "When she shows her family members, she'll say, 'When I got my new heart, these are the doctors who helped me out, and these are the landscapers who came in and brought me a bouquet of flowers.' "

The landscapers have received a slew of cards and letters from appreciative patients. "Sometimes when you're in the hospital, you don't want to reflect back on it," Sanchez says. "You want to go back to your daily life. So the fact that somebody actually took the time to write and say, 'This really made my day,' that's the best."

It used to be that the landscapers knew few of their fellow employees beyond a passing wave. Now, doctors and nurses come up to them, offering thanks for the program. "I would have never thought in a million years a doctor would come up to me and say,, 'You're doing a great job,' " Sanchez says.

The crew even got a weeklong, all-expenses paid trip to Disney World last year to receive the Spirit of Caring Award from Sodexho, one of Sharp Grossmont's vendors.

"It was a great feeling," Sanchez says. "These guys are such hard workers, and they've never had this before."

Grossman ended up with a conundrum he hadn't anticipated, though. The engineers he manages became a little jealous of all the attention the landscapers were getting. So now, the engineers have "Cheer Bouquets" with balloons and teddy bears to hand out when they stop by a room to adjust the temperature or change a light bulb.

"This kind of helps break the ice," Grossman says. "You go in and introduce yourself. You become human and treat the people like people."