Lead Your Team

Colorado’s “small team with the big impact” has surpassed even its own expectations, reporting an additional $7 million in Medicare reimbursements last year. That brings the total capture to $10.3 million for Medicare Advantage visits in 2010.

The Medicare Risk Business Services unit—made up of five auditors, a data analyst and a manager—is in charge of auditing all inpatient Medicare Advantage charts to make sure the agency is billed correctly.

Two years ago, a technical issue with Kaiser Permanente’s partner hospitals in the region resulted in incomplete physician signatures on patient charts—which prevented KP from submitting the bills for hospital stays and procedures to Medicare for reimbursement. The error was corrected, but the team had to review 26,000 hospital inpatient notes for that year.

When it first began correcting the error, the unit-based team predicted collecting an additional $2 million to $3 million for 2010 and team members are pleased that their efforts netted KP an additional $7 million.

“It amazes me what the UBT is able to harness and have such great outcomes,” says management co-lead Treska Francis.

The department has worked through the backlog and is now able to submit bills to Medicare within 10 days of a patient’s discharge.

The small team attributes its ongoing success to:

• quick huddles
• holding each other accountable
• transparent communication

“On a daily basis, we know what needs to be completed for the day, (we) set a goal and we go for it,” says labor co-lead Stephanie White, a Medicare risk auditor and SEIU Local 105 member.

Managers newly charged with co-leading unit-based teams sometimes need to build team cohesion before diving into the nitty-gritty of setting goals and improving performance.

Brenda Johnson, optical site supervisor at the South Bay Medical Center in Southern California, has found a way to do just that—and improve her staff’s eating habits at the same time.

Inspired by a presentation at a regional leadership conference hosted by Jeffrey Weisz, MD, executive medical director of the Southern California Permanente Medical Group, she launched a healthy eating club in her department. Every week, staffers chip in $12 each—and get four healthy, fresh-cooked meals in return.

At the early spring meeting, Dr. Weisz discussed Kaiser Permanente’s Healthy Workforce initiative and distributed a booklet listing the calorie count of hundreds of food items.

Making change easier

“I looked at the book, and I thought, ‘Oh, my goodness,’” said Johnson, shocked at the number of calories in some of her favorite foods.

“I looked around at my employees,” she said. “Some have health issues. Some drink sodas by the 32-ounce cup every day.” The medical center is ringed by mini-malls with fast food restaurants. “We’ve been eating the same stuff for years,” she said. “The only question was who’s going to go pick it up.”

Gil Menendez admits he was one of the 32-ounce-cup soda drinkers—a habit he gave up when he joined the club. Menendez, an optical dispenser, SEIU UHW member and  labor co-lead of the UBT, was so motivated by the changes in his lunchtime habits that he also began a strict diet and exercise routine. He’s lost 20 pounds.

New ways to work together

Johnson cautions that the healthy eating club isn’t a diet club. She picks recipes out of a pamphlet produced by the California Department of Public Health, Champions for Change, and prepares the ingredients at home. Others sometimes prepare recipes from their families and cultures. She combines ingredients in the morning, steams them in a slow cooker the staff keeps at work, and a meal is ready by lunchtime.

“I have to cook for my family anyway,” says Johnson. At home, “We’ve changed our habits because of high blood pressure. I prepare this food with love because I’m preparing it for both of my families: my family at home and my family at work.” 

About 15 to 20 people participate in the club each week, up from 10 when it first began in May 2010. In addition to its health benefits, the club has helped her department be more productive and collegial, says Johnson.

“It’s going strong,” adds Mendez. “It brings us together.”

Mandy Sly, a unit-based team consultant in Kern County (Southern California), was facilitating the launch of a unit-based team. The group suffered from low morale—a problem compounded by their habit of taking up difficult issues over email and liberal use of the “reply all” button.

“There was a lot of miscommunication,” says Sly, who is now a UBT coordinator in Southern California assigned to the Coalition of Kaiser Permanente Unions. “Email is there to improve communication, but if it is not used properly, it can do a lot of damage to individuals, teams and organizations.”

Why does it matter?

Communicating by email is the norm for managers and many other workers at Kaiser Permanente—a great innovation, but fraught with potential pitfalls. And with the advent of unit-based teams, managers are likely to be carrying on email conversations with more people at more levels of the organization: labor co-leads, sponsors, facilitators and employees. That means email etiquette is more important than ever if the open, respectful communication that is part of the foundation of the Labor Management Partnership is going to help improve performance.

What’s the problem?

Stripped of tone of voice, body language and facial expression, email communication means those receiving the message don’t have some key (unwritten) information on which to base their interpretation of the content. In fact, people only correctly ascertain the intended tone of an email only half the time, according to research published in the Journal of Personality and Social Psychology in 2006. Worse, they have no clue they are getting it wrong. They think they’ve correctly interpreted tone 90 percent of the time.

“Email is not very good at conveying tone and nuance,” writes Alan Murray in The Wall Street Journal Guide to Management, to be published in October 2010. “That seems to be doubly true when the sender is a manager and the receiver is a subordinate. Suggestions made in jest can too easily be mistaken for serious commands; observations made with irony can too often be received as literal.”