Fall 2012

Poster: Supreme Sponsor

Submitted by Andrea Buffa on Mon, 10/10/2016 - 16:02
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This poster, which appeared on the back cover of the Fall 2012 Hank, is a fun take on sponsorship, featuring a "supreme sponsor" action figure.

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Tyra Ferlatte
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Poster: Supreme Sponsor

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PDF (color and black and white)

Size: 
8.5" x 11"

Intended audience:
Frontline employees, managers and physicians

Best used:
Share on bulletin boards, in break rooms and in other staff areas to provide a lighthearted look at sponsorship.

 

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Around the Regions (Fall 2012) Andrea Buffa Mon, 09/19/2016 - 16:17
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Around the regions
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In support of sponsors
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Eight quick hits, one from each region, on work being done in partnership. 

Story body part 1

Colorado

The Regional Imaging teams in Colorado are lucky to have two effective sponsors: Joseph Gonzales, clinical operations for Regional Imaging, and Rebecca “Becky” Torres, a pharmacy technician and SEIU Local 105 member. Part of their success, the pair says, is the emphasis they have placed on sharing information—with each other and with their teams. The pair also figured out a way to spread effective practices. Using a PowerPoint template, the sponsors asked co-leads to explain what they’re working on, how it supports regional goals, whether it worked and the outcome. Then, the teams came together for a UBT Fair and shared their PowerPoints.

Georgia 

David Jones, MD, has a title unique at Kaiser Permanente: assistant to the medical director for unit-based teams. He mobilizes his fellow physicians in the Georgia region to get involved with UBTs and unleash the power of partnership to improve performance and grow membership. “The first thing I tell physicians about the UBTs is that it is about improving the work that we’re already doing,” he says. “It’s not about adding more work, it’s about looking at the work you're doing and figuring out how to do it better.” Read more from Jones—including how his experience with UBTs has transformed the way he delivers care to his patients.

Hawaii

A small region, Hawaii needed a novel approach to sponsorship: Branch out rather than always branch up. Initially, a five-member unit-based team committee tried to troubleshoot issues for the region’s fledgling teams. Often, those committee members, who also had roles as team co-leads or contract specialists, were trying to wear too many hats and got jammed. So the region, which now has more than 40 teams, has tapped 19 people to receive sponsorship training. The group includes middle managers, directors and other executives, frontline nurses who serve on the Kaiser Permanente board of the Hawaii Nurses Association, OPEIU Local 50, and former labor team members and co-leads.

Mid-Atlantic States

While the Mid-Atlantic States region’s clinical unit-based teams have management and labor co-sponsors, large teams such as lab and radiology are sponsored in a different way: A UBT leadership group made up of labor and management from these area performs sponsorship functions as a united body. “We generated a vision of our UBT sponsorship. We got very specific on how we would work together,” says Jane Lewis, executive director of health plan regional services and a member of the group that sponsors eight pharmacy UBTs. The UBTs report their projects and team dynamics at monthly meetings. The leadership group reviews People Pulse, service scores, quality results and other metrics, identifies struggling teams, and recognizes teams that excel.

Northern California

The region has been on a roll with its “A Leader’s Role as UBT Sponsor” training. Launched in the spring, the tutorial gives management and labor leaders an easy-to-understand yet in-depth look at providing effective support to unit-based teams and their performance improvement work. The short, online training covers everything from outlining a sponsor’s role and how a sponsor can model partnership to tips on developing strong UBT co-leads and high-performing teams. Several facilities have combined the training with in-person, interactive exercises, and early feedback suggests the blended approach is striking a chord with sponsors. The online training can be found at KP Learn.

Northwest

“My role as a senior sponsor is to bring the message of UBTs to physician leadership,” says Rasjad Lints, MD, the region’s executive sponsor of UBTs. Lints is especially interested in helping teams focus on outcome metrics—a measure of the final result of something, such as how many patients with hypertension have their blood pressure under control—and to help everyone on the team understand that improving on process metrics often drives improvement on outcomes. It can be difficult to see the value in participating in process metrics if team members don’t see how it relates to the outcome measures. “At the end of the day, physicians have to drive the care,” Lints says. While working in UBTs presents physicians with some unique challenges, he believes that “if the physicians aren’t engaged, it’s a lost opportunity.”

Ohio

In an effort to improve the quality of team project information in UBT Tracker, the regional LMP support team solicited the help of the people who support the work of teams—sponsors. In June, an improvement adviser met with Ohio’s 20-plus sponsors and asked them to work with their teams to boost the input of that data. To illustrate the value and role of quality data in UBT Tracker, they used the data in Tracker to brief the sponsors on their UBTs’ projects and status. Their approach made an impact: The region has reported an increase in sponsor engagement, and several teams have reported performance and relationship improvements. 

Southern California

The regional Labor Management Partnership department is launching a new sponsor training curriculum that covers the nuts and bolts of what sponsors do and how they do it. Topics include: the responsibilities of sponsoring bodies (such as helping define how the teams should be structured and guiding selection of co-leads); coaching skills to help develop UBT leaders; the similarities and differences between labor and management sponsorship; how managing in partnership differs from traditional management; and how the sponsor role differs from that of facilitators, project managers, trainers and consultants. Also included in the course are basics of the Labor Management Partnership and unit-based teams, such as the key elements for UBT success, the roles and responsibilities of UBT co-leads and members, and consensus decision making.

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Sponsors Joseph Gonzales, senior radiology manager, and Rebecca Torres, pharmacy technician and SEIU Local 105 member
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From the Desk of Henrietta: 180 Flavors Later Andrea Buffa Mon, 09/19/2016 - 16:16
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From the desk of Henrietta: 180 flavors later
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Henrietta, the regular columnist in the LMP's quarterly magazine Hank, explains why it’s important for partnership advocates to support the increasing LMP focus on sponsorship.

Story body part 1

A friend of mine with a heart flutter had to spend a day in a Kaiser Permanente emergency room recently, and he asked one of the staff members helping him, “Are you in a unit-based team?”

“Oh, yeah,” the staff member said, without much enthusiasm. “We have one of those.”

The exchange may not have been altogether surprising, but it underscores the work that still lies ahead for those of us who believe—as I suspect most readers of this column do—that partnership and unit-based teams are the right way to do business.

Naysayers nurture the old arguments. Partnership means management caving in to the unions or, conversely, partnership means unions selling out to management. Some people just sit on the fence, dismissing partnership as a “flavor of the month” and apparently hoping that if they ignore it long enough, it will go away.

Fifteen years after the Labor Management Partnership’s founding agreement was signed—at 12 flavors a year, that would be 180 flavors later—what’s a partnership advocate to do?

Spread the word. Do what you’ve been doing: Acknowledge the challenges of working in partnership, and cite the considerable achievements being piled up by UBTs. And here’s one more: Do what you can to support the increasing LMP focus on sponsorship, which is the subject of this issue’s cover article and companion stories.

Active sponsors are an essential component of a high-performing team’s makeup—and active sponsors serve as bridges between teams. They are positioned to spread effective practices up, down and sideways. Looking back after another 15 years, we may see that active sponsors were the partnership ingredient that finally turned LMP doubters into players. 

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Icebreaker: Are You My Partner?

Submitted by Beverly White on Thu, 10/30/2014 - 16:50
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Hank
hank33_meeting_icebreaker_are_you_my_partner

Use this meeting icebreaker to find out interesting things about your team members. From the Fall 2012 Hank.

Beverly White
Tyra Ferlatte
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Meeting Icebreaker: Are you my partner?

Format:
PDF

Size:
8.5” x 11”

Intended audience:
Frontline employees, managers and physicians

Best used:
Use this meeting icebreaker to find out interesting things about your team members. 

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HANK Fall 2012

Format: PDF

Size: 16 pages; print on on 8½” x 11” paper (for full-size, print on 11" x 14" and trim to 9.5" x 11.5")

Intended audience: Frontline workers, managers and physicians

Best used: Download the PDF or read all of the stories by clicking the links below.

Cover story: The Sponsorship Dilemma 

tyra.l.ferlatte Mon, 01/28/2013 - 10:06
All in a Day's Work: Just Add Water tyra.l.ferlatte Fri, 11/09/2012 - 14:12
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Intended audience:
Anyone with a sense of humor

Best used: Download and post this gentle reminder that teams need sponsors to thrive on bulletin boards, in your cubicle or in emails. Have fun!

 

 

hank33_cartoon

This cartoon provides a light-hearted reminder that teams thrive when they have active sponsors.

Tyra Ferlatte
Tyra Ferlatte
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The Sponsorship Dilemma

Submitted by cassandra.braun on Thu, 11/08/2012 - 23:08
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A look at UBT sponsorship, the challenges it faces, and the key role it plays in the success of teams.

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Tyra Ferlatte
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Gena Bailey, a service area director and UBT sponsor in the Northwest, and Melissa Garan, a medical assistant and SEIU Local 49 member
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The sponsorship dilemma
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Active sponsors drive high-performing teams. Can partnership overcome the short supply?
Story body part 1

If you ask Los Angeles Medical Center sponsors Ilda Luna and Sanjit Sodhi for the secret to successful sponsorship, they’ll agree it boils down to investment—of time, trust and respect—in each other, in their teams and in the collaborative work process.

Luna, a family medicine receptionist, and Sodhi, the chief financial officer for LAMC, didn’t know each other when they were asked to co-sponsor the Health Information Management, Admitting and Patient Revenue, and the local business office teams—teams that were failing to meet performance goals and were entrenched in mistrust between labor and management.

“Sanjit said, ‘Tell me what I need to do to get us up and running,’ ” recalls Luna, a member of SEIU-UHW. “I said, ‘You need to meet with your teams. If you invest time in labor, you’ll get huge dividends.”

Like most investments, success didn’t happen overnight—and it wasn’t guaranteed. But after a year and a half of perseverance, dedicating time and hard work to supporting the work of those teams, the pair has watched the departments go from being in the red in most metrics to seeing huge improvements in areas like attendance and co-pay collection.

“We’re taking on types of projects that we could never have dreamed of a year ago,” Sodhi says. “And when you work though relationship issues and put the focus back on partnership and performance improvement, it’s highly satisfying.”

What’s so special about sponsors?

A 2011 study by Johns Hopkins University, Rutgers University and Kaiser Permanente identified five key characteristics of high-performing teams, including “consistent, aligned and visible sponsorship.” It confirmed what has been seen throughout the organization—strong sponsorship and support from higher levels of leadership are key factors in a team’s success.

The reasons are straightforward. Many frontline workers say simply having leaders’ involvement and support gives their work validation, letting them know that what they’re working on is important, that their contributions matter. In addition:

  • Sponsors mentor unit-based teams and connect them with effective practices and other resources to help them do their work.
  • They help break down barriers and provide guidance on setting goals that line up with local and national performance goals.
  • They act as role models and advocates for working in partnership.

“There are teams that need both management and labor sponsors to model partnership behaviors, who can agree to disagree and who can have some healthy courageous conversations till they get to an outcome,” says Vicki Barkan, the UBT consultant at the Los Angeles Medical Center. “Sometimes teams and co-leads haven’t experienced that, so they need to see it. It really helps to further the team dynamics.”

Sodhi agrees.

“As sponsors,” she says, “we have the same common goals and mutual respect for each other” that team members should have. “It trickles down to the rest of the UBT.”

“Sponsorship is a way to help move UBTs forward,” says Diane Ochoa, the regional director for Medical Group Support Services in Northern California and a former San Jose Medical Center medical group administrator. “It’s just like having a mentor, somebody you can talk to, to help you with issues and celebrate with you, and be there to really acknowledge the work you’re doing.”

So, what’s the problem?

Yet sponsorship is still a developing area in the partnership structure, even though many regions find that without active union and management sponsors, UBTs’ performance improvement work stalls.

Several challenges get in the way, and chief among those is time. Sponsors repeatedly cite the difficulty of finding time in their regular work to mentor teams. Labor sponsors face the added challenge of needing to cover their duties when they’re away from their usual post, lest those duties fall to colleagues.

Even with a commitment from facility and department leadership to backfill her position when her sponsorship work takes her away from her regular job, Luna, who is the union co-lead for the medical center’s LMP Council, says there isn’t enough time for everything she needs to do.

“But you have to make time,” she says. “I put in my own time, during lunch and after I clock out.”

Luna’s partner Sodhi agrees. The time challenge has to be reckoned with—but it’s a challenge worth solving.

“I’ve definitely made it a priority,” she says. “It was tiring devoting all that time, but I knew that I needed to do that to develop my relationships. In order to achieve any results, I knew I had to invest in time.”

“Capacity” is another word that surfaces when sponsors talk about challenges. Identifying people who can be strong sponsors and ensuring they have the tools and skills for the role is not easy. Labor bears the brunt of this barrier, in part because the unionized workforce typically has a smaller pool of leaders to draw from than management has. Many potential labor sponsors lack the consulting and facilitative skills required to mentor a team. As a result, union sponsors are in short supply, and those few become overwhelmed, with too many teams to support.

“I think that with labor, with so much work to do for our regular jobs, this is too much,” Luna explains. “So a lot of my peers didn’t want to do it. (Or) the ones who want to do it couldn’t get released because of operational needs. Patient care comes first, so operational need is a huge barrier.”

Solutions?

Some say successful sponsorship won’t happen until sponsors are held accountable, with their success tied to performance goals and financial compensation.

But in the meantime, many medical centers and regions are wrestling with finding other solutions to these issues. As a first step, some are revamping their training to clarify roles and responsibilities, which many sponsors—both labor and management alike—say have not been clear.

“It will be helpful for people to understand what they are supposed to do and see examples of how that’s done,” Ochoa says. “This is relatively new for some labor folks especially, and the more we can give them the tools to be a good sponsor, we need to do that.”

At the Los Angeles Medical Center, the facility’s LMP Council has made a series of changes in the last year it thinks will help shore up sponsorship. These include establishing criteria for becoming a sponsor, to make sure the right people are in the role and can model partnership and leadership behaviors; aggressively recruiting union co-leads of high-performing teams to become sponsors to increase the labor sponsor pool; and reassigning UBTs so a sponsor has no more than five teams.

Ultimately, time and commitment always will be challenges, but the potential rewards—the culture change and performance improvement work that come with high-performing teams—make the investment worthwhile. If sponsorship remains a barrier, there is a risk that teams will get discouraged.

As Luna says, “To be successful, we need successful sponsors and to build credibility with our teams. And we want to be successful.”

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Solving the Sponsorship Bind

Submitted by cassandra.braun on Thu, 11/08/2012 - 23:02
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Preliminary results from a comprehensive Office of Labor Management-sponsored study on the state of sponsorship across Kaiser Permanente.

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Tyra Ferlatte
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Solving the Sponsorship Bind
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High-performing teams deliver better results. Figure out how to get teams the sponsorship they need
Story body part 1

It’s hardly a secret that sponsors are critical to a unit-based team’s performance. Look at any high-performing team, and you’re likely to find an engaged sponsor. The link is so fundamental that teams can’t be rated at Level 4 or 5 on the Path to Performance without sponsors.

That leaves teams with a Catch-22, however, because they can’t control whether they have sponsors or how effective those sponsors are.

Paradoxically, despite the clear links between sponsorship, high-performing teams and results, sponsorship has not received as much attention as other areas in the partnership structure.

“We have had a plan for team development but not a plan for sponsorship,” says John August, the executive director of the Coalition of Kaiser Permanente Unions. But that, he says, is changing with the 2012 National Agreement, which took effect Oct. 1.

The agreement outlines prescriptive measures to strengthen sponsorship organization-wide, mandating that “sponsors will receive more comprehensive support to be effective in their role.”

As a first step, the Office of Labor Management Partnership conducted a study this summer that surveyed more than 8,700 co-leads, sponsors and UBT consultants and included focus groups and dozens of one-on-one interviews.

“This is a great opportunity to impact sponsorship,” says Janet Coffman, the coalition’s director of education and transformation. “Sponsorship can feel so far away when it’s ineffective, but when it works well, it can be the key to UBTs’ success.”

The preliminary results give credence to the anecdotal, recurring complaints about sponsorship. The frequently expressed concerns documented by the study include:

  • Multiple and inconsistent training for sponsors.
  • Limited leadership development training, tools and resources.
  • Poor comprehension and inconsistent use of tools and processes.
  • Inconsistent engagement and oversight of sponsors by executive management, physician and labor leaders.
  • Few opportunities for sponsor-to-sponsor sharing and networking.
  • Limited resources available to assist in addressing complex UBT issues.
  • Lack of an organizational plan and commitment to develop UBT sponsorship as a business strategy across management, physician and labor groups.
  • Perception of insufficient funds and staffing allocated to sponsorship work.
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Physician Sponsor Profile: Tom Harburg, MD Jennifer Gladwell Thu, 11/08/2012 - 22:55
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Physician sponsor profile: Tom Harburg, MD
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Tom Harburg, MD, talks about his experience as a sponsor and the value of having the physician involved in the unit-based team.

Story body part 1

Tom Harburg, MD, is the physician in charge at Division Medical Office in the Northwest. He co-sponsors two primary care teams in the medical office along with the medical office manager and their labor partners. “Doctors can’t be cowboys anymore,” says Dr. Harburg, referring to physician Atul Gawande’s New Yorker article “Cowboys and Pit Crews.” Harburg agrees with Gawande that doctors need to work in a team environment and that, as Gawande wrote, “places that function most like a system are most successful…(where) diverse people actually work together to direct their specialized capabilities toward a common goal for patients.” Dr. Harburg talked with LMP communications consultant Jennifer Gladwell about being a sponsor and the value of having the physician involved in the team.

Q. What is your role as a sponsor?

A. As the medical director of the clinic, I work with the medical office manager and labor partners to help sponsor the teams. We help facilitate leadership. I think the strength of the unit-based teams lies with the grassroots approach. The ideas come from the front line. My role is to help build awareness and alignment to the goals of the organization and ensure that our approach is member-centric.

Q. What’s the biggest barrier you see?

A. The measurement is the biggest barrier. We have to be able to measure our performance to see if what we’re doing has any effect on our patients.

Q. How do huddles improve the work of the team?

The true benefit of the huddles is communication. There’s a social aspect to in-person huddles that allows you to address issues that pop up. It also facilitates learning and disseminating information—like the first day of a new protocol, you can remind folks at the huddles. I also think it’s a morale builder. Huddles foster good camaraderie. We only have two huddles per week at the clinic, but we have been doing huddles for three years. We’ve changed the time of the huddles based on the clinic hours, and now we’re going back to mornings.

Communicator (reporters)
Jennifer Gladwell
Editor (if known, reporters)
Tyra Ferlatte
Notes (as needed)
Referenced the Atul Gawande article in New Yorker Cowboys and Pitcrews, http://www.newyorker.com/online/blogs/newsdesk/2011/05/atul-gawande-harvard-medical-school-commencement-address.html.

We might also want to include the articles on Gawande from our site for the website. http://lmpartnership.org/stories-videos/surviving-complexity-operating-room-and-workplace
http://lmpartnership.org/stories-videos/how-checklist-saves-lives-or

This about his book "Better":
http://lmpartnership.org/stories-videos/aim-be-positive-deviant
Tom Harburg, MD
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Sponsor Stories and Tools

Help your team with these resources.

Physician co-lead(s)

Tom Harburg, MD, Tom.Harburg@kp.org, 503-772-6314

Labor Sponsor Profile: Andrea Badellebess

Submitted by Shawn Masten on Thu, 11/08/2012 - 22:46
Hank
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Andrea Badellebess, OPEIU Local 29 labor liaison, and a labor sponsor of unit-based teams, talks about what it means to be a "family team" in the Fall 2012 Hank.

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Andrea Badellebess
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Additional resources

Andrea Badellebess, Andrea.Badellebess@kp.org, 510-248-7285

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Sponsor Stories and Tools

Sponsorship is a work in progress. But the beauty lies in the process as you and your teams progress.

Take a look at these ideas to help you move forward.

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Labor sponsor profile: Andrea Badellebess
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Andrea Badellebess has been a labor co-sponsor in the Greater Southern Alameda Area (GSAA) in the Northern California region for seven years. She sponsors 37 teamsincluding EVS, Health Management and the pharmacy UBTs, all of which include OPEIU Local 29 membersby “spreading myself around as much as I possibly can.” In talking with LMP communications consultants Shawn Masten and Cassandra Braun about the challenges and rewards of being a labor sponsor, she introduced the idea of a “family team”—a team that is above even Level 5, when “teams just interact and do what’s needed…It’s a real partnership. And it’s unspoken; it just gets done. It’s not about whose job it is.”

Q. First: How do you sponsor 37 teams?

A. Mostly, I do it electronically. I look at team meeting minutes on the shared drive and look at UBT Tracker to see where they are on projects. For those teams that are unique and need additional pushes, I work with our UBT consultant and visit them more often. If they’re a Level 5 team, I try to get to meetings at least two to three times a year. Then I have teams that need a little more motivation. I have to visit those teams more often to let them know they’re not by themselves. So it’s kind of hard. But you have to let them know you’re there.

Q. What’s the state of sponsorship today?

A. The work of sponsors has evolved slower than the work of unit-based teams. At one point, teams thought their consultants were their sponsors. But that’s the beauty of this whole performance improvement thing—it is its own ongoing small test of change. Everyone is learning as they go. There’s been a whole new culture change.

Q. What about sponsorship needs improving?

A. Here in the GSAA, we have been taking steps to improve union sponsorship especially. There are not enough people who can wear that sponsor hat. So now we are looking for stewards who want to—and have the capacity to—be sponsors. They have to be capable of seeing the common barriers teams face. And they have to either know who can remove those barriers or to point their teams in a different direction. What we’re doing is providing the training and development needed for stewards to succeed as sponsors. This is a significant shift, and one that we hope will make a difference.

Q. What do you like most about being a sponsor?

A. One of my greatest thrills—and sometimes one of my hardest jobs—is helping UBT members recognize that if they speak up they will be listened to. This is still hard for some, especially those skeptical that this whole unit-based team thing isn’t just another experiment that will pass. But this is what I tell them: “You are the experts. Who knows how to do your job better than you?” Once they realize they are the experts and have a say, and they are heard, they become a partner. UBTs make the frontline staff become partners. You’re not just a worker, you’re a partner, and you have a say in what’s going on.

Q. Can you give an example where the workers solved the problem?

A. Our call center operators were having a problem with elderly members getting hung up on or calls being dropped after they were transferred. They came together as a unit-based team and found a solution: Instead of simply putting such calls through, they stayed on the line and would talk with the person at the other end, explain who the member was and why they were calling. They had a problem, they solved it and there was no finger-pointing, no blame.

Words from the front line

“She’s very involved. It’s not like you just see her once a month or every other month. And you can tell that she’s interested in what we’re trying to say and do. If we go out of bounds, she’ll ask, ‘Is this what you meant?’”—Leilani Mejia, Health Information Management specialist, OPEIU Local 29 member and union co-lead, Fremont Medical Center

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