change

All improvement requires making change — and change can be difficult. These practices are culled from Kaiser Permanente’s Organizational Effectiveness consultants and from unit-based teams that have moved through change successfully, developing new processes, transitioning to new leadership, etc. These tips are meant to support UBT co-leads and team members as they manage change — and the resistance that often comes with it.

For unit-based team co-leads and sponsors: Identify and manage resistance

• Clearly communicate reasons for the change.
• Make it safe to voice concerns throughout the change process.
• Identify team members mostly likely to resist the change and give them key roles.
• Involve naysayers as early and as often as possible to minimize grumbling.

For all UBT members: Assess the effects of the change and enlist support

• Develop a common understanding of the change, getting everyone’s point of view:  Ask, "What’s being done now and what will be done differently?"
• Engage everyone affected, including physicians, members of other departments and your team sponsor.
• Identify specific enablers and barriers to implementation — areas that will require greater attention.
• Allow team members to identify solutions and make decisions that affect them most.

Celebrate short-term successes — and acknowledge failures

• After each test of change, recognize and reward contributing team members at huddles and meetings. Use these small wins to increase credibility and keep the momentum going.
• Accept failures — and talk about what can be learned from them.

Amazon. Facebook. Uber. Count the ways that technology has changed the way people shop, share information, get around—and the way work is done in those industries. Now add health care to that list.

That was the message of the 2016 Work of the Future Conference in November, where 200 Kaiser Permanente managers and workers looked at how health care is changing, and how management and labor can collaboratively shape those changes at KP.

Industry and union leaders shared emerging workforce trends and practices. They also praised KP and the Coalition of Kaiser Permanente Unions’ approach to performance improvement, problem solving and workforce development.

“Kaiser and the union coalition have nailed it when it comes to workforce training, workforce planning and making sure we're preparing for the future,” said Liz Shuler, secretary-treasurer of the AFL-CIO. “The collaborative approach really shines when we talk about training, workforce development and finding ways to help workers ladder up in their careers.”

Shared wisdom

With the help of unit-based teams, health care innovation has brought patients better and faster treatment at KP, said Nirav Shah, MD, senior vice president of clinical operations for the Southern California region. For instance, KP hip replacement patients often walk off the operating table, go home without spending a night in the hospital and get nursing care and physical therapy at home. “Radical transparency, shared data and the wisdom of unit-based teams” are essential to making such changes work, he said.

Skills for success

KP and union workforce planners shared how workers can prepare for more changes coming to health care by mastering four critical skills:

• consumer focus
• digital fluency
• collaboration
• process improvement

These skills are among the new training programs, previewed at the conference, to be offered to coalition union-represented workers in 2017 (learn more). Digital fluency, for instance, covers mobile devices, applications and their impact on health care. Kaiser Permanente and the coalition unions, working in partnership, have given KP workers a head start in at least two of the other critical skills—collaboration and process improvement.

Learning from others

Conference participants also learned from the experience of other organizations. DTE Energy, a Detroit-based public utility, worked with its unions to avoid layoffs even during the Great Recession, said Diane Antishin, DTE Energy’s vice president of HR Operations.

Michael Langford, president of Utility Workers Union of America, described his union’s training and apprenticeship programs, which have helped his members nationally adapt to changes in their industry.

As with our work in the Labor Management Partnership, interest-based bargaining helped both parties achieve their goals.

“If you come in with positional arguments you’ll never get it done,” said Langford. “But if you can get to what the underlying problem is, you can solve it.”

When discussing change, it’s a rare person who doesn’t have that question lurking at some level of consciousness. Since health care reform will bring change to just about every corner of Kaiser Permanente, it’s safe to assume a lot of people are wondering how their jobs will be affected.

The short answer is, no one exactly knows yet.

The better answer is, no one exactly knows and it doesn’t really matter.

Because the 130,000 frontline workers, managers and physicians who are engaged in the Labor Management Partnership already are on a path of continuous improvement, which means taking change in stride is becoming second nature to this crowd.

Doing better tomorrow what we did well today is the name of the game for unit-based teams. Team innovation, as this issue’s cover story notes, may result in a clinic making sure new members understand what they can do to ensure speedier service. It may result in new members getting the kind of attention on their first visit that impresses them and makes them want to stay with KP.

So the best answer to “what about me?” is: It doesn’t matter if a change arrives because a lab decided it wants to get results out faster or if change is a result of health care reform. Change is change. It isn’t out there waiting to roll over us, it’s already here. It arrived when UBTs began using the Value Compass as a guide to providing our members with the best service and quality of care at the best price, while creating the best place to work.

More members on their way because of health care reform? We’re already getting ready—it’s the same work we’re doing to serve our current members well.