This PowerPoint slide features a facilitywide UBT that successfully encouraged more employees to get the flu shot.
This poster features a UBT encompassing our entire facility that successfully encouraged more employees to get the flu shot.
When the Anaheim Medical Center Admitting department unit-based team set out to increase its collection of inpatient hospital copayments, it had several hurdles to overcome.
Some staff members had to get comfortable with asking for money from patients. Others had to learn how to calculate copayments. They also needed to notify Admitting of a patient’s pending discharge so copayments could be collected at the point of service.
And since the team goal of collecting copayments didn’t always dovetail nicely with individualized goals, that put some staff members at odds.
“We had created this unhealthy competition,” admitting supervisor/manager and union co-lead David Jarvis says.
They also had the problem of convincing staff members in other departments that collecting copayments from hospitalized patients was not a bad thing.
"They used to think of me as Public Enemy No. 1," says Patti Hinds, a financial counselor and member of SEIU UHW.
To educate and motivate staff members about the importance of collecting copayments, the unit-based team held a kickoff meeting in January 2010.
Staff members who were good at collecting and calculating copayments were deemed “master users” and received training so they could help their peers learn to correctly calculate amounts due. They also got pointers on speaking with patients about the money they owed.
"We wrote scripts, we role-played and, as people did it more, they became more comfortable with asking for money and with knowing when it is appropriate to do so," admitting clerk, SEIU UHW Patricia Hartwig says.
The team also had to teach staff members in other departments about the benefits of copayment collection.
"We showed them the bottom-line connection between revenue collection and their paychecks," Hartwig says.
Better working relationships developed between admitting department staff and the nursing units, prompting nurses to contact admitting staff more consistently before patients are discharged.
"They came to realize we’re not the 'bad guys,' " says financial counselor Marcela Perez, an SEIU-UHW member.
This Southern California Admitting team tackles the touchy subject of copay collection head on and becomes one of the highest collectors in the region.
Senior Orange County executive shares keys to success
I have worked at Kaiser Permanente for 33 years, starting as a distribution worker in materials management. Being on the front lines helped me better understand the challenges staff face—and helped me, in my current role, see what it takes to spread and sustain change in a complex organization.
When we launched our first unit-based teams in 2007, I knew they could give our managers and teams a powerful tool for change. But to achieve their full potential, UBTs need the support of leaders at every level. In working with UBTs every day, I have found five practices that can help teams achieve their goals, and have helped me be a more effective leader.
I’m not a patient person by nature, and it took a visit to the world-class health care system in Jonkoping, Sweden, for me to see that it takes patience to sustain meaningful change. When you’re solving problems in a team-based workplace, real systemic change takes time. But it also takes hold deeper into the organization.
Spend time with a UBT, or hear teams present their test of change, to understand what they’re working on and how you can support them. There’s no way you can feel the excitement and energy from the team members and not feel proud and motivated by their work.
In Orange County—which has two large hospitals, in Irvine and Anaheim—we expect all teams to continually test and then spread their ideas and successful practices. We call it “One OC” and we talk about it all the time. You’re never going to achieve greatness globally if you don’t spread good work locally.
Early on we formed an Integrated Leaders group of senior labor and management leaders who meet monthly to monitor and assist our 107 UBTs. If a team is struggling, the IL group doesn’t descend on them and try to fix the problem. We provide tools and resources that help the team work through a problem and get results. For instance, we put together a UBT Start-up Toolkit with information on everything from setting up teams to finding training. We’re also looking at toolkits on fishbone diagramming, conducting small tests of change and providing rewards and recognition. And we’re asking how to make it easier for teams to access resources quickly—for instance by identifying go-to people for questions on budgeting, patient satisfaction metrics and so on.
I have a saying: “Hire great people, give them the coaching and mentoring they need, then get the heck out of their way and let them do what they were hired to do.” I think that works at all levels of the organization, whether or not people are your direct hires. You don’t tell people to make a change or streamline a process without any encouragement or support, but you don’t need to micromanage them either. Delivering great health care is not just a job. It is a calling. Whether you’re a housekeeper preventing infection or a surgeon treating cancer, people’s lives are in our hands. That shared mission drives us to be the best.