Key information about each of KP's regions.
The Labor Management Partnership operates in seven of Kaiser Permanente's eight operating regions across the United States. These regions serve the needs of their respective KP members and patients, guided by a common set of partnership principles and practices. Learn more about each.
Serves 541,000 members in 34 medical offices. Of its 256 unit-based teams, 188 (73 percent) were rated high performing as of June 2021.
Serves 316,000 members in 29 medical offices. Of its 108 unit-based teams, 94 (87 percent) were rated high performing as of June 2021.
Serves 258,000 members throughout the islands, in 24 medical offices and one hospital. Of its 60 unit-based teams, 54 (90 percent) were rated high performing as of June 2021.
Serves 787,000 members in Maryland, Virginia and the District of Columbia in 39 medical offices. Of its 277 unit-based teams, 213 (77 percent) were rated high performing as of June 2021.
Serves 4.5 million members in 249 medical offices and 35 hospitals. Of its 1,347 unit-based teams, 1,006 (75 percent) were rated high performing as of June 2021.
Serves 633,000 members in Oregon and Southwest Washington, in 59 medical and dental offices and three hospitals. Of its 407 unit-based teams, 280 (69 percent) were rated high performing as of June 2021.
Serves 4.7 million members in 257 medical offices and 19 hospitals. Of its 1,115 unit-based teams, 789 (71 percent) were rated high performing as of June 2021.
Serves more than 688,000 members in the Puget Sound area and east to Spokane with 48 medical facilities and one hospital. The Washington region became part of Kaiser Permanente in 2017. The region's LMP council held its first meeting in Q2-2019.
These departments (Finance, Health Plan Administration and IT) serve KP members, patients and staff across the program. Of 81 unit-based teams, 50 (62 percent) were rated high performing as of June 2021.
Call centers typically breed burnout—but KP’s teams are finding ways to be the exception to the rule.
At 8 a.m. every workday, an alarm sounds at the Member Services Call Center in Denver. Instantly, Olivia Johnson and her entire unit-based team of customer service representatives to leap out of their seats.
And dance.
The dance break tradition started when one of Johnson’s co-workers set a regular medication alarm that plays music.
“He started dancing when his alarm went off, then another person started dancing with him. Now it’s all of us dancing every morning,” says Johnson, a member of SEIU Local 105. “Afterwards we clap and tell each other it’s going to be a good day.”
Shaking their groove thing, having regular potlucks and sharing information that might make work easier for others are ways Johnson’s team combats potential stress at work. Constant stress can result in faster breathing and an increased heart rate, which the American Heart Association says can lead to physical pain, depression and unhealthy behaviors to compensate.
The members of Johnson’s UBT also alternate work assignments, so that representatives aren’t doing the same thing every week. One week, half of the team fields the calls from Kaiser Permanente members, while the other half answers questions from all of Colorado’s customer service representatives via SameTime chat. The next week, they switch. The variety helps keep the demands of the job manageable.
Terrence J. Cooper, who manages the Maple Lawn Call Center in Fulton, Maryland, says one reason working in a call center can be stressful is, simply, the nature of the work.
“We take complaints here,” says Cooper, who has been at Kaiser Permanente since 2006. “Complaints alone can be stressful.”
Cooper, who manages 20 people, tries to keep his team upbeat by injecting humor into his UBT’s daily huddles and team meetings. The team also host potlucks and does team-building activities outside of work, such as bowling.
“This allows us to catch up as a team,” Cooper says. “We talk about the weekend or the kids. It gives everyone an opportunity to take their minds off that last call.”
Cooper also serves as the local co-lead for the Kaiser Permanente wellness program “Live Well, Be Well” and tries to promote a healthy work environment to reduce stress. Frequently, fitness video games, board games or music are available in the break room to help folks “de-stress,” he says. “We try to lighten the mood.”
There’s a serious side to adding fun and festivities to the job: A study in the 2006 Ivey Business Journal Online found that workers who feel empowered and engaged—one of the outcomes of the light-hearted endeavors—are more productive and have fewer safety incidents.
Another key element to reducing stress is giving people the ability to make more decisions at work, says Deashimikia Williams, a customer service representative in Maryland and member of OPEIU Local 2. Williams also serves as her UBT’s union co-lead and is a member of the national call center “Super UBT,” whose membership crosses regional boundaries.
Williams says empowering workers and improving their work processes can have a positive impact on stress at work. Making customer service representatives, CSRs, aware of what they can do to resolve a member’s issue also reduces frustration, says Williams, whose role on the Super UBT includes exploring different improvements.
“We look at the issues CSRs and managers experience on the floor. If we streamline a process, it may not be as stressful,” Williams says. “If we can let them know what can be done by each department and who can help resolve a member’s problem, it reduces frustration.”
What can your team do to approach a serious issue in a more playful way? What else could your team do to help "violators" change without blame?
What can your team do to evaluate where savings can be found? What else could your team do to be more productive and not have to use contractors?
Eight quick hits, one from each region, on the performance improvement work being done in partnership in each region. From the Summer 2013 Hank.
The nurses in the Primary Care department at the Englewood Medical Office were short-staffed due to medical leaves and feeling overwhelmed. Messages from patients were piling up in the electronic inbox in KP HealthConnect. So the team brainstormed ideas, and the physicians offered to help clear the backlog. After testing a couple of time blocks, the doctors began setting aside 30 minutes every morning and afternoon to triage messages and call patients back directly without involving the nurses. As a result, the team consistently closes encounters within an hour more than 40 percent of the time—and, with more problems resolved by phone, access for patients needing in-person appointments has improved. Morale in the department is up, too—and the team recently won the region’s quarterly “Value Compass” award.
At the Crescent Centre Medical Office Building in Tucker, the Adult Medicine unit-based team is closing care gaps, managing chronic conditions better and improving screening rates for colon cancer—all key elements that differentiate Kaiser Permanente from its competitors. For example, the team increased the percentage of patients with diabetes getting the recommended blood sugar control and cholesterol tests by enlisting licensed practical nurses who help review, print and process pending test orders. To increase colon cancer screening rates, the team began tracking the number of take-home screening kits handed out by providers and made outreach calls to patients who didn’t return them. Starting from scratch, the team ramped up rapidly and handed out 173 kits between September and December 2012 and achieved an impressive return rate of more than 76 percent.
At the Moanalua Medical Center’s 1 East unit, patients are learning more about their medications, thanks to a successful test of change by the medical-surgical nurses. Two significant steps helped the Honolulu unit-based team achieve its goal of increasing patients’ medication awareness: Nurses took the time to review a single prescription and its common side effects with each patient, and then they reinforced the information at subsequent office visits. A follow-up survey showed that the percentage of patients saying they understood their medications and the possible side effects increased from 36 percent to 50 percent in just three weeks in May.
Several UBTs have joined the region-wide Member Demographic Data Collection Initiative, gathering crucial information about race, ethnicity and language preference. The data is needed to fulfill accreditation and contractual requirements—and, even more importantly, to eliminate health disparities and provide culturally competent care. In Springfield, Va., the Pediatrics team increased data collection from 46.8 percent of patients to 95 percent in less than two months by changing its workflow. In addition to nurses surveying patients in exam rooms, the team’s receptionists start data collection at check-in. Using laminated cards to describe ethnicity choices helped the Reston, Va., Pediatrics team improve by 10 percentage points. Region-wide rates improved 31 percentage points since May 2011, says Tracy S. Vang, the region’s senior diversity consultant.
The benefits of performance improvement work aren’t just in the results. Sometimes the work helps teams discover the crucial role they play in providing quality care. That’s what happened when the Richmond Medical Center’s patient care technician team set out to improve its workflow. The technicians, who help hospital patients get up and moving, had been meeting only 45 percent of physicians’ mobility orders. Their goal was to reach 75 percent by October 2012. By September, the team was fulfilling 95 percent of daily mobility orders. Communication with nurses and physicians improved, and the work had an added benefit: By helping patients get up more regularly, hospital stays were shortened, which is estimated to have avoided $600,000 in costs over five months.
By eliminating variation and wasted time, the regional lab’s Histology unit-based team improved slide turnaround time by 11.8 percentage points from its starting point in 2011 to April 2013. The team has reduced delays by tracking its slide volumes every hour, implementing huddles and adding additional equipment to minimize downtime due to lack of equipment. These improvements also helped improve employee morale: People Pulse scores for the department Work Unit Index increased by 30 points from 2011 to 2012.
The Labor Management Partnership is supporting frontline employees as the region transitions to become part of Catholic Health Partners. Once the process is complete, employees, physicians and operations and administrative personnel who are currently part of the Ohio Permanente Medical Group and Kaiser Foundation Health Plan-Ohio will become part of Catholic Health Partners. They will continue to work in the existing medical offices in Northeast Ohio.
Being accurate 98.9 percent of the time sounds pretty great. But the Central Processing department at the West Los Angeles Medical Center sterilizes almost 4,000 trays a month, so even a tiny drop in accuracy can disturb Operating Room efficiency. But with managers and employees working together to analyze the department’s data, the unit-based team was able to reach its goal of 99 percent accuracy between June and August 2012. It continues to maintain that level of precision by using a buddy system to audit instrument trays, involving lead techs in quality assurance spot-checks, posting tray accuracy reports in break rooms and holding weekly meetings with the Operating Room department administrator.
A quick tour of what's going on around the regions. From the Spring 2014 Hank.
A round-up of newsy bites from all of KP's regions. From the Summer 2014 Hank.
Newsy notes from all of KP's regions. From the Fall 2014 issue of Hank.
Spurred on by a Performance Sharing Program goal, UBTs in the region are focusing on affordability and efficiency by taking on improvement projects with identified cost savings or revenue capture. Teams are finding ways to work together. For example, the Stapleton Cytology and Molecular lab teams increased productivity by cross-training and solving problems together. As of August 2014, the teams are processing five times more HPV screenings a month than in 2012. The region also is celebrating strong membership growth.
Clinicians know a lot about medicine and less about the health insurance benefits their patients have. Members of the unit-based team at the Douglasville Medical Office knew that frustrated patients. They set out in July 2013 to improve the staff’s understanding of member benefits through an ambitious 12-week training session. Before starting the weekly classes, staff members scored an average of 68.5 percent on a test about member benefits. By the end of October, their average score was 95 percent. The team credits its newfound business literacy for boosting service scores, which helped Kaiser Permanente retain a major city account and win a new one.
More than 1,000 new health plan members joined Kaiser Permanente this summer, thanks to the collaboration between Kaiser Permanente and the Coalition of KP Unions to grow KP membership. The effort started in May with a strong presence at a conference of the Hawaii Government Employees Association—one of six unions covered by the state Employees’ Retirement System, KP Hawaii’s largest customer. Conference delegates visited the KP booth, took Body Mass Index (BMI) readings and participated in a KP-sponsored walk. KP followed up with mailers to prospective members, presentations to union retirees, invitations to tour KP facilities and more. Lynn Ching, labor liaison for the Labor Management Partnership in Hawaii, and Troy Tomita, a KP senior account manager, worked on the project together. “It’s a great headstart for open enrollment in October,” Ching says.
Members of the Ambulatory Surgery Center unit-based team in Gaithersburg, Md., not only are putting the patient at the center of every effort, but also bringing the patient’s family members and friends into the fold. The team created a perioperative liaison role, in which a staff person is assigned to a patient and acts as point person, updating a patient’s friends or family members throughout the patient’s journey through the surgery center. After creating the new role in February 2014, the surgery center’s service scores jumped from 75.8 percent in January 2014 to 88.8 percent in April 2014.
Fremont Medical Center employees took all obstacles in stride when it came to adding physical activity to their workday as part of the KP-wide Instant Recess® week in early August. Nearly 200 Fremont workers Hula-Hooped, boxed, danced, hop-scotched and jump-roped as part of the facility’s Instant Recess obstacle course. Usually, Instant Recess is a 5- to 10-minute activity done to music, but it also can be any kind of fun activity that gets people moving. The San Francisco, Richmond and San Rafael medical centers were among the other Northern California locations that joined in the week of Instant Recess, which was organized by national and regional Workforce Wellness programs and the union coalition.
Working through unit-based teams, the region has launched a new focus on affordability. The UBT Resource Team is leading the charge by providing such resources as a project template and performance improvement tools, including 6S and the Waste Walk, as it works with teams. In addition, teams can reach out to subject matter experts in finance, purchasing and other areas for assistance. The region’s UBT Data Team will calculate the return on investment of the efforts and enter that information into UBT Tracker. Some teams, such as the Rockwood Medical Office Patient Registration UBT, are working on reducing paper registration forms to cut down on waste and save money.
Leaders at the South Bay Medical Center hosted a performance improvement fair for unit-based teams this summer, aimed at giving teams the tools they need to reach levels 4 and 5 on the Path to Performance. After grabbing some healthy snacks at the sign-in table, UBT co-lead pairs sat with an improvement advisor or UBT consultant and got customized advice on how to move their projects forward. For instance, the union co-lead from a medical-surgical unit reviewed data collection techniques at one table, while at another, food and nutrition team members filled out a fishbone diagram for their efforts to collect errant cafeteria trays. Co-leads got help entering their projects into UBT Tracker, then left with a packet of performance improvement tools.
Newsy notes from all of KP's regions. From the Winter 2015 issue of Hank.
When the region revamped how it assesses unit-based teams’ Path to Performance rankings in 2014, some teams dropped down on the five-point scale. But the National Agreement and the region’s Performance Sharing Plan motivate teams to reach high performance, and UBTs are rallying around the more objective and accurate evaluation method. The downgrades are proving to be temporary. One Level 5 team is the Cardiology department at the Franklin Medical Office, which improved access by streamlining the referral review process for patients.
Musicians aren’t the only ones who go on tour. Loretta Sirmons, a Total Health labor lead, and Tracie Hawkins-Simpson, a contract specialist, who are both members of UFCW Local 1996, hit the road to encourage people to complete the Total Health Assessment. They were joined by their business representative, Louise Dempsey, and Russell Wise, the Coalition of Kaiser Permanente Unions national coordinator for Georgia. “We blitzed the facilities,” Wise says. “For those who hadn’t taken the THA, we explained its importance.” They visited during the work day, dropped in on farmers markets and held cyber cafés. Wise credits the collaboration for increasing regional participation in the THA: In May, it stood at 37 percent. By September, it had increased to 63 percent.
The Hawaii region is partnering with 25 local labor trusts to enhance its members’ benefits and build loyalty to Kaiser Permanente. The new benefit, called Well Rx Hawaii, makes drugs for high blood pressure, high cholesterol and diabetes available free of charge for enrolled members. “Union leaders like it because it shows the value they bring to their members,” says Harris Nakamoto, KP’s director of labor and trust sales for Hawaii. “We like it because it emphasizes the strength of KP's integrated delivery system—and helps members with chronic conditions save money and stay healthier.” KP is funding the program through expected savings in future medical costs and is tracking enrolled members’ compliance with medication, follow-up care and any decrease in emergency room visits or hospital stays.
The supply closets for the Physical Therapy department at the Woodlawn Medical Center in Maryland were “in disarray,” admits Dexter Alleyne, materials coordinator and member of OPEIU Local 2. “The overabundance of supplies was money not being used.” Using the 6S method, the inventory operations team took responsibility for the closets—organizing them and setting par levels while preparing to use OneLink for ordering supplies. The team created a spreadsheet for surplus supplies and sent an “up for grabs” email to colleagues at its own medical center and beyond, says Jennifer Hodges, inventory operations supervisor for the Baltimore area. Purging four closets over the summer is yielding savings. The team plans to spread the success throughout Woodlawn and to three nearby medical centers.
Concerned by the slow pace of growth in the number of high-performing unit-based teams in the first part of 2014, both the Northern and Southern California regions piloted a SWAT team approach to accelerate the development of Level 4 and 5 teams. The results were impressive. In June, Northern California temporarily reassigned UBT consultants and union partnership representatives from high-performing service areas to assist the consultants and UPRs working in three struggling service areas. As a result, from June to September 2014, the region moved 42 UBTs in the targeted service areas to Levels 4 and 5, out of a total of 90 teams that moved up to high-performing status. During the same period in 2013, 15 UBTs had become Level 4 and 5 teams in those same areas.
The Northwest is the only KP region to offer dental services to health plan members—and its dental program is celebrating its 40th anniversary. The idea for the program, which launched in 1974, came from Mitch Greenlick, then director of the Center for Health Research, KP’s medical research unit. Today, Greenlick is a state representative in Oregon—and more than 800 KP dental staff and dentists provide more than 234,000 people with dental care and coverage. The program is home to 19 unit-based teams, almost all of them high performing. Sunset Dental UBT reduced unfilled appointments by creating a wait list and calling patients when a spot opened up. Unfilled appointments improved by 22 percent in 2013, and team members have sustained the result. Get some quick facts and figures on the dental program.
Taking a SWAT team approach to boost the number of high-performing unit-based teams, Southern California concentrated resources on several strategically selected facilities. By October, the percentage of UBTs at Levels 4 and 5 was 59 percent, up from 34 percent in January. A key component of the approach was hiring seven new union partnership representatives, including Elsie Balov, an SEIU-UHW member who is aiding teams at the South Bay Medical Center. “It is really important that labor is helping with this work,” Balov says. “We are pulled from the front line to help, so we know the obstacles and the challenges and can work with the UBT consultants on those.
A newsy highlight from each of Kaiser Permanente's regions. From the Spring 2015 issue of Hank.