Northwest

It’s one thing to identify effective practices in an issue as important as workplace safety. It’s another to educate and engage teams in adopting a consistent set of practices across a region.

The Northwest’s Employee Health and Safety Department has done just that—and earned program-wide recognition for its approach.

In November 2012, the department’s Labor Management Partnership Workplace Safety team issued a challenge to the region’s 16 facility safety committees. The committees, established to help identify and resolve safety issues at the facility level, often differed in their approach and results. The safety challenge provided a fun way for the local committees to get to know more employees in their facilities, follow a consistent protocol and improve safety.

Challenging teams to step up

“The Safety Awareness Challenge provides safety committees an opportunity to work together with their labor, management and Permanente partners to effect real change around workplace safety,” says Chris Mozingo, RN, workplace safety labor consultant for the NW Region.

The yearlong campaign challenged each facility to:

• submit monthly or quarterly safety meeting minutes, to help keep their work on track
• have physicians and dentists attend at least 80 percent of their facility’s safety meetings, to ensure widespread participation and leadership (nonclinical departments were asked to send representatives to each meeting)
• promote safety conversations (a blame-free approach for observing work practices) and ensure at least 25 percent of employees are trained to lead such conversations
• adopt and promote safety awareness plans to help teams identify and correct at least three different workplace hazards (for instance, trips and falls or sprains and strains)
• host a safety fair, safety barbeque or other facility event within the year

“The Safety Committee Challenge goes beyond recognizing achievement. It fosters and reinforces the relations between Regional Safety, management and frontline staff,” says Employee Health and Services Safety Specialist II Brian Cekoric.

Getting results, recognition

Nine facilities completed the safety challenge by meeting each of the five established criteria. These efforts helped the Northwest region—already a leader in some key measures of workplace safety—record a 4 percent decrease in injury rates compared with the previous year. Teams that met the challenge will receive additional funding to support safety awareness promotions in their facilities.

For its part, the Northwest Employee Health and Safety team won the 2013 National Workplace Safety Award for its work in engaging frontline teams.

“The simple focus on injury prevention and raising awareness goes a long way to changing the culture of safety,” says Rob Weiking, Employee Heath and Services program manager.

Leonard Hayes, manager of Environmental Services culture and training in the Northwest, oversees workplace safety for 125 outpatient EVS workers in five service areas. This includes the East Side service area, whose EVS unit he directly supervises and which has recorded no injuries for nearly five years. In February 2014, Hayes won the National Workplace Safety Individual Award. He spoke recently with Jennifer Gladwell, LMP communications consultant, about how he engages teams to work more safely.

Q. You and your department have achieved a great turnaround in workplace safety. How did you do it?

A. You have to give people information and recognition. Workplace safety is a standing item on our UBT agendas. We talk about working safely, acknowledge how well our teams do and tell them “thank you.” I’ve been put in this job to take away the myths that injuries are inevitable, so people can go home at the end of their shift and enjoy their time outside of KP.

Q. What do you do personally to engage your staff on safety?

A. I’m in there with them physically.  I’ve been a worker and I take interest in what the teams are doing. I try to make sure people know I care for them by being available to them and making sure they have the tools to do their job. I am committed to responding to issues as quickly as possible and resolving them. I have a great labor partner and co-lead, Sherri Pang. She’s been my anchor with the campus and the (East Side) team. She helps me a lot by sending emails, creating fliers, understanding and encouraging the team.

Sheryl Miller, a licensed practical nurse and a member of SEIU Local 49, is the technology coordinator for the Coalition of Kaiser Permanente Unions for the Northwest region. She’s worked for Kaiser Permanente for 30 years and has been involved in most of the major electronic changes of our time—including implementation of KP HealthConnect®—and has helped the organization with the challenge of integrating electronics into our everyday work. She was interviewed by LMP Communications Consultant Jennifer Gladwell.

Q. What did you learn working on KP HealthConnect?

A. I look at the people component of technology. If people are paralyzed with fear, they’ll never use the technology. With KP HealthConnect, we learned that peer-to-peer training, sponsor support and funding for labor flex teams—which have the people who do the job become subject matter experts—was a model for success.

In the 1980s, you did not learn typing as part of your schooling as a nurse. When we implemented KP HealthConnect, we had significant generational gaps. Some employees didn’t type. Through the labor flex teams, we ensured peers were training each other around work they understood.

Technology impacts workforce planning. We have to think ahead so we don’t become extinct. Roles will change, but through the partnership and workforce planning, we can plan for the changes and redeploy impacted staff.

Q. How is technology affecting roles today?

A. Self-check-in kiosks are rolling out in the Northwest clinics. This is what some of our patient population has been asking for. Registration representatives are a group of dedicated employees that have been doing customer service behind a desk. Now, they are being asked to be a concierge, a greeter, as well as answer complex benefit questions.

The Visual Dermatology Assist project is being piloted at two clinics in the Northwest. Medical assistants are being trained, following the provider’s order, to take a picture of a skin irregularity on an iPhone and send it to Dermatology. Sixty-eight percent of the photos were reviewed, diagnosed and had treatment plans within 24 hours. A typical appointment could take six to eight weeks to schedule. This is improving access.

Q. Have you been able to spread effective practices from the KP HealthConnect implementation?

A. ICD-10, the new coding system, goes live in October. We’ve been able to engage UBTs and labor so they are part of making the decisions and determining processes. We’re using peer-to-peer training and trying to break down barriers early on so our staff and members have the best possible outcome.

Q. All this technology is great, but what about privacy and security?

A. It keeps me up at night. I have spoken to steward councils about privacy. We are seeing an increase in social media violations that could result in people losing their jobs or being fined. We have to be very careful about what we’re posting in social media. It’s so easy to vent about a bad day, but you have to be vigilant to ensure you are not revealing patient information. I am here for the patient and to educate employees on privacy and security.

Q. You’re a chief steward, yet you seem adamantly in favor of management policy. How do you explain that?

A. I work off of fact. It’s a policy that we do not go into our own medical record or those of others unless we have a business need to do so. I am a union member, but I will never lose sight that I am here for the company, patient and union, and we all have to work together to be successful.

Q. After so many projects—what’s the secret to success?

A. I work with great people, locally and nationally. I’m not a technology expert, but if you remember the people behind the technology, it works really well. If I can help someone in care delivery enhance their ability to take care of our patients, then I’ve done my job. Technology and people are not going away—so we have to be willing to advance with it.

It started with a question from Oncology RN Tom Fought, a member of the Oregon Federation of Nurses and Health Professionals (OFNHP), at the Interstate Medical Office in the Northwest.

Why, he wondered, was primary tubing used for low-reaction drugs instead of the less-expensive short or secondary tubing?

That prompted the department’s unit-based team to start an improvement project that wound up saving $25,000 a year.

When patients come in for chemotherapy or other infusion medications, the drugs are administered via an IV: The bag holding the medication is hung on a pole, with a line that goes into the patient’s vein. When primary tubing is used, the valve to stop the flow of medication is very close to the patient’s body.

If the drugs being used have a high potential for an adverse reaction, it’s essential to use primary tubing, so that if there is an emergency and the line has to be shut, only a very little additional medication reaches the patient.

Appropriate times for less expensive options

When the short tubing or secondary tubing is used, the valve to stop the flow of medication is farther from the patient. In this situation, if the valve is closed, more medication is in the line and will flow into the patient until the tube is empty. These types of tubing are appropriate when the medication has a low potential for a negative reaction.

Primary tubing is $4.10 per unit, short tubing is $3.65 and secondary tubing is 65 cents. The costs add up if primary tubing is used when it’s not necessary.

“I had no idea that we would be saving the unit that much money by conforming the tubing,” Fought says.

This team alone was able to save $25,000 a year. If every Kaiser Permanente oncology infusion department adopted this practice, the savings would be dramatic.

“This was such an easy tweak—we just needed to think outside of the box,” says Lacey Anderson, RN, the Infusion Team Lead and a member of OFNHP, who was involved in the project. “The team realized this was such a great idea and wondered, ‘Why haven’t we been doing this all along?’”

Greater camaraderie

Heidi Rolf, the department manager and the UBT’s management co-lead, is proud of the work the team has accomplished. She attributes the success to the leadership of the team and notes that since the team has advanced to a Level 4 on the Path to Performance, team members have more camaraderie and are more engaged.

“At first it was a little difficult to change the habits of the nursing staff,” Fought says. “Within a few weeks, we had everyone on board and our tubing project took off.”

Maureen “Moe” Fox, RN, is a member of the UBT Resource Team in the Northwest region, helping teams with process improvement, and also teaches regional LMP classes. She credits her exercise routine with giving her the energy to keep up with her busy life as a working woman, wife and mother of three boys. She was interviewed by LMP communications consultant Jennifer Gladwell.

Q. Moe, you have a ton of energy. Where does that come from?

A. Like most working moms, my life is busy. I try to eat foods that will fuel me, drink lots of water and exercise. I’m a Jazzercise instructor two days a week, and the other days I run. Exercise helps me keep up my energy level as well as maintain strength and balance. I think I’d be less optimistic and more stressed out if it weren’t for my daily exercise routine.

Q. I notice you have a lot of ribbons and medals—what are those from?  

A. I always wanted to run but thought my size would be a problem. As I began my weight-loss journey a few years ago, I added running as an extra way to burn calories. A new friend and fellow novice runner convinced me to sign up for my first 5K (3.1 miles). Finishing that race was such a huge accomplishment. It took months to train for and required a lot, both physically and mentally. I was hooked. Since then, I’ve done multiple 5K to 15K races, 16 half-marathons (13.1 miles) and finished my first marathon (26.2 miles) on Dec. 31, 2012. The problem with running is that it’s addictive!

Q. What started you on your wellness journey?

A. I’ve been active my whole life, lettering in high school sports and playing on teams as an adult. I’ve also been “bigger” my whole life. I started doing Jazzercise in 1999 and became an instructor seven years ago. Despite my best efforts, it seemed that the weight I gained with my last son was not going to budge. I had actually come to accept it—the whole “as long as I can buy cute clothes, I’ll be fine” thing.

About five years ago, I found that I couldn’t keep up with the students in my Jazzercise class. I would get to the most intense part of the workout and feel like I was dying. I knew something had to change. I made a plan and set a date to start. I started counting calories and recording everything I ate with an online journal. I also took the total health assessment and that prompted me to get my labs done, which is how I found out about my elevated cholesterol level.

We are at an advantage at Kaiser Permanente because the labor unions and the health plan are willing to put their money where their mouth is—pun intended. I joined a Mix It Up team in the spring, and the weekly emails are full of helpful and positive tips. If the total health assessment and accompanying healthy living programs can help an employee get interested in getting healthy, it’s a step in the right direction.

Q. What was it like to lead the flash mob at the 2012 Union Delegate Conference in Hollywood?

A. Oh my goodness, that was the best thing ever! I was so in my element. I love dancing and I love getting other people to dance. It was a bit of a game changer for me, because up to that point, I hadn’t ever thought of myself as a leader for physical fitness and healthy living. I had people coming up to me by the end of the conference who were vowing to make life changes. I spoke with some of them at this year’s conference and some have stayed true.

Q. What advice would you give someone who is trying to get healthy?

A. Get help and support. If you have a friend who understands and your family’s on board, it really helps, even if they aren’t changing anything. Make a (food) plan. Know what you’ll do for weekends, family events, parties and nights out. If you bite it, write it—all of it—even on a bad day. Also, I have to have something sweet every day—just a little something sweet. Know when you’ll exercise and what you’ll do and for how long. It’s important to move every day, even if only for a few minutes. You need to have an exercise plan that is realistic and fun. If you love to dance, dance. If you love to ride a bike, ride a bike. Cheat a little. I don’t count calories on the weekends or for special occasion meals. Reward yourself for reaching milestones. Lastly, find ways to de-stress and be kind to yourself. You’re not ready for the journey if you’re going to punish yourself through it. It’s hard enough on its own. Don’t make it harder by not rooting for your own team.