LMP News

Many of the several hundred health care workers who gathered at the Manhattan Beach Marriott on May 10 are used to working through the night—it goes with their jobs. But they aren’t used to waiting. By midnight, some were napping on the couches in the lobby. Others milled about in small groups, talking quietly. And some retired to their rooms and asked friends to call them if and when anything happened.

Finally, around 2 a.m., the news came: A subgroup had ironed out the final details. By 3 a.m., the hotel’s central ballroom was filled with cheering, hugging workers—and supervisors, middle managers and senior vice presidents. The 140 management and union negotiators who formed the Common Issues Committee (CIC) gave their unanimous thumbs-up to a new National Agreement that will guide the work of some 130,000 workers, managers and physicians in the nation’s largest private health system.

“It was like we had just won the World Series,” says Alan Kroll, director of the Clinical Contact Center in Colorado and a first-time member of the CIC. “We’d had our ups and downs as a team, but in the end, we all came through as a team. The energy and camaraderie was tremendous.”

R-E-S-P-E-C-T

“The energy of the room was not because we liked each other. It was because of the respect that partnership had brought,” says Ashwin Deo, an orthopedic technician in Sacramento and SEIU UHW member who served on the CIC.

The agreement, reached in the course of five three-day sessions from March to May, is the largest private-sector labor agreement negotiated in the United States this year. Like previous National Agreements, it covers not only wages and benefits but also goals related to service, quality, affordability, workforce and community health, and more. 

Yet how the CIC reached the agreement is even more remarkable than the agreement itself. Rather than engage in a power struggle, the negotiators used interest-based bargaining to solve problems. That process allowed it to focus on solutions to the biggest issue facing health care today—that it costs too much, and too few Americans can afford it—while maintaining Kaiser Permanente’s industry-leading wages and benefits.

Rather than chopping care or benefits to control costs, says John August, executive director of the Coalition of Kaiser Permanente Unions, the agreement “provides union members with the tools to tackle cost by improving care and efficiency. Improved care and efficiency, delivered by workers at the front line, are the key to extending quality care to every person in our country.”

“Our national bargaining is unique,” says Dennis Dabney, the senior vice president of National Labor Relations and the lead management negotiator. “There is not only a group of labor negotiators at the table, but a broad cross-section of our employees providing recommendations on how to better deliver high-quality, affordable care and ensure Kaiser Permanente is a great place to work well into the future.”

Moreover, the outcome is a testament to the interest-based approach to partnership, not just interest-based bargaining.

“As our facilitators told us, economic issues are tough to resolve in interest-based bargaining,” says Adam Nemer, care delivery finance officer in the Northwest and a member of the bargaining subgroup that focused on benefits. “In the end, we met both management and labor's key interests. But I suspect that was not just because of what happened at the benefits table. It was also the result of an open and honest dialogue on benefits between senior labor and management leaders over the past few years. It was about trust and transparency. In my view, we didn’t reach a solution just because of interest-based bargaining—but we couldn’t have gotten there without it.”

Revolutionary healthy workforce plan

As part of the solution to controlling costs, the agreement includes a revolutionary plan to create the healthiest workforce in the health care industry. Beginning in 2013, the agreement will reward the collective workforce achievement of reduced health risk factors, measured by body mass index (BMI), cholesterol levels, blood pressure levels, smoking rates and workplace injury rates.

“Unions and management agreed that health improvement is an essential strategy for reducing chronic conditions—one of the leading drivers of rising, unsustainable cost,” says SEIU UHW President Dave Regan. “This is a high-road, long-term strategy for the common good.”

Those involved in the process say it’s unlikely that the high road would have been taken had these been traditional, adversarial negotiations. As Joan Mah, an optometrist at San Rafael Medical Center in Northern California and a first-time observer representing her ESC-IFPTE Local 20 colleagues, put it: “Traditional bargaining is really about what I want and not about what is right….When you take the time to allow management and labor to surface their interests, it’s really looking for a global solution.”

“At times it was frustrating, but it was also interesting to see how the interest-based process led us to options we could work with,” says Jean Melnikoff, a senior director of human resources for Southern California, one of the management co-chairs of the workforce of the future subgroup.

Opening doors—and minds

Her sentiment was echoed by members of every subgroup. But that is not to say the process is easy.

“When things get difficult, you need to regroup and work your way through it,” says Arlene Peasnall, senior vice president of human resources in Southern California. “But you end up with better results and stronger relationships.”

“The people who’d done it before said, ‘It’s OK, it can be done,’” says orthopedic technician Deo. “Don’t be afraid of the tension in the room. Don’t be afraid of emotions, because that’s what gets creativity out….When labor and management are at the table, talking to each other as equals, and the ideas are valued equally—I think that opened a lot of doors. And minds, too.”

What if every organization and every union had a labor management partnership like ours?

It’s not as far-fetched as it sounds. On Aug. 16, more than 250 union, business and government leaders from all over the United States gathered in Chicago for Partnership Day, a meeting hosted by the Federal Mediation and Conciliation Service at its biennial conference—and offered a realistic look at the ups and downs that occur in partnerships and what it takes to launch and sustain them.

“We know partnership can make a difference,” Allison Beck, FMCS director, told the gathering. “This is not some fantasy that happens in a make-believe world.” She should know. As leader of the FMCS, the federal agency that mediates labor disputes across the United States, she’s seen firsthand how acrimonious relationships can ruin companies and unions—and how more open and respectful ones can help them both succeed.

The partnership between Kaiser Permanente and the Coalition of Kaiser Permanente Unions is the longest-lasting and strongest one in the nation, so conference participants asked many questions about how it operates.

A race to the top

Dennis Dabney, KP's senior vice president of National Labor Relations and Office of Labor Management Partnership, told the packed room he spends a lot of time on the phone with leaders from other companies interested in starting and strengthening partnerships.

“I've seen so many companies engaged in a race to the bottom,” Dabney said. “I'd like to see more engaged in a race to the top.” If he has any regrets about Kaiser Permanente’s partnership, he said, it's that we didn’t create unit-based teams sooner.

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.

Colorado

When people go to school to learn how to perform X-rays or take blood pressure, they don’t generally expect they’ll be bonding with colleagues while getting their commercial driver’s licenses or that putting on snow chains will be part of their job. But members of the “mobile coach” unit-based team, who travel to clinics that do not offer mammograms on site and who are in charge of every aspect of running a mammography lab on wheels, took these tasks on and more. Their unusual assignment is improving the quality of care—they screen an average of 15 patients a day and performed 2,584 exams in 2012, finding 12 cancers.

Georgia

The Pharmacy team at the Cumberland Medical Offices cut labeling costs by more than 50 percent by improving accuracy in printing prescription labels. Techs now take a medication off the shelf before typing in the prescription or passing it off to a pharmacist. This helps them select the right code from the National Drug Code database—reducing the need to reprint labels and the associated medication information sheets that are given to patients. Within three months of the change, the number of incorrect codes on labels went from 13 a week to zero. Spending on labels dropped from $1,355 in November 2011 to $569 in March 2012, and monthly shredding costs dropped from $90 to $30. 

Hawaii

The Gerontology specialty team at the Honolulu clinic uses a distinctive combination of red and blue tape to keep its nursing staff free of accidental syringe needle sticks, which can lead to serious disease. More than a year ago, the team set a goal to have no more than three sticks a year—the number of incidents in the previous year. But telling busy caregivers not to rush was not enough. Today, a designated area blocked off by the tape signals to other staff that a nurse needs to concentrate fully on preparing an injection or disposing a needle. The UBT reinforces the warning with signs and a monthly safety message. There have been no needle sticks since October 2012.

Mid-Atlantic States

When busy patients kept canceling appointments, the Baltimore Behavioral Health unit-based team had to find a way to address the no-shows, which were having a negative impact on the clinic’s workflow. In June 2012, 32.7 percent of open slots for new referrals went unused. Then the team stepped in with personal reminder calls and letters, as well as in-person coaching during the after-visit summary review about—yes—how to cancel an appointment. Once patients learned how easy it is to use kp.org to cancel an appointment and understood how other members benefit from the newly opened slots, the no-show rate dropped to 25 percent in February 2013.

Northern California

When parcels arrive at the Fremont Medical Center, they are placed onto a conveyor that rolls them into a warehouse, where they are processed and staged for delivery. Before the conveyor was installed—a suggestion made by UBT member Pablo Raygoza, a storekeeper and SEIU UHW member—workers had to do a lot of bending and lifting to pick boxes up, handling each one multiple times. The improvement was part of a three-year effort to increase worker safety by redesigning and streamlining work processes. As of March 2013, the effort had kept the Supply Chain department injury free for more than 660 days and earned it this year’s regional President’s Workplace Safety Award.

Northwest

The Northwest welcomed 2013 with a recommitment to the region’s hospital’s unit-based teams at a three-day Value Compass Refresh meeting, attended by more than 300 UBT co-leads, subject matter experts and regional leaders. Groups explored subjects like overtime, process improvement and patient flow. In the end, hundreds of potential projects were identified by co-leads and subject matter experts to take back to their UBTs for discussion and next steps. Representatives from the Operating Room UBT discussed opportunities to improve communication with surgeons. On hand was Imelda Dacones, MD, the chief medical officer of the Westside Medical Center (slated to open this summer). She listened with an eager ear and asked questions of the teams to help understand the challenges. “All the physicians who have privileges at the new hospital,” she says, “will go through the Patient Safety University training.”

Ohio

Members regularly complained about long waits for prescriptions at the Parma Pharmacy, so the unit-based team decided to map the prescription-filling process using a spaghetti diagram. The tangled web of lines captured in the drawing told the story and pointed to the root cause of the problem: Pharmacists did a lot of unnecessary walking and backtracking. The primary culprit was walking to and from the technicians, who are located in the front of the pharmacy, to deliver prescriptions. The team decided to move pharmacists closer to the techs—a small change that gives pharmacists more time to dedicate to filling prescriptions and shaved wait times by 84 seconds, or 14 percent.

Southern California

The eight-person nephrology unit at the Stockdale Medical Offices has always exceeded regional goals for its discipline and prided itself on the care it provides its kidney transplant patients—but it got a rude awakening in January 2012, when it saw fresh data from the regional renal business group. The team was merely average. Team members got busy, analyzing the metrics and scouring patient records. To help flag the care each patient needs, they turned to the Proactive Office Encounter functions in KP HealthConnect™. They hosted a special short-term clinic just for transplant patients. Nurses made outreach calls. And the percent of patients getting five key services shot up—flu shots (up 50 percentage points), dermatology appointments (up 32 points), renal ultrasounds (up 22 points), annual follow-up visits (up 25.5 points) and lab work (up 26 points).

Colorado

More than 60 trained champions are helping to motivate co-workers in their facilities to live a healthy lifestyle. Employees, managers and physicians are taking part in health fairs, 5Ks, healthy potlucks and Instant Recess™ sessions throughout the region. The region is also participating in the Spring Into Summer Challenge, a program-wide, team-based KP Walk activity to encourage walking during the longer daylight hours. Teams are forming with people of all fitness levels, especially employees who aren’t normally active. “Any change toward a healthy lifestyle is a success,” says Susan Mindoro, Total Health labor liaison for UFCW Local 7.

Georgia

The Southwood Specialties gastrointestinal UBT in Georgia increased efficiency and saved money by scheduling contract physicians, patients and nurses more strategically. The department handles both anesthesia cases (which require a physician to perform) and also sedations (which can be done by nurses). This Level 4 team figured out how to schedule contract physicians for four days a week instead of five by tracking which patients needed what level of care—making the most efficient use of a very expensive resource. The project required agreement, communication and coordination between the GI providers and teams at four KP clinics in Georgia to schedule their cases accordingly. The project saved $113,000 between April 2013 and January 2014.

Hawaii

After the nurses at Hawaii’s Ambulatory Surgery and Recovery unit created a brochure that standardized the information given to members during their visits, patients have a better understanding of wait times, department hours, visiting hours, where to get parking validated and the location of key departments. The team surveyed selected patients three times from October 2012 to April 2014. Team members tweaked information in the brochure based on feedback, says Maria Scheidt, an RN and member of the Hawaii Nurses Association, OPEIU Local 50. After the first survey, 70 percent of patients reported they received and understood the brochure. After the second survey, 90 percent said they understood it. By the third survey, the nurses had successfully educated 95 percent of patients.

Mid-Atlantic States

From Virginia to Maryland to Washington, D.C., nutritionists in UBTs identified children at risk for obesity and recruited them for Kaiser Permanente’s Healthy Living for Kids and Families course. Piloted in Northern Virginia, the project tracks the success of 11- to 14-year-old patients in establishing healthy eating habits, increasing daily activity and bolstering self-esteem. By drinking less soda or juice, exercising each day and curbing television viewing, a third of participating children at one medical center lost an average of 5.8 pounds in three months. Team members credit their partnership with pediatricians and the families for the results. 

Northern California

The region’s new Real-Time Attendance Estimator does what no other tool has done before: It projects into the future. The tool lets a cost center see how sick day use is affecting its ability to meet its year-end attendance goal by calculating the number of sick days that could be taken in an upcoming pay period without derailing progress toward that goal. If the number of sick days being taken needs to be reduced to meet the goal, the estimator shows that, too. The information is shown as a signal light—easy to print out and post.

Northwest

Fifty-eight percent of staff members in the Northwest who are eligible for the Total Health Incentive have taken the Total Health Assessment—one of the highest participation rates program-wide. Members of unit-based teams are finding ways to help cover each other so they have time to take the assessment. Managers are backing the effort, which is a key step in earning the incentive. “Since the UBT agreed that the THA would be a project, I supported folks completing the assessment during work time since it is work- and goal-related,” says Jason Curl, department administrator for Primary Care at Tualatin Medical Office. 

Southern California

The region’s Jobs of the Future Committee has assigned four subgroups to identify trends in technology and innovative care delivery methods. The subgroups are inpatient nursing, ambulatory nursing/primary care, laboratory and diagnostic imaging. Each is led by labor and management partners. The groups are researching the impact of innovations on today’s jobs and making recommendations regarding training and recruitment of the workforce of the future to best support these initiatives. Work already is starting, for instance, at the South Bay Medical Center, which is exploring new staffing models as part of its plan to open a mini-medical office building—which is in turn part of the larger Reimagining Ambulatory Design initiative. In Kern County, UFCW has collaborated with management on a mobile health van project to optimize staffing for this creative way to deliver care.

Colorado

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.

Georgia

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. 

Hawaii

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. 

Mid-Atlantic States

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.

Northern California

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.

Northwest

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.

Southern California

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.

Colorado

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.

Georgia

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.

Hawaii

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.

Mid-Atlantic States

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.

Northern California

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.

Northwest

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.

Southern California

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.