Culture

The Sponsorship Dilemma

Submitted by cassandra.braun on Thu, 11/08/2012 - 23:08
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A look at UBT sponsorship, the challenges it faces, and the key role it plays in the success of teams.

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Non-LMP
Editor (if known, reporters)
Tyra Ferlatte
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Gena Bailey, a service area director and UBT sponsor in the Northwest, and Melissa Garan, a medical assistant and SEIU Local 49 member
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The sponsorship dilemma
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Active sponsors drive high-performing teams. Can partnership overcome the short supply?
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If you ask Los Angeles Medical Center sponsors Ilda Luna and Sanjit Sodhi for the secret to successful sponsorship, they’ll agree it boils down to investment—of time, trust and respect—in each other, in their teams and in the collaborative work process.

Luna, a family medicine receptionist, and Sodhi, the chief financial officer for LAMC, didn’t know each other when they were asked to co-sponsor the Health Information Management, Admitting and Patient Revenue, and the local business office teams—teams that were failing to meet performance goals and were entrenched in mistrust between labor and management.

“Sanjit said, ‘Tell me what I need to do to get us up and running,’ ” recalls Luna, a member of SEIU-UHW. “I said, ‘You need to meet with your teams. If you invest time in labor, you’ll get huge dividends.”

Like most investments, success didn’t happen overnight—and it wasn’t guaranteed. But after a year and a half of perseverance, dedicating time and hard work to supporting the work of those teams, the pair has watched the departments go from being in the red in most metrics to seeing huge improvements in areas like attendance and co-pay collection.

“We’re taking on types of projects that we could never have dreamed of a year ago,” Sodhi says. “And when you work though relationship issues and put the focus back on partnership and performance improvement, it’s highly satisfying.”

What’s so special about sponsors?

A 2011 study by Johns Hopkins University, Rutgers University and Kaiser Permanente identified five key characteristics of high-performing teams, including “consistent, aligned and visible sponsorship.” It confirmed what has been seen throughout the organization—strong sponsorship and support from higher levels of leadership are key factors in a team’s success.

The reasons are straightforward. Many frontline workers say simply having leaders’ involvement and support gives their work validation, letting them know that what they’re working on is important, that their contributions matter. In addition:

  • Sponsors mentor unit-based teams and connect them with effective practices and other resources to help them do their work.
  • They help break down barriers and provide guidance on setting goals that line up with local and national performance goals.
  • They act as role models and advocates for working in partnership.

“There are teams that need both management and labor sponsors to model partnership behaviors, who can agree to disagree and who can have some healthy courageous conversations till they get to an outcome,” says Vicki Barkan, the UBT consultant at the Los Angeles Medical Center. “Sometimes teams and co-leads haven’t experienced that, so they need to see it. It really helps to further the team dynamics.”

Sodhi agrees.

“As sponsors,” she says, “we have the same common goals and mutual respect for each other” that team members should have. “It trickles down to the rest of the UBT.”

“Sponsorship is a way to help move UBTs forward,” says Diane Ochoa, the regional director for Medical Group Support Services in Northern California and a former San Jose Medical Center medical group administrator. “It’s just like having a mentor, somebody you can talk to, to help you with issues and celebrate with you, and be there to really acknowledge the work you’re doing.”

So, what’s the problem?

Yet sponsorship is still a developing area in the partnership structure, even though many regions find that without active union and management sponsors, UBTs’ performance improvement work stalls.

Several challenges get in the way, and chief among those is time. Sponsors repeatedly cite the difficulty of finding time in their regular work to mentor teams. Labor sponsors face the added challenge of needing to cover their duties when they’re away from their usual post, lest those duties fall to colleagues.

Even with a commitment from facility and department leadership to backfill her position when her sponsorship work takes her away from her regular job, Luna, who is the union co-lead for the medical center’s LMP Council, says there isn’t enough time for everything she needs to do.

“But you have to make time,” she says. “I put in my own time, during lunch and after I clock out.”

Luna’s partner Sodhi agrees. The time challenge has to be reckoned with—but it’s a challenge worth solving.

“I’ve definitely made it a priority,” she says. “It was tiring devoting all that time, but I knew that I needed to do that to develop my relationships. In order to achieve any results, I knew I had to invest in time.”

“Capacity” is another word that surfaces when sponsors talk about challenges. Identifying people who can be strong sponsors and ensuring they have the tools and skills for the role is not easy. Labor bears the brunt of this barrier, in part because the unionized workforce typically has a smaller pool of leaders to draw from than management has. Many potential labor sponsors lack the consulting and facilitative skills required to mentor a team. As a result, union sponsors are in short supply, and those few become overwhelmed, with too many teams to support.

“I think that with labor, with so much work to do for our regular jobs, this is too much,” Luna explains. “So a lot of my peers didn’t want to do it. (Or) the ones who want to do it couldn’t get released because of operational needs. Patient care comes first, so operational need is a huge barrier.”

Solutions?

Some say successful sponsorship won’t happen until sponsors are held accountable, with their success tied to performance goals and financial compensation.

But in the meantime, many medical centers and regions are wrestling with finding other solutions to these issues. As a first step, some are revamping their training to clarify roles and responsibilities, which many sponsors—both labor and management alike—say have not been clear.

“It will be helpful for people to understand what they are supposed to do and see examples of how that’s done,” Ochoa says. “This is relatively new for some labor folks especially, and the more we can give them the tools to be a good sponsor, we need to do that.”

At the Los Angeles Medical Center, the facility’s LMP Council has made a series of changes in the last year it thinks will help shore up sponsorship. These include establishing criteria for becoming a sponsor, to make sure the right people are in the role and can model partnership and leadership behaviors; aggressively recruiting union co-leads of high-performing teams to become sponsors to increase the labor sponsor pool; and reassigning UBTs so a sponsor has no more than five teams.

Ultimately, time and commitment always will be challenges, but the potential rewards—the culture change and performance improvement work that come with high-performing teams—make the investment worthwhile. If sponsorship remains a barrier, there is a risk that teams will get discouraged.

As Luna says, “To be successful, we need successful sponsors and to build credibility with our teams. And we want to be successful.”

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Solving the Sponsorship Bind

Submitted by cassandra.braun on Thu, 11/08/2012 - 23:02
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Hank
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Preliminary results from a comprehensive Office of Labor Management-sponsored study on the state of sponsorship across Kaiser Permanente.

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Non-LMP
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Tyra Ferlatte
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Solving the Sponsorship Bind
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High-performing teams deliver better results. Figure out how to get teams the sponsorship they need
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It’s hardly a secret that sponsors are critical to a unit-based team’s performance. Look at any high-performing team, and you’re likely to find an engaged sponsor. The link is so fundamental that teams can’t be rated at Level 4 or 5 on the Path to Performance without sponsors.

That leaves teams with a Catch-22, however, because they can’t control whether they have sponsors or how effective those sponsors are.

Paradoxically, despite the clear links between sponsorship, high-performing teams and results, sponsorship has not received as much attention as other areas in the partnership structure.

“We have had a plan for team development but not a plan for sponsorship,” says John August, the executive director of the Coalition of Kaiser Permanente Unions. But that, he says, is changing with the 2012 National Agreement, which took effect Oct. 1.

The agreement outlines prescriptive measures to strengthen sponsorship organization-wide, mandating that “sponsors will receive more comprehensive support to be effective in their role.”

As a first step, the Office of Labor Management Partnership conducted a study this summer that surveyed more than 8,700 co-leads, sponsors and UBT consultants and included focus groups and dozens of one-on-one interviews.

“This is a great opportunity to impact sponsorship,” says Janet Coffman, the coalition’s director of education and transformation. “Sponsorship can feel so far away when it’s ineffective, but when it works well, it can be the key to UBTs’ success.”

The preliminary results give credence to the anecdotal, recurring complaints about sponsorship. The frequently expressed concerns documented by the study include:

  • Multiple and inconsistent training for sponsors.
  • Limited leadership development training, tools and resources.
  • Poor comprehension and inconsistent use of tools and processes.
  • Inconsistent engagement and oversight of sponsors by executive management, physician and labor leaders.
  • Few opportunities for sponsor-to-sponsor sharing and networking.
  • Limited resources available to assist in addressing complex UBT issues.
  • Lack of an organizational plan and commitment to develop UBT sponsorship as a business strategy across management, physician and labor groups.
  • Perception of insufficient funds and staffing allocated to sponsorship work.
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Manager Sponsor Profile: Linda J. Bodell

Submitted by anjetta.thackeray on Thu, 11/08/2012 - 22:34
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Linda J. Bodell, clinical director of Medical-Surgical Services at the Fontana Medical Center, discusses what works as a management sponsor of UBTs.

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Non-LMP
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Tyra Ferlatte
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Linda J. Bodell
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Additional resources

Linda Bodell, Linda.J.Bodell@kp.org, 909-427-6467

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Manager sponsor profile: Linda J. Bodell
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Helping teams do their best work
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Linda J. Bodell has a simple formula for being a good sponsor of unit-based teams: Show up. Be of service. Clear a path. Bodell, a former clinical nurse specialist, spent much of her career in critical care settings where patient cases are often unstable and complex. She learned to be watchful and attentive. Today, those lessons define her as a sponsor of four teams at the Fontana Medical Center. She meets with her teams and her labor partners each month. Her personal goal is to understand what works and what doesn’t—and to get to the “why.” Bodell’s teams praise her for guiding them through facility and regional business goals, yet trusting the teams to find solutions that deliver needed results. She talked about being a sponsor with LMP senior communications consultant Anjetta McQueen.

Bodell was clinical director of Medical-Surgical Services at the time this article was written; she is now director of Clinical Care.

Q. Please share one of your best practices.

A. Show up at every team meeting, even if it’s only just one 15-minute window. It’s once a month per team. It’s essential. There is no substitute for being present. Let your teams tell you what they are currently working on. You tell them what’s going on…because they need it to complete their projects successfully. They haven’t had a bloodstream infection in 16 months? They need to hear where they are being successful.

Q. Would you describe an instance when you removed a barrier?

A year and a half ago, an RN and PCA (personal care attendant) from one of my teams asked to get a blood pressure machine that could stay in the patients' rooms. I did that—we had a department closing. I acquired a unit that could stay in one of the isolation rooms. It’s just those little things that make a difference in their work experience every day.

Q. Are there aspects of your past experience that have enhanced your sponsorship?

A. I have served on several nonprofit boards and as a volunteer, in different areas of health care and in Oman and South America, and that’s about taking a service to people, and it’s the same thing I do here as a sponsor. It’s my job to serve them so that they have everything they need to do their job the best they can. I know they care about their patients and their colleagues. They need to know that I care about them and what they do, and that it matters.

Q. Have your teams ever solved something you thought was unsolvable?

A. I would ask them! But the 4 West Med-Surg team was having a difficult time with workflows and getting to their supplies. They work where there are long hallways, where the 34 beds are arranged in a rectangular shape around the unit. This did not look like a process that could be fixed. They did the spaghetti diagram on how many steps nurses take. And the staff, together, made decisions about how to change, where they have their supplies, and how they were arranged. They worked on their workflow. Now the service scores are phenomenal.

Q. What inspires you each day in your duties as a sponsor?

A. So when you know what the goals are and what the actual plans are, and you go out and round on the department, and you can see those in living proof. It’s just exciting to see that this process really affects practice and activity at the unit level.

Words from the front line

“She really has an open door and an open heart. Linda has been a wonderful mentor. She is patient and stays calm under pressure. She knows how to lead you without just handing you the answers. She keeps you focused on what’s important.”—Letty Figueroa, RN, assistant clinical director and management co-lead, 4 East Med-Surg UBT, Fontana Medical Center

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Poster: Three Steps of Systems Thinking Andrea Buffa Thu, 11/08/2012 - 22:22
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Tool Type
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Hank

Format:
PDF

Size:
8.5" x 11"

Intended audience:
Frontline employees, managers and physicians

Best used:
This poster, for use on bulletin boards in break rooms and other staff areas, explains how the three steps of systems thinking can be used when solving a problem.

poster_systems_thinking

This poster, which appeared in the Fall 2012 Hank, explains how the three steps of systems thinking can be used when solving a problem.

Non-LMP
Tyra Ferlatte
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Hank Libs: Calling on Sponsors!

Submitted by Andrea Buffa on Thu, 11/08/2012 - 22:17
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Format
Hank
Taxonomy upgrade extras
puzzles_and_games_Hank_libs_fall_2012

Have some fun—and reinforce the importance of sponsorship—by using this "Hank lib" at your team meeting.

Jennifer Gladwell
Tyra Ferlatte
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Format:
PDF

Size:
8.5" x 11"

Intended audience:
Frontline workers, managers and physicians

Best used:
This "Hank lib" provides some variety and fun at a team meeting while highlighting the importance of sponsorship.

 

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Crossword: Leadership

Submitted by tyra.l.ferlatte on Wed, 10/24/2012 - 18:16
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Format
crossword_leadership

Use this crossword puzzle to provide some variety in your next meeting.

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Tyra Ferlatte
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Format:
PDF

Size:
8.5" x 11"

Intended audience:
Frontline workers, managers and physicans

Best used:
This crossword reinforces concepts of leadership; use it to provide some variety and fun at a team meeting.

 

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Word Search: Spreading the Word

Submitted by tyra.l.ferlatte on Wed, 10/24/2012 - 18:03
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Format
Running Your Team
wordsearch_spreadingtheword

Use this word search to provide some variety in your next meeting.

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Tyra Ferlatte
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Word Search: Spreading the Word

Format:
PDF

Size:
8.5" x 11"

Intended audience:
Frontline workers, managers and physicians

Best used:
When you need to break it up next time, use this word search about electronic communications and other marketing terms.

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Word Scramble: Partnership Fundamentals

Submitted by tyra.l.ferlatte on Wed, 10/24/2012 - 17:45
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Topics
wordscramble_partnershipfundamentals

Use this word scramble to provide some variety in your next meeting.

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Tyra Ferlatte
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Word Scramble: Partnership Fundamentals

Format:
PDF

Size:
8.5" x 11"

Intended audience:
Frontline workers, managers and physicians

Best used:
To provide some variety and fun at a meeting while helping team members learn partnership concepts.

 

 

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Tile Scramble: Guided by the Value Compass

Submitted by tyra.l.ferlatte on Wed, 10/24/2012 - 17:36
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Format
TileScramble_GuidedByValueCompass.jpg

Use this tile scramble to provide some variety in your next meeting.

Non-LMP
Tyra Ferlatte
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Tile Scramble: Guided by the Value Compass

Format:
PDF

Size:
8.5" x 11"

Intended audience:
Frontline workers, managers and physicans

Best used:
This tile scramble underscores concepts about the Value Compass. Use to provide some variety and fun at a team meeting.

 

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UBT Facilitative Support Plan

Submitted by Vaughn.R.Zeitzwolfe on Mon, 10/08/2012 - 16:54
Tool Type
Format
Content Section

Developmental support is a key element in helping teams move along the Path to Performance. This worksheet helps consultants, advisors, sponsors and co-leads map out a support plan.

Non-LMP
NOTE: Description in worksheet is a little over twice as long as it is here for better communication of purpose, while keeping this section below 300 characters.
For Leadership 1-5, Use of Tools 1-5
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UBT Facilitative Support Plan

Format:
Word document

Size:
8.5" x 11"

Intended audience:
Support staff including consultants, advisors, co-leads, and sponsors

Best used:
Developmental support is a key element in the successful implementation of transitioning UBTs. Support teams must be aware of the three behavioral "levers" they can pull to effectively help a team: expressing (what you say), modeling (what you do), and reinforcing (how you back it up). Use this form when beginning to work with a support consultant or advisor.

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