‘Problems Are Only Opportunities…’
Disagreements among teammates suck up time and energy. The National Agreement offers a solution that fuels creative problem solving: the issue resolution process.
This department used issue resolution to make the selection process for a plum leadership role fair and transparent. How can your team use that process to improve your work environment?
Disagreements among teammates suck up time and energy. The National Agreement offers a solution that fuels creative problem solving: the issue resolution process.
When this team looked deeply to find out why its turnaround time wasn't up to par, it found a web of problems. Issue resolution helped members untangle that web and speed service to patients.
Patient transportation workers at Sunnyside Medical Center in Portland were in a tough spot: No matter how hard they scrambled, they were constantly running late to pick up patients.
Some of the challenges were clear. The transport workers, members of SEIU Local 49, are qualified to backfill certified nursing assistant positions—and short-staffed nursing units were calling on them to do just that.
In addition, a new computer-based dispatch system had automated patient transfer requests but required fewer dispatchers. The resulting staff upheaval, along with rumors about changes to their certification requirements, threw the unit-based team into turmoil.
Amid frustration and mounting delays—the team was only infrequently meeting its goal of getting to the patient within 15 minutes—improvement advisor Lolita Burnette worked with the team to resolve its issues. To better understand its challenges, she created a process map of the team’s workflow. That turned up a variety of obstacles that were thwarting efforts to improve times.
“Shadowing the team was an eye-opener. We discovered issues that were immediately actionable,” says Burnette. Because of the complexity of the situation, team members called for an issue resolution to identify solutions.
“My staff are really concerned about their patients. They had valid concerns about what was hindering our on-time performance,” says Marta Witsoe, the team’s management co-lead.
The issue resolution took place from July to September last year and helped further identify issues that were impacting on-time performance, as well as showing how delays affected imaging appointments and patient satisfaction.
As it tracked the source of delays, the team discovered that often, the patient was not ready to be moved when transporters arrived. The patient might need a different gown for imaging, or needed to take medications before being moved. Making matters worse, nurses and other staff members had gotten accustomed to transport arriving late and often put in orders ahead of time. But if the transport person arrived on time, the resulting delay had a domino effect, making it more difficult to be on time for subsequent transport requests.
As a result of the issue resolution, the team is partnering with other units to become more efficient. Several improvements are being worked on simultaneously to increase productivity and overall satisfaction—and the team is confident the changes will lead to improved metrics.
In perhaps the most significant change, hospital leadership agreed to hire additional transport staff. The new positions are dedicated to support the Emergency Department, a frequent source of patient transfer requests.
“With time and commitment,” says Esther Logan, the team’s union co-lead, “we agreed upon issues that needed to be addressed within the department.”
Olivia Devers, a labor partner with SEIU Local 49, added, “This IR process was the most positive that I have witnessed in many years—the team and management worked in true partnership from start to finish.”
When problems linger, they make it hard for departments to focus on improving care and service. Use issue resolution and other partnership tools to vanquish those problems, once and for all.
Henry J. Kaiser, Kaiser Permanente’s co-founder, famously told fellow industrialist Warren Bechtel, “Problems are only opportunities in work clothes.”
If you work with unit-based teams—as a co-lead, consultant or sponsor—you might be rolling your eyes right now and thinking, “Well, if that’s true, I sure have a lot of ‘opportunities.’ Grrr!”
When a team has problems, it’s difficult—if not impossible—to boldly improve service and quality for our health plan members. Especially if problems linger and fester, eroding trust and goodwill. These can depress morale and even endanger patients.
Lucky for us, the leaders of Kaiser Permanente and the Coalition of Kaiser Permanente Unions had the moral imagination more than two decades ago to envision a better way to solve problems. Together, they formed what would become our Labor Management Partnership.
As we celebrate our partnership’s 20th anniversary this year, we can look back and see how we have built the tools, structures and culture that support this alternative vision of how workers and employers can interact.
One of those tools is issue resolution. As you will see in the stories that follow, this process bypasses more traditional forms of problem solving in favor of going deeper to really uncover the source of the difficulty. By doing that, union members, managers and physicians not only can preserve their working relationships, but also make them stronger. This, in turn, fosters innovation and improvement.
Now that sounds like a great opportunity.
Format:
PDF (color or black and white)
Size:
8.5" x 11"
Intended audience:
Union members, stewards and leaders.
Best used:
Use this tip sheet to help you prepare for taking part in the issue resolution process.
Insider tips from a union leader about how to ensure workers' voices are heard during the issue resolution process.
Format:
PDF (color or black and white)
Size:
8.5" x 11"
Intended audience:
Faciliators and others involved in leading the issue resolution process.
Best used:
Use these tips when you are having hard conversations during the issue resolution process.
When the going gets tough during the issue resolution process, the tough need these tips about how to move things forward and preserve working relationships.
Format:
PDF (color or black and white)
Size:
8.5" x 11"
Intended audience:
Any union and management leaders involved in solving workplace problems.
Best used:
Use this chart to decide whether a grievance or issue resolution would be the best method for solving a sticky situation.
Need a quick refresher on the difference between grievances and the issue resolution process? Download this handy chart.
Format:
PDF (color or black and white)
Size:
Two pages, 8.5" x 11"
Intended audience:
UBT co-leads, consultants and sponsors, as well as facility-level leaders.
Best used:
This infographic is best used to understand the issue resolution process, step by step.
Got issues? Use this handy flow chart to follow the road to issue resolution.
What's a phrase that helps you keep your cool in a tense situation?
Our comic superhero shows how everyone has a part in solving problems in their department's UBT.