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The Transportation department in the Northwest is coming out of a tumultuous time. A lack of trust between managers and employees created a barrier that affected morale—and made it difficult to focus on improving routes and processes.

The department uses a robust but complex process for optimizing its routes. For maximum efficiency, it has to integrate a variety of work streams and figure out where there are redundancies that can be eliminated. Because of the complexity of the process, however, it had been more than 15 years since the criteria and requirements for the transportation system from the customer’s point of view had been reviewed.

Eventually, the UBT worked out a thorough route-modernization plan based on data-driven service requirements and metrics that established parameters on how to revise and design its routes.

But before it got there, it had to fix its communication, which broke down so badly the team entered into an issue resolution. In the Northwest, the LMP Education and Training department is responsible for facilitating issue resolutions.

Blame-free solutions

“There was a lot of tension in the department, and people were nervous about losing their jobs as a result of our work around revamping routes. Poor communication was a problem,” says Greg Hardy, sponsor and manager of the department.

The issue resolution process uses interest-based problem solving, and that helped the team focus on a common goal: Serving its customers was the top priority and improving communication was a necessity. From there, other agreements came more easily, and the department was able to maintain staffing levels and improve processes as a result of its efforts.

Improved communication improves service

As a result of the improved communication, the team was able to improve service levels and achieve the efficiency and cost savings it had strived for.

“We have a group of dedicated workers who want things done the right way,” says logistics supervisor Chris Dirksen, the team’s management co-lead.

When it came to improving communication, the team members’ first step was to get a baseline measurement of what they were trying to improve. They created a survey that would measure not only communication but also morale and UBT effectiveness. Once they had that information, they created a SMART goal: to improve employee perception of communication, morale and UBT effectiveness by 15 percent within three months, raising the overall survey score from 2.55 to 2.93 by February 2014.

As the team began to investigate the issues, it discovered email was not a good form of communication. Fewer than 20 percent of the team members knew how to log on and use Lotus Notes. The team brainstormed ways get employees to use Lotus Notes email and frontline staffers began to instruct and coach one another.

Three months later, the team sent the survey out again and found it had met its goal. Perception of communication improved 48 percent, morale improved by 56 percent and UBT effectiveness improved by 21 percent. The team scored 3.4 on its survey, exceeding its stretch goal of 2.93, and anecdotal reports are that the communication success is continuing now that the team has successfully completely the issue resolution.

New ways to communicate

Team members use several means now for communicating with one another, including email. A communication board has been set up in the department’s headquarters, near dispatch, that includes information about the projects the team is working on, notes from UBT meetings and a copy of the department’s weekly e-newsletter, “Heads Up.”

In addition, the team has gone from a representative UBT to a general membership UBT and now has regularly scheduled meetings throughout the region, so that all employees are able to participate. “This has been our biggest success to share information,” says UBT union co-lead Nickolas Platt, a courier driver and member of SEIU Local 49.

“It’s cool to watch from meeting to meeting how more people show up each time,” Hardy says. “The engagement of the team has increased as we began to see improvement, and people could see change.”

A January UNAC/UHCP steward meeting in Southern California included a traveling version of the Imagining Care Anywhere exhibit, and nurses across Southern California weighed in with their thoughts about the emerging technologies.

Gracie Johnstone, RN
Kern County

Our dermatologist left and we didn’t have one for a while. We did “tele-derm” with a doctor in Orange County. We trained the medical office assistants on how to set up the technology. We could do the biopsies, if needed, at Kern. It evolved really nicely. It saves a visit for the patient. I don’t think all this technology will take jobs from nurses because we still need the human touch. Nurses will become more techno-savvy.

Pam Brodersen, NP
Downey Medical Center

It’s great, but we have to slow down a bit. We don’t want to become an app. We still need that human connection.

Yoshini Perera, RN
Downey Medical Center

I love change, but I’m a little concerned we might get out of touch with the patient. As long as we can listen to and touch and feel the patient, that’s OK.

Nelly Garcia, RN
Panorama City Medical Center

I am concerned about the ability of computer systems to communicate with each other. We need to get the systems to connect in order to provide the best service.

Gerard Corros, RN
Irvine Medical Center

It’s like having a Ferrari all of a sudden. You can drive really fast, but you need speed limits.

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.