Library

I have a friend who loves to play softball. In 1999, she tore her left Achilles tendon while sliding into first base. Her surgery involved getting cut open and then stitched up, which was painful and created a risk of infection. It put her in a heavy cast for six months, left a five-inch scar and was an all-around miserable experience.

Four years later, while playing racquetball, she (you guessed it) tore her right Achilles tendon. In just those few years, surgical technology had improved so much that she could get her leg patched up with laser surgery. She still had to wear a cast — but for only three months this time, and there was no scar. There was hardly any pain. “It was like night and day,” she says. 

When someone says, “I don’t want to learn the new way. The old way works just fine,” I tell them about this friend.

Imagine that her doctor and care team had not bothered to learn about the laser surgery. Their patients would have suffered with a longer and tougher recovery than necessary. Caregivers want the best for their patients. That wouldn’t have been the best.

In everything we do, we put the patient and member at the center. Developing the skills of our workforce is no different. We learn new treatment methods to help our patients get better faster. We learn new software programs to help them get their medications more quickly and efficiently. We figure out the new technological gizmos so we can have virtual visits with our members, saving them the time, effort and sometimes discomfort of getting to our brick-and-mortar offices. We invent new ways of doing old jobs, or create entirely new jobs, to meet new needs.

Giving up the old way of doing things is scary, but also liberating. Learning new things can be difficult, but also fun. We’re navigating our way into the future together, supporting one another all along the way. 

In the early 2000s, Blockbuster ruled the video rental roost.

Now it’s all but gone.

Blockbuster didn’t adapt to customer needs and technology trends. Netflix did.

Kaiser Permanente and the Coalition of Kaiser Permanente Unions recognize that if you don’t change with the times, you can get left behind.

The National Agreement addresses the importance of preparing for the future in partnership; section 1D of the agreement covers workforce planning and development.

Under the 2015 agreement, two educational trusts — Ben Hudnall Memorial Trust and SEIU UHW-West & Joint Employer Education Fund — received additional funding to provide workers represented by a coalition union with a variety of services, and training and education programs. Joint work on addressing experience barriers, which have sometimes prevented newly trained workers from being hired into KP jobs, is also under way.

The agreement details the structure for coordinating workforce planning and development. A national team aligns, integrates and coordinates workforce development and training efforts in partnership with the regions. Each region has a workforce planning and development committee chaired by labor and management co-leads.

The five key components of this work are:

• workforce planning and development
• career development
• education and training
• redeployment
• retention and recruitment

“The goal is to prepare union workers for changes to jobs,” says LeAnda Russell, the coalition’s national coordinator for job innovation. “We support the lifelong learning and career development of our workers.”

It’s paying off. Use of the educational trusts has increased to record levels.

Russell encourages employees to keep learning to build the job skills needed as health care evolves. In other words — don’t hit the rewind button. It’s time to press play.

“Technology is here,” Russell says. “Don’t be afraid.”

For Carolina Aceves, technology and health care go hand in hand.

Shortly after completing a new online digital fluency course for Kaiser Permanente employees, she saw firsthand how technology can transform a life. Her mother needed a kidney transplant, but neither she nor her siblings were a match. In October 2017, however, in a series of matches orchestrated through a national computer system, she donated a kidney as part of a chain of donations that resulted in her mother receiving a kidney.

In December, she returned to work at the California Service Center in San Diego, where she is an account administrative representative, fielding calls from KP members and answering their questions. She also chairs a young leader council for OPEIU Local 30 — and is leveraging that role to mobilize all represented members of her unit-based team, urging colleagues of all ages to take the digital fluency course.

“Health care is changing,” Aceves says. “Be current. Do your homework. Advance your career.”

At ease with technology

Digital fluency is one of four critical skills that will be essential in the health care of the future. The new online program, which helps participants understand the role of technology in health care, is free to workers represented by a union in the Coalition of Kaiser Permanente Unions through the Ben Hudnall Memorial Trust, the SEIU UHW-West & Joint Employer Education Fund, and National Workforce Planning and Development.

The national workforce office also is developing programs for the other three critical skills — consumer focus, collaboration and process improvement — as part of a larger strategy to encourage employees to upgrade their skills, advance their careers and meet the changing demands of health care.

“Whether you work in a medical center, clinic or office, we encourage employees to take the digital fluency program,” says Monica Morris, the director of National Workforce Planning
and Development.

Digital fluency skills are good for workers, KP members and the organization, says Jessica Butz, the coalition’s national coordinator for Workforce Planning and Development. While some may fear technology will eliminate jobs, the push at KP is to use it not to replace workers but to enhance the care and service they deliver.

“Learning these critical skills will prepare our workers for jobs in the future and give them the tools to shape and improve care for our members and patients,” Butz says.

As we celebrate the 20th anniversary of the Labor Management Partnership, Hank would like to call out the tens of thousands of individuals who have made partnership a success: the frontline workers, managers and physicians who have believed in our ideals and taken the time to build the positive working relationships that are the backbone of this groundbreaking endeavor.

Visit Humans of Partnership to read their stories—and look through their eyes into our past, our present and our future. 

When Terri Imbach, Family Practice manager at Mt. Scott Medical Office in the Northwest region, and labor co-lead Christina English, a licensed practical nurse and a member of SEIU Local 49, began to work together as UBT co-leads several years ago, they knew they needed to shake things up with the department’s unit-based team. 

The staff worked hard to meet the demanding needs of the fast-paced medical office, but morale wasn’t great—and team members weren’t taking ownership of improvement work. UBT meetings were poorly attended and often turned into complaining sessions.  

The co-leads’ first move was to go to UBT training classes together. That experience gave them an idea for their next move—which was to shake things up between the two of them by stepping away from work and getting to know each other outside the office. 

“Getting out of the work environment is a good way to get away from the stress of the department,” explains English. This mindset set the tone for how they would operate together and helped them sustain a good relationship over time.

The co-leads also adopted “fun” as part of their regular UBT agenda, and meetings now are attended by nearly 100 percent of the staff.  

“We think of fun ways to get to know each other in and out of the office, and we work to include fun elements in all of our meetings,” Imbach says. During the holidays, team members played relay games at their UBT meeting, and they participated in a fundraiser for a local youth organization that included playing basketball on donkeys. 

The creative energy of the co-leads has helped engage all 40 members of the Level 5 team, who are juggling more than a dozen quality projects. 

“Team members step up to take on projects now,” English says, “and there are friendly competitions to meet our goals.”

Emile Pinera, MD, a second-generation Kaiser Permanente employee, came to the company five years ago and immediately became co-lead of an adult medicine unit-based team in the Georgia region.

“I had the clinical part down,” says Pinera, who is now lead physician for diversity and inclusion in Georgia and an adviser on the region’s transgender task force. But being a co-lead and working in a UBT were unfamiliar. “I had to implement my medical knowledge in a team, as opposed to a top-down approach where the doctor tells everyone what to do.” 

He wasn’t convinced at first—but the partnership approach and physician participation helped elevate the team’s performance, and it posted some of the region’s highest quality scores for managing diabetes and blood pressure. 

“We achieved it through hard work and collaboration,” Pinera says. “I loved working with my management and labor co-leads. We were respectfully honest about what was achievable. Working in the UBT gave us the tools to effectively communicate, track, adjust and improve.”

Pinera currently guides and supports co-leads as a UBT sponsor for three teams and is lead physician for three adult medicine offices. His enthusiasm helps his teams, the members and the Georgia region. 

“I was skeptical at first about UBTs’ relevance, but we couldn’t achieve our success with hypertension and diabetes management without each other’s help. I’m a believer,” he says. “My tip for fellow providers is to be engaged as much as possible, because it will help us achieve better outcomes and help our patients thrive.”

“You have two ears and one mouth for a reason,” television’s Judge Judy frequently says, quoting an ancient Greek philosopher. “You should listen twice as much as you talk.” Successful co-leads realize that making a partnership work requires listening and learning from one another. 

Caroline Masikonde, RN, had been a management co-lead with the urgent care team at Largo Medical Center in the Mid-Atlantic States, an experience that helped her understand the importance of valuing her partner’s input. But when she accepted a new role as clinical operations manager in Northern Virginia Audiology in January 2016, she didn’t have any experience in audiology. So she’s relied heavily on her new labor co-lead, Lynn M. Reese, Au.D., a UFCW Local 400 member. Masikonde has learned why audiology UBT members escort patients outside (so they can try out new hearing aids in different conditions)—and her willingness to listen helped the co-leads bond quickly. 

“Lynn is very experienced,” says Masikonde. “I lean on her even now.” 

Reese, on the other hand, was new to the unit-based team structure, since the audiology UBT had just formed. That’s where Masikonde’s expertise came in. “We fit together pretty well,” says Reese. “Caroline is very open to listening and learning new things.”

Reese, too, expanded her knowledge, growing into an appreciation that she and Masikonde have equal say on what’s now a Level 4 UBT. “Everyone contributes,” says Reese. The ability to speak up led to Reese and the rest of the team requesting and receiving approval for an additional booth to test patients’ hearing. 

Relationship tested

Their new relationship was tested when a member—after waiting more than 12 weeks for a refund on a hearing aid that had cost more than $1,000—alerted them, loudly and angrily, to the problem. 

Instead of pointing fingers, UBT members figured out the issue: The refund request had to be processed through a department in Southern California, but the team had no way to follow up once the request was submitted. 

“This lady forced us to look at this and do better for our members,” Masikonde says. “It prompted us to come up with a better workflow,” and now the team has names and contact information for the people who work on the refunds.

“Even though it was a bad situation, she made us want to improve,” Reese says. 

Because the co-leads already were accustomed to relying on and listening to each other, they were able to quickly and calmly handle this tense situation with the unhappy member.

“We really learned our lesson,” Masikonde says. “Recently, we did a refund on a Monday—and by Friday, the member had the check. Lynn and I know our parts and do our dance.”

They finish each other’s sentences; they call each other “Mrs.”; they praise in public and correct in private.

Antronette Moore-Mohead and Joanna Harris are a model couple. They’d make a marriage counselor proud. 

They’ve been together for three years, but they’re not married (to each other, that is)—they’re the unit-based team co-leads in the National Claims department, based in Oakland. Since co-leads frequently move on to new positions, Moore-Mohead and Harris are a long-term couple in the world of UBTs. 

“We are all for the team,” says Harris, a national claims processor and OPEIU Local 29 steward, the UBT’s labor co-lead. “Praising workers’ effort or accomplishments helps keep morale up and folks engaged in their work.” 

“Being transparent is key to succeeding as a team,” adds Moore-Mohead, the department’s processing supervisor and the management co-lead. “Also, honest, clear, concise communication is a must. So is having fun.”

'Let's talk it out'

They share stories and photos of their families, they tease each other about maybe not needing that sugary snack, and they can tell when the other is “in rare form.” Even on days when stress is high, the two know when to give each other space or when to say, “Let’s talk it out.”

“We are free to bounce ideas off of each other, without fear of being shot down,” Harris says.

The positive vibe and mutual respect between the co-leads is apparent, but they are clear that they don’t mix outside of work time to alleviate any appearance of favoritism. 

“I love that Antronette is passionate about her work. She operates from the perspective of ‘there is no Big Me, little you,’” explains Harris. 

The department they lead is responsible for collecting fees and processing claims from services performed outside of Kaiser Permanente facilities. Last year, the high-functioning Level 4 team of 39 claims processors and examiners, who are represented by OPEIU Local 29, saved more than $6 million by negotiating better rates for services rendered outside of the network. 

“It’s important to pay it forward,” says Moore-Mohead. “We want to make sure we are growing our team and others have opportunities to learn.”

Su-Xian Hu and Runeet Bhasin make partnership look easy. The telemetry team co-leads at Downey Medical Center in Southern California share a relaxed rapport that belies the time, planning and occasional friction that are part of running a busy inpatient unit. 

Together for more than a year, the pair attribute the success of their budding relationship to communication and a commitment to partnership principles—especially consensus decision making. Those core values came in handy recently when a disagreement arose about the best way to educate patients about medications. 

Nurses preferred a less overwhelming one-page sheet, but managers wanted to switch to a detailed three-page form that had been adopted by other units in the hospital. 

“It was a major issue,” says Bhasin, RN, a staff nurse and member of UNAC/UHCP who is the team’s labor co-lead. “We had to come up with a solution to fulfill management’s needs and labor’s needs.”

At the time of the disagreement, UBT members turned to consensus decision making to determine next steps they all could support. A subsequent test of change resulted in a short-term fix: Nurses used the short form with patients, while the longer handout was provided as a resource guide in patient rooms.

New to partnership

Managing in partnership was a new experience for Hu when she joined the team in April 2016 as assistant clinical director and became a co-lead. She previously had overseen a Kaiser Permanente inpatient nursing unit that was not part of the Labor Management Partnership. Bhasin, a co-lead with two years of experience, served as mentor and coach.

“Runeet was wonderful with helping to bring me onboard,” says Hu, who is also an RN. 

Both say LMP training has given them a shared understanding of their roles as co-leads, the purpose of UBTs and how to use consensus decision making. A business literacy class both took proved especially fruitful: With the information they brought back, the team tackled an affordability project that reduced overtime costs by more than $95,000 last year. 

“The UBT classes,” says Bhasin, “made me realize the real meaning of partnership, the collaboration of labor and management to work toward the same goal to provide high-quality care and to have a great work environment.”

The pair’s approach seems to be working. Their 75-member UBT is at Level 4 on the five-part Path to Performance, and it has earned accolades for outstanding patient care and gains in workplace safety and affordability. 

“We want what is best for patients and for staff,” says Hu. “We might have differences, but we always come together with open and professional communication, sitting down together to solve those issues.”