LMP Focus Area

Peace and relaxation don’t usually come to mind when visiting the dentist, but Kaiser Permanente dental teams in the Northwest are making that a reality by offering spa-like services for patients.

KP members can choose from an array of complimentary offerings that include heated blankets, pillows, and personal headphones. Started in 2013 by team members in the Glisan Dental Office, the amenities are a hit with patients. Even better, the team’s idea has spread to other KP dental offices in the Northwest region. Read the whole story on the Northwest InsideKP portal.

Every quarter, Colorado leadership recognizes a unit-based team that excels at putting our members first while building camaraderie.

The Autism and Development Pediatrics UBT, which started in April 2015, is a classic example of how collaboration can make the care experience even better. Members of this cross-functional team tackled the dreaded ‘no-show’ rate for their area of focus. They zeroed in on making process improvements to significantly lower the rate while also increasing access and member satisfaction.

To see this team in action, watch the video on Inside KP at http://www.insidekpco.net/value-compass-award-improving-access-lowering-no-show-rate. Please note, this link works on KP computers only.

“The idea came from our manager, when one of our young, alert patients fell and got an injury. We were all upset,” says Jenalyn Andres, RN, one of the union co-leads for her department’s UBT.

That incident spurred nurses on the 4 East-Malama West unit-based team at Moanalua Medical Center in Hawaii to set a goal to cut the number of falls in half within 12 months—from 18 in 2013 to nine or fewer by the end of 2014. The team exceeded its goal and had only six patient falls in 2014.

Steps to success

Team members adopted the No One Walks Alone falls prevention program, pioneered at the San Diego Medical Center, to help them reach their goal. The team set up a standard process to ensure success. Some of the elements of the plan included:

• checking that all bed alarms are on at the start of shift and during the shift
• having alarm pads for chairs readily available in rooms, ready for patients who get out of bed and into a chair
• placing nonskid socks on patients’ feet
• positioning call lights within reach
• using walkers to help patients become mobile

Andres, a member of Hawaii Nurses Association, OPEIU Local 50, says the team educated patients and families by sharing literature with them that included tips on preventing falls and information about the No One Walks Alone protocol. The protocol starts with the assumption that all patients are fall risks, instead of nurses trying to identify which patients are at risk. Patients are accompanied every time they get up, especially to and from the bathroom, which is when most falls occur.

Troubleshooting “hot spots”

As part of the team’s process improvement, it identified “hot spots”—things that could happen that could prevent success. For example, the team quickly discovered that it had different types of patient beds on the unit, with different bed alarms. Some of those alarms weren’t wired into the nurse call system, so staff members had to follow the sound of the alarm to figure out which patient needed assistance—which meant it took longer to get to the patient.

The UBT worked to get the issue fixed, and as a result, “a project was opened with facility maintenance and beds have been switched to a universal cord, which resolves the problem,” says Manlee Velasco, the unit’s manager and management co-lead. “In the few cases where the cord wasn’t compatible, new beds have been ordered.”

The team has had five falls so far this year, which came before the cord issue was resolved. 

Spreading a successful practice

The overall success of the prototcol has been noticed by other teams and “all of the inpatient units at the Moanalua Medical Center are now using the program," says Kim Lu, RN, the 4-East unit’s other UBT union co-lead and also a Hawaii Nurses Association member. 

The practice is a great example of spread for another reason: The “No One Walks Alone” slogan and program was created by a San Diego Medical Center UBT in Southern California that was involved in a Joint Commission pilot in 2012.

“I was almost devastated,” says Karen Cardosa, a grocery clerk in Albany, Oregon, “when UFCW told us they were no longer offering Kaiser Permanente as an insurance option.”

Cardosa and her family had been KP members for years through the union’s Local 555 Employers Health Trust. That changed when a variety of issues resulted in KP losing the account, which covered many Local 555 members. The union continued to represent nearly 2,000 Kaiser Permanente pharmacy and radiology employees, who—as KP staff members—continued to have KP health care.

But today, Kaiser Permanente is again an option for up to 15,000 UFCW members and dependents in the Northwest region who are covered by the health trust.

New way to compete

An affordable price, high quality, a new hospital, expanded clinics and a new billing system helped win back this account. But something else was also at play.

Thanks to the Labor Management Partnership, the Coalition of Kaiser Permanente Unions and Kaiser Permanente take a joint approach to winning and keeping health plan members that is almost unheard of elsewhere in this country.

Bringing together union members and KP sales and marketing teams, the campaign helped win, expand, win back or retain 33 accounts covering 125,000 KP members in 2014, with a focus on public-sector accounts.

A broad reach

The effort spans almost every level of the organization and the unions.

Leaders of the local and international unions that belong to the union coalition play an active role in advocating for KP as the preferred health care provider when negotiating contracts or benefit programs with employers.

In addition, some 45 frontline union ambassadors spoke to 25,000 KP members and potential members at outside union and community events in 2014. “I have enjoyed working side by side with the sales and marketing representatives to promote Kaiser Permanente,” says Sera Jordan, a medical assistant, union ambassador and SEIU Local 49 member in the Northwest. “It has enabled me to share my firsthand knowledge of Kaiser Permanente and the care we provide.”

UBTs are a selling point

And unit-based teams, by giving frontline workers a voice in improving quality, service and affordability, are a big selling point for union purchasers of care. UBTs launched more than 8,000 performance improvement projects last year at every point on the KP Value Compass, including thousands of affordability projects that saved, on average, more than $40,000 per project.

“Working with our union partners, we’ve been able to come to the table with customer solutions that meet everybody’s needs—including the unions that aren’t part of KP, who have tremendous influence in purchase decisions,” says Kate Kessler, a Member Sales and Service Administration director. “We are unique in having a strong labor partnership in our own business, and we can speak that language.”

Find out why record membership matters to our current and future members on InsideKP.

Good things happen when more members join Kaiser Permanente.

Kaiser Permanente and our unions gain strength and stability. Good jobs become more available and secure. More people in our communities benefit from KP’s affordable, quality care.

And all KP employees can help make those things happen.

For example, the Labor Management Partnership and KP’s sales and marketing organization work together in unique ways to build KP health plan membership. Thanks to their efforts, in 2014:

• 125,000 KP members joined or stayed with the health plan. 
• 100,000 KP members or potential members got letters from their local unions encouraging them to select KP during open enrollment.
• KP union ambassadors reached 20,000 potential KP members at worksite, community and union events in five regions.

Workers tell their story

In addition, thousands of KP workers, managers and physicians in unit-based teams win and keep KP members by delivering great care and service every day.

Louise Casa, a nurse practitioner, UFCW Local 400 member and union ambassador in the Mid-Atlantic States, says all workers have stories to tell about what makes KP a better place to give and get care.

“I share the story of being part of a partnership that values union workers and their ideas,” she says. “I talk about our unit-based team work on goals for care improvement, problem solving and workflow improvement in our departments. People in the community been very interested in the UBT process.”

What you can do

Everyone has a role to play in helping Kaiser Permanente grow and retain its membership. It starts with the work we do every day to serve members and patients:

• Deliver the best member experience. If you know someone is a new member, take an extra minute to explain how things work.
• Encourage members to sign up for kp.org. Surveys show that members who sign on are more likely to stay with Kaiser Permanente.
• Look for ways to improve work processes or cut waste, to help keep KP affordable for the people we serve.

Kaiser Permanente and the Coalition of Kaiser Permanente Unions have reached a formal agreement that ensures the safety and compensation of KP employees involved in caring for patients with the Ebola virus.

The agreement, reached December 15, 2014, clarifies questions coalition unions had about the engagement and protection of their members who may encounter or care for a patient with Ebola. It codifies standards outlined by the Centers for Disease Control around protective protocols and equipment. It also outlines training and support provided to employees, including for employees who may be unable to work during an isolation period for a possible Ebola exposure.

Safeguarding workers and patients

“As health care workers, we’re used to putting our patients first,” said Ken Deitz, president of United Nurses Associations of California (UNAC). “Because Ebola is an infectious disease, to maintain patient safety we also had to ensure our own safety.”

The parties came to agreement quickly and with little disagreement, with conversations focused on clarifying the practices KP facilities already are doing as outlined by Centers for Disease Control guidelines.

Union and KP leaders say it reflects their desire to work together—and to continue to focus on educating, protecting and preparing employees who may come in contact with Ebola patients.

“By working together, we have ensured that employees are prepared to care for patients with Ebola while keeping themselves and their colleagues protected from infection,” said Kathy Gerwig, vice president of Employee Safety, Health and Wellness for KP.

Education, training and protection

Specific provisions of the agreement include:

• All employees with the potential to interact with, treat, or do cleaning or waste handling for suspected Ebola patients will receive paid time for education and training in such areas as Ebola signs and symptoms; care and treatment; proper donning and doffing of personal protective equipment; proper cleaning of treatment rooms or areas; and proper disposal of the patient’s body fluids and wastes.
• Employees in key treatment or intake areas will receive sufficient personal protective equipment supplies.
• Ebola treatment teams would be staffed by volunteers. If there are not enough volunteers, local KP and union leaders would identify team members.
• If a coalition union-represented employee cannot work, or receives care as a result of work-related exposure to Ebola, the employee will receive paid time off, and all medical costs will be covered through workers’ compensation.

Read the agreement.

Standing on a stage in front of hundreds of his fellow health care workers at the largest Ebola educational session on the West Coast to date, registered nurse Peter Sidhu demonstrated how to use personal protective gear in the way that keeps both patients and workers safe.

Sidhu inspected his equipment first—two pairs of gloves, a gown, mask and face shield. Then Arjun Srinivasan, MD, the associate director for health care-associated infection prevention programs at the federal Centers for Disease Control and Prevention, gave him detailed, step-by-step instructions in putting them on.  

The Nov. 7 educational session in Los Angeles was hosted by Kaiser Permanente, the Coalition of Kaiser Permanente Unions and other organizations that are coming together to help frontline caregivers learn about the newest CDC protocols and guidelines for handling Ebola patients. Hundreds attended in person, while thousands more nationwide watched a live telecast of the event.

For at least one Colorado facility, workplace safety started with awareness. And building awareness was a team effort.

Wheatridge Medical Office, with about 140 employees, had three workplace injuries in the first half of 2013. The Wheatridge Safety team, representing departments across the facility, agreed that was unacceptable. But team members weren’t sure where to start, and the team lacked a management representative, making it hard to find time or resources to implement ideas.

That changed when Jeanne Kraft, RN, nurse manager for Internal Medicine, joined the safety team. The team adopted two ideas that had worked elsewhere. One was to host a safety fair, following a tried-and-true format: People visited several booths where they got information and answers to a quiz on basic safety practices. Everyone who completed the quiz then got a ticket for a barbecue lunch on the patio.