Regional Leaders

Health care workers’ first obligation is “do no harm”— to see that the members and patients in our care suffer no injury or further illness. Unit-based teams across Kaiser Permanente launch hundreds of projects every year to improve patient safety. These tips can your guide your team in a patient safety improvement project and help ensure that KP is the safest place to get and to give care.

1. Wash your hands often, and in accordance with local policies and procedures.
2. Speak up if you observe a drift from safe practice. As the saying goes, “If you see something, say something!”
3. Make sure patients (or family members) understand their diagnosis and plan of care. Have them describe, in their own words, their condition, what they need to do next and why that’s important.
4. Label specimens accurately, completely and legibly.
5. When administering high-alert medications have two people separately check specific steps of the process. For example, a pharmacist calculates dosage, prepares a syringe and compares the product to the order; then a nurse independently does the same and compares the results.
6. Use tools such as SBAR (Situation, Background, Assessment, Recommendation) and clear language like “Safety Check” to identify a hazard, if someone is uncertain and does not feel it’s safe for the patient to proceed. 
7. Keep yourself free from injury so you can keep your patients free from harm.

Unit-based teams are getting results — and are finding ways to share their learning with their peers face to face, online or in print. Talk with your team about how to use these and other ideas to share your learning and spread success.

1. Track your progress. UBT Tracker is a web-based tool that helps unit-based teams and consultants collect and report information about their performance improvement work. Our UBT Tracker User Guide can help you make the most of your Tracker entries or search for model projects.
2. Tell your story. Storytelling is one of the best ways  to explain partnership and show others your results. Sign your team up for our storytelling training. 
3. Step right up. UBT fairs are a dynamic forum for spreading effective practices face to face. Hosting your own webinar online lets you reach beyond the walls  of your facility.
4. Lights…camera…take action. Kaiser Permanente’s Care Management Institute uses video ethnography— interviewing KP patients at the care site—to help teams share ideas and keep patients at the centerof performance improvement. To learn more, visit CMI’s Video Ethnography & Storytelling page [KP intranet].
5. Write all about it. Use fliers, posters and newsletters to keep others informed and engaged in your team’s projects. Post your results in the break room. Invite another unit to your huddle for a progress report. Use these templates to create your next newsletter.

Unit-based teams encourage employees to make wise use of the National Agreement's sick-leave provisions, which help ensure that individuals have income in the event of a long-term illness or disability. Absences can also create hardship on other employees and affect member service and care. Here are some tips for improving attendance in your department: 

1. Survey your unit or department to determine if there’s confusion about the use of sick time. If needed, find ways to educate staff on sick leave, tardiness and clocking in and out.
2. Create an “attendance star” board to recognize staff members with great attendance.
3. Encourage colleagues to schedule routine appointments during off-hours or in conjunction with lunch or breaks when possible.
4. Track call-outs and use anonymous surveys to test for reasons why they are occurring.
5. Use cause-and-effect tools such as fishbone diagrams to address unforeseen circumstances, morale, physical environment, workload or personal reasons.
6. Engage staff with frequent conversations and be alert for — and respond to — indications of unhappiness or tension.
7. Recruit an attendance champion to be on the lookout for opportunities to coach others on the importance of banking sick leave.
8. Help employees track sick-leave usage by printing out and distributing the attendance calendar.
9. Use the attendance scorecard to learn about the six essentials of good attendance and to see how your team rates. Then  develop small tests of change to address the weak spots identified by the scorecard.

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.

Course description

Interest-Based Problem Solving offers labor management partners a method to solve problems using a non-adversarial process. This training program provides guidance in the four-step interest-based problem-solving process, along with a simulation exercise that gives participants an opportunity to practice the process.

Path to Performance

Levels 1, 2 

Duration

• 4 hours (classroom)
• 30 minutes (online)

Who should attend

People engaged in problem solving at the unit-based team level up to regional Labor Management Partnership committees should attend this training, along with any union and management staff members working on issue resolution and corrective action. Job categories who can take this class are labor, management and physician members of a unit-based team, Labor Management Partnership and unit-based team consultants, improvement advisers and Union Partnership Representatives.

Beep! Beep! Beep! The electronic sound of Cary Brown’s alarm clock wakes him at 5 a.m.

The Kaiser Permanente member rises to shower and make breakfast, careful not to disturb his sleeping wife, Elissa, who is recovering at home after surgery on a broken leg at the Woodland Hills Medical Center in Southern California.

On top of completing household chores, the retired Hollywood TV director spends his day making sure Elissa is comfortable and pain-free.

The experience has taken a toll on him.

“The hours of staying awake and the repetitive nature of it—and not having any life at all outside of home—is very difficult,” says Brown, who worked on the hit TV series Doogie Howser, M.D.

Now he’s part of an ambitious effort by the Southern California region to enhance support for caregivers, who play a vital role helping to heal and comfort patients outside the hospital. By reducing caregivers’ social isolation, integrating them into the hospital care team and addressing their health needs, regional leaders hope to improve patient safety and quality in the home.

‘Human-centered design’

Under the initiative, frontline workers, physicians and managers are partnering with KP members and their families to design the ideal in-home care experience for patients and caregivers. Participants are using a creative approach to problem solving known as human-centered design, which starts with the people you’re designing for and ends with solutions that are customized to their needs.

“It’s a way to engage the folks who are most affected from day one,” said Dr. Nirav Shah, senior vice president and chief operating officer for Clinical Operations in Southern California. “No program that I could ever design will be as good as one that had the people who are most affected design it with us. It’s about empathy and understanding.”

Human-centered design is also an ideal tool for unit-based teams to use on performance improvement projects. It delivers on the fundamental concept of the Value Compass—to put the member and patient at the center of decision making—and both frontline workers and Labor Management Partnership leaders, from management and the Coalition of Kaiser Permanente Unions, have been supporting the caregiver project.

Reducing the overwhelm factor

At a meeting in Pasadena, the participants—patients and caregivers, KP employees and physicians—gathered in small groups to share personal tales and draw storyboards to help identify barriers, come up with potential solutions and provide insights to regional Home Health leaders.

Shawna Wallace, a senior physical therapist for Home Health and member of UNAC/UHCP, said the experience was eye-opening.

“I’ve gone into homes where caregivers really care about their loved ones, and they are extremely overwhelmed,” she said. “This is a great opportunity for us to see where we can make better programs for our caregivers and members in these scenarios.”

Brown is hopeful that the approach will give caregivers—and their loved ones—the emotional and physical support they need to thrive.

“If you take care of the family as a unit,” Brown says, “you make it possible for each individual in the family to be better.”