UBT Co-Leads

At 8 a.m. every workday, an alarm sounds at the Member Services Call Center in Denver. Instantly, Olivia Johnson and her entire unit-based team of customer service representatives to leap out of their seats.

And dance.

The dance break tradition started when one of Johnson’s co-workers set a regular medication alarm that plays music.

“He started dancing when his alarm went off, then another person started dancing with him. Now it’s all of us dancing every morning,” says Johnson, a member of SEIU Local 105. “Afterwards we clap and tell each other it’s going to be a good day.”

Shaking their groove thing, having regular potlucks and sharing information that might make work easier for others are ways Johnson’s team combats potential stress at work. Constant stress can result in faster breathing and an increased heart rate, which the American Heart Association says can lead to physical pain, depression and unhealthy behaviors to compensate.

The members of Johnson’s UBT also alternate work assignments, so that representatives aren’t doing the same thing every week. One week, half of the team fields the calls from Kaiser Permanente members, while the other half answers questions from all of Colorado’s customer service representatives via SameTime chat. The next week, they switch. The variety helps keep the demands of the job manageable.

Stress comes with the job

Terrence J. Cooper, who manages the Maple Lawn Call Center in Fulton, Maryland, says one reason working in a call center can be stressful is, simply, the nature of the work.

“We take complaints here,” says Cooper, who has been at Kaiser Permanente since 2006. “Complaints alone can be stressful.”

Cooper, who manages 20 people, tries to keep his team upbeat by injecting humor into his UBT’s daily huddles and team meetings. The team also host potlucks and does team-building activities outside of work, such as bowling.

“This allows us to catch up as a team,” Cooper says. “We talk about the weekend or the kids. It gives everyone an opportunity to take their minds off that last call.”

Cooper also serves as the local co-lead for the Kaiser Permanente wellness program “Live Well, Be Well” and tries to promote a healthy work environment to reduce stress. Frequently, fitness video games, board games or music are available in the break room to help folks “de-stress,” he says. “We try to lighten the mood.”

There’s a serious side to adding fun and festivities to the job: A study in the 2006 Ivey Business Journal Online found that workers who feel empowered and engaged—one of the outcomes of the light-hearted endeavors—are more productive and have fewer safety incidents.

Giving people a say

Another key element to reducing stress is giving people the ability to make more decisions at work, says Deashimikia Williams, a customer service representative in Maryland and member of OPEIU Local 2. Williams also serves as her UBT’s union co-lead and is a member of the national call center “Super UBT,” whose membership crosses regional boundaries.

Williams says empowering workers and improving their work processes can have a positive impact on stress at work. Making customer service representatives, CSRs, aware of what they can do to resolve a member’s issue also reduces frustration, says Williams, whose role on the Super UBT includes exploring different improvements.

“We look at the issues CSRs and managers experience on the floor. If we streamline a process, it may not be as stressful,” Williams says. “If we can let them know what can be done by each department and who can help resolve a member’s problem, it reduces frustration.” 

For the second year in a row, the Northwest region experienced the fewest workplace injuries of any hospital-based region in Kaiser Permanente. The Northwest ended the 2011 reporting year with a 15 percent improvement over injury rates in 2010. (The two California regions, Hawaii and the Northwest operate hospitals, while Colorado, Georgia, the Mid-Atlantic States and Ohio do not.)

Workplace Safety Committee co-leads Marilyn Terhaar and Susan McGovern Kinard attribute the region’s success to several factors:

• Real-time information. Terhaar sends safety alert emails to managers, stewards, UBT co-leads and safety champions. The alerts list the injuries for the prior week and offer safety tips and resources.
• Goals at the frontline. Keeping injury rates low is a regional goal and a PSP goal. Unit-based teams are encouraged to work on these workplace safety issues prior to tackling other goals.
• Culture change. Safety conversations have become part of the workplace culture. If an employee sees someone not working safely or a hazard in the work area, she or he speaks up, knowing the problem will be addressed.
• Investigation. The approach to safety is proactive. The Employee Health and Safety department investigates the root cause of an accident and tries to make sure the accident does not happen again.

High cost to both employees and KP

Employee injuries are significant in several ways. An injured employee may lose pay and time at work, and a department may have to work short, which may impact patient care. And there’s a financial impact on the organization—which eventually could affect member premiums.

 “The cost to open a workers’ compensation claim is about $1,200 on average,” says Terhaar. “Once you start adding in medical and surgical costs, the expenses can soar.”

Indemnity claims—those claims that cover employees with more serious injuries that require a longer time off—average $21,000.

 “That’s one of the reasons we have such a laser focus on safe patient handling. The risk to the employee for injury is so great,” explains McGovern Kinard.

Prevention

The Northwest region employs a well-constructed safe patient handling program. New employees are trained on safe patient handling, and more than 1,000 employees were retrained in 2011. Hospital and clinic policies require staff to move patients using safe handling techniques and equipment.

 “We have mobile lifts and overhead lifts at Kaiser Sunnyside Medical Center and will have the same equipment at our new hospital opening next year,” says Paulette Hawkins, RN, a workplace safety consultant. “In addition, all medical and dental clinics have mobile lifts and receive annual hands-on refresher training on request.”

Members of the workplace safety committee aren’t resting on their laurels. This year, they plan to bring the focus of safety to the UBT level.

“Most teams can solve their own issues,” say McGovern Kinard. “There’s been an increase in awareness that’s been growing steadily over the last five years. Our numbers say it all.”

For nearly a year now, the Neonatal Intensive Care unit at the Fontana Medical Center has welcomed parents 24 hours a day, thanks to a unit-based team that put the patients’ needs first.

Since April 5, 2011, parents have been able to stay on the unit with the newest member of the family regardless of the hour and even during shift changes and rounding.

“The belief in family-centered care is put into action here,” says management co-lead Annette Adams, RN. “Nothing should come between parents and babies.”

Team members put themselves in the shoes of the parents whose children are treated on the unit: The distress of having a newborn baby staying anywhere other than right by your side, of having to leave your baby in the hands of strangers, and being told when you could come and see your own child.

Making it better for parents

Keeping the service point on the Value Compass in mind, the team looked inward to tackle the problem of concerned parents lacking 24-hour access to the unit.

The UBT began by researching what it takes to have successful open visitation in the NICU and what the benefits are for members and patients. The team found that many NICUs were not truly open to parents 24 hours a day, as parents were asked to leave during change-of-shift reports and physician rounds.

The UBT concentrated on how to make sure parents could remain, despite the concerns.

Shift reports are done at the bedside. But the NICU is one big room where anyone can hear anything. Team members researched how to solve this problem by asking how other Los Angeles-area NICUs, such as Cedars-Sinai Medical Center, handle shift reports without compromising privacy.

Involved in shift hand-offs

Not only do parents now get to see their babies whenever they desire, they are also asked to participate when the physicians round and during the change of shift hand-off, which gives them the opportunity to meet the nurse assuming care of their baby.

“The belief that family-centered care is an essential part of each family’s experience was the driving philosophy behind the progressive move in visiting policy,” says Sheila Casteel, RN, the NICU team’s labor co-lead and UNAC/UHCP member.  

The representative team members enlisted help from the rest of the unit by introducing the concept through the monthly staff newsletter and giving presentations at staff meetings.

Unit staff members were asked for their ideas about how to overcome barriers—real and perceived. Some of the practices adopted included:

• moving the staff hand-off huddle outside the unit to the conference room
• making the relief and admitting nurse available to answer parent questions during hand-offs