Collaboration

It’s summertime, and the living has been far from easy.

The past year-plus has seen a global pandemic, social unrest and political turmoil.

But signs of hope are emerging.

Vaccines are helping to turn the tide against COVID-19. As we move forward, the Labor Management Partnership has played a key part in supporting vaccinations. Our cover story highlights how labor-doctor huddles and community collaborations have helped get more shots in arms — and provides tips for boosting vaccine confidence and increasing inoculations.

See our Humans of Partnership, where employees share heartfelt stories of why they got vaccinated. It’s OK if you cry.

With conditions improving, many nonclinical employees are preparing to return to the office. Our Q&A with a licensed clinical social worker offers advice about how you and your teams can reduce stress related to the transition.

When it comes to advancing the Partnership, LMPartnership.org offers more than 700 tools to help you and your teams complete your performance improvement work. See our guide to finding the right tool, along with links to a few of our favorites.

Meanwhile, Washington has become the newest region to join the Labor Management Partnership. Watch a video in which team members share their hopes about working in partnership.

Also, don’t miss our puzzles and games for reminders of how to protect you and your family against COVID-19. And check out our back cover for convenient ways to fill and manage your prescriptions.

Lastly, the movie “Back to the Future” — a summertime release — inspired our front cover. As we reflect on the pandemic, we thank you for your partnership. Such collaboration offers hope for a healthier future.

“Dexter” Janet Borrowman is an operational excellence coach for performance improvement in the Southern California Region. She recently spoke with LMP Communications manager Sherry Crosby about the importance of rounding conversations for managers and frontline workers. Building a workplace culture where everyone’s voice matters is key to our Labor Management Partnership.

What is rounding?

Rounding is an evidence-based practice that relies on purposeful conversation and observation to drive workplace engagement and insights. Direct report rounding involves conversations between a team member and that person’s supervisor, manager or leader.

How does rounding benefit managers and frontline workers?

When done well, rounding helps managers build trust with staff, gain insights into workplace challenges and recognize employees, which fosters joy in work. Frontline workers benefit by having a chance to connect individually with their managers, share ideas, express concerns and find deeper purpose in their everyday work.

What evidence shows rounding is an effective practice?

Rounding is one of the most effective ways for managers to spend their time. And the more they consistently round, the greater the impact. According to People Pulse, departments where rounding is routinely practiced achieve more meaningful levels of engagement, better patient care outcomes, fewer workplace injuries and improved attendance.

How can frontline workers get the most out of rounding conversations?

Sometimes employees don’t see the benefit of direct report rounding; they just see it as helping the boss complete their checklist. It’s totally missing the point! Rounding is your chance to discuss what you need to be successful and the support you need. This is all about you!

How can managers get the most out of rounding conversations?

Rounding is one of the best tools that managers have for proactively surfacing and addressing issues which can create safer, more efficient and productive teams and environments. Use rounding to connect with your team members. People need to feel that their life and work has meaning, and that they are personally supported and cared for as a complete person. People need a personal touch, especially during difficult times, and rounding can help with that.

How can managers use rounding to build trusting relationships?

Your direct reports need to feel that what they’re saying is important and that you’re following up with action. Circle back to that person who brought up the issue with you. Go to the huddle and follow up with the whole team. We build trust by following up after a rounding conversation. We break trust by not following up.

What advice do you have for those who want to enhance their rounding practice?

If we are doing rounding the right way, if we’re doing it consistently, if we’re doing it authentically, then we will discover what matters most to our people and we’ll be able to better support them and the work they do.

Union leaders crunched the numbers, and they didn’t like what they saw.

At the beginning of February, less than 50% of SEIU-UHW members at Kaiser Permanente were vaccinated against COVID-19. It was even worse for employees in the Emergency Department at Downey Medical Center in Southern California, where Gabriel Montoya works as an emergency medical technician. There, only 40% of his fellow union members got the shot.

Montoya and his fellow union members — working with physicians and managers — wanted to raise those rates, so they pulled together labor-doctor huddles. And by mid-April, 64% were vaccinated. 

“We did it in partnership,” says Montoya. “The labor partners led the huddles and introduced the doctors. I can’t imagine that happening in a nonunion hospital or even a non-Partnership hospital.”

Going live

SEIU-UHW members set up a phone bank to call — in Spanish and English — members who worked in housekeeping, food service and central supply departments, where vaccination rates were lowest. The union also hosted a Facebook live event where Black and Latino KP doctors answered questions.

Those proved so popular that they wondered, why not do this live at the facilities?

Angela Glasper loved the idea. The chief shop steward at Antioch Medical Center in Northern California got frustrated when she talked to fellow union members who were conflicted about getting vaccinated.

“I listened, but I couldn’t address their concerns,” says Glasper, who works in optical sales and needed someone with the clinical expertise to answer their questions. “Wouldn’t you rather hear it from a doctor than me?” she asks, with a hearty guffaw. “People would say to the doctors, ‘Labor has been telling us about it, but you answered our questions.’”

One of the most popular doctors at the huddles in Antioch was Jeffrey Ghassemi, MD, an anesthesiologist. He shared his harrowing stories about working on the COVID units and was, in Glasper’s words, “patient and gentle.” With a newfound confidence, employees signed up for vaccine appointments during huddles.

Building trust

Pediatrician Carol Ishimatsu, MD, who volunteered to talk at a huddle in Downey, has given children shots to prevent measles, mumps and chickenpox for more than 2 decades.

“Vaccines are our most important intervention,” says Dr. Ishimatsu.

To build trust, Dr. Ishimatsu emphasized her shared experience with SEIU-UHW members as warriors on the front line.

“I told the employees: I do the same thing you do after work,” she says, describing her ritual of removing her clothes in the garage and putting them directly in the washing machine before entering the house. “We are in different professions, doing the same thing.”

Joel Valenciano, an Environmental Services manager at Downey, helped organize huddles at outlying clinics.

“I encouraged the staff to be honest, relate their fears and doubts, anything holding them back,” he says. “And they really opened up.”

The trust and open communication cultivated by working in partnership were key to building vaccine confidence.

“Working in partnership has intensified during the pandemic,” says Valenciano, “because people realize we need to work together.”

Dr. Ishimatsu agrees. She was involved with the Labor Management Partnership when it started more than 20 years ago. “At the time, I wasn’t sure it would evolve,” she recalls. “It treats us like one big family, instead of segments. The thing that keeps one person safe, keeps everyone safe.”

COVID-19 is testing partnership as never before.

Management and labor have had to work together quickly to retool the delivery system to support rapidly changing needs. Employees’ and physicians’ skills and talents are needed in new ways and in new places — so leaders from Kaiser Permanente and unions created labor pools to get KP employees to where they were needed.  

It’s one of dozens of innovations made to provide top-quality care at a time when every day is bringing new challenges. The swift work was possible in part because of the foundation provided by the relationships and values of the Labor Management Partnership.

In Southern California's Riverside service area, “It’s all-hands on deck,” says Jiji Abraham, area chief financial officer. “Even physicians are in the labor pool.”

As physician assistant Larry Rick, PA-C, made his rounds of the South Bay Medical Center one recent morning, staff stood at the hospital’s main entrance and screened members, patients, and employees for signs of cold- and flu-like symptoms. Like Kaiser Permanente facilities enterprise-wide, the Southern California hospital adopted the new procedure to protect patients and staff from COVID-19, the respiratory illness caused by the novel coronavirus.

A well-established approach is also helping: Frontline workers here say years of working collaboratively with managers as part of the Labor Management Partnership has better prepared them to fight the pandemic. The Partnership has saved money, improved care, and led to better service – and now will literally be saving more lives because frontline workers, managers, and physicians are working together.

An opportunity to speak up

“Partnership is a fantastic tool,” says Rick, a member of UNAC/UHCP, who has 34 years of experience fighting infectious diseases including H1N1, HIV, and sexually transmitted diseases to prevent the spread of HIV. “Every Kaiser Permanente senior leader has been responsive to our requests and has heard us. We’re working together and everybody is leaning in” to treat more patients now, while preparing for an expected surge. In response to unit-based team members’ concerns, for example, tape was placed in 6-foot intervals on pharmacy floors to help members and patients maintain social distancing while standing in line.

“We’re able to speak up as labor and help figure out the solution,” says Alejandra Navarro, a registered nurse in Maternal Child Health and a member of UNAC/UHCP.

Working in partnership together has also built trust between management and labor. That’s been key to maintaining open lines of communication now and helping counter misconceptions spread by social media, say frontline workers.

Education and support

“They’re educating us and giving us a lot of support,” said Lizz Burnett, a licensed vocational nurse in Geriatrics and a member of SEIU-UHW. “If I can help educate someone and they can tell their family, then maybe we can stop this.”

Tynikko Snyder, a registered nurse in Family Medicine at the Gardena Medical Offices, has 2 children with asthma and her mother suffers from chronic obstructive pulmonary disease. She is worried about the impact of her work on her family. “I am afraid, but I know that I need to step up to the plate and do what needs to be done,” says Snyder, who is a member of UNAC/UHCP. Rick says that can-do spirit is needed to combat the spread of the disease: “If we all do our jobs, we will save lives.”

Alaine Lounsbury, RN, is proud of her nursing team at Downey Medical Center in Southern California. 4 West team members have worked together for decades, forming bonds that have led to high patient satisfaction rates and region-wide recognition.

Lounsbury, nursing assistant clinical director, attributes the team's success to rounding — the practice of engaging frontline workers in face-to-face conversations on the floor and listening to their concerns. Managers who round say it helps build a culture of engagement and dialogue, a key goal of the Labor Management Partnership between Kaiser Permanente and the Partnership unions. 

“It’s about making a connection,” explains Lounsbury, who rounds quarterly on 90-plus staff members using Kaiser Permanente’s Rounding Plus online tool [KP Intranet]. “You want to hear the good with the bad.”

Removing roadblocks

With the tool, managers can use their mobile device to identify, track and escalate issues surfaced during rounding conversations. Program-wide, nearly 10,000 leaders and managers use the program.

At Downey, nurses used rounding conversations to speak up about a workflow issue. Because 4 West is the only unit with nurses qualified to give chemotherapy to adults, it meant staff members sometimes had to leave their department to administer drugs to patients. Their frequent absences meant more work for others.

“I heard them in rounding say, ‘You need to figure this out,’” recalls Lounsbury. She and her team developed new protocols to enable others outside the unit to give the medication. “That was a big satisfier.”

Getting visual

To help her systematically follow up and act on her team’s questions and concerns, Lounsbury uses a colorful poster, called the Stoplight Report, that assigns green, yellow and red colors to track the status of issues.

The poster was conceived by Downey Quality Coordinator Suxian Hu, RN, based on the color-coded reports managers receive through the Rounding Plus program. Last year, all of Downey’s inpatient nursing units began using it.

In 4 West, the poster hangs prominently in the conference room, where everyone can see it.

“Staff members know something is being done,” says Donielle Tresvant, RN, a staff nurse and member of UNAC/UHCP, one of the unions in the Alliance of Health Care Unions. “They know they’re being heard.”

Nurses say the information shared on the poster also fosters team communication and collaboration. “It keeps us updated about things at work and it helps us improve our care by being focused,” says Brianna Schneider, RN, a member of UNAC/UHCP. “It makes for a cohesive atmosphere.”

Managing in partnership is different from traditional management. You still have responsibility for managing employees’ performance, but when it comes to your department’s performance, the whole team plays a role in making the department a great place to work and to receive care. Frontline employees know where the problems are and have great ideas for solutions. Research shows that managers who engage their teams get better results, and team members are more enthusiastic about implementing the solution because they helped come up with it.

1. Be knowledgeable about the National Agreement. Download the National Agreement or get from your local human resources representative.
2. Get trained on the Labor Management Partnership. See your local learning and development website or our list of regional training contacts.
3. Proactively develop relationships with your union partners. Get to know your shop steward, union representative and other local labor leaders. Check in with them on a regular basis to share information and get their ideas.
4. Model partnership with your union partner. Treat each other with mutual respect. Attend LMP trainings together. Jointly develop meeting agendas and share meeting facilitation responsibilities. Share information, identify problems and develop possible solutions in collaboration.
5. Be accessible to staff. Spend time visiting with people on the front lines. Roam the department on a regular basis. Eat in the lunch room. Implement an “open door” policy for staff members who come by and want to talk.
6. Be open to the ideas of all employees. Encourage people to share ideas and have input on procedures or work flow. Create an environment in which people feel comfortable speaking up. And be open to trying new ways of doing things.
7. Create a structure for dialogue and engagement. Make sure time is set aside for partnership meetings, huddles and training.
8. Tell it like it is. Be open and honest in your communication and transparent with information. Share your department’s budget with team members to get their ideas on reducing costs.
9. Recognize and value employees’ contributions. Go out of your way to acknowledge someone who comes up with or implements an idea that has made the department a better place to work and provide care.
10. Develop employees to become department leaders. If union partners or other team members want to help the department succeed by polishing their problem-solving, meeting management or other skills, encourage and support them in their efforts.