Consensus Decision Making

What does it mean to work in partnership?

It’s a joint commitment to collaborate, enshrined in the Labor Management Partnership’s national agreements.

It’s employees, managers, physicians and dentists building on common interests to make decisions and solve problems.

It’s Kaiser Permanente and the Partnership unions finding creative, mutually beneficial solutions that result in improved care, service and affordability.

There's never been a better time than right now to shine a fresh spotlight on the basics — the team-tested tools and practices fundamental to a strong partnership, such as the Rapid Improvement Model, consensus decision making and interest-based problem solving.

Whether you’re new to partnership or well-versed in its ways, use these performance improvement tools to identify issues, test changes, solve problems, make decisions, deliver better care and service, and enhance your work life.

LMP tools are designed to help you work together when things are going well — and bridge differences when the going gets tough. This approach addresses the needs of union members and helps the organization improve performance — which ultimately benefits Kaiser Permanente’s patients, members and communities.

Course description

Participants will learn core facilitation practices and will practice these skills and receive feedback from instructors. The participants will determine how facilitation skills are used when leading a UBT.

Path to Performance

Level 3, 4, 5 

Duration

2 days

Who should attend

This course is intended for anyone facilitating unit-based teams. Job categories who should attend include physician, management, labor, unit-based team consultants and union partnership representatives.

Course requirements

None

Course description

It is critical for steward sponsors and management sponsors to invest in the development of the unit-based team, which will have a long-term impact on the organization, and to learn about tools and resources available to them in their sponsor role. This course is designed to help union, physician and management sponsors discover the benefits of effective sponsorship and how it can help them develop successful, sustainable unit-based teams.

Union and management sponsors will gain an awareness of how their role is critical to the transformation of how the work at Kaiser Permanente is done.
 

Path to Performance

Level 2

Duration

3 hours

Who should attend

This course is intended for participants who are sponsors of unit-based teams. Job categories who should attend labor, management and physician.

Course requirements

Labor Management Partnership Orientation (LMPO)

Course description

The Co-lead workshop exposes co-leads to the skills and knowledge needed to make unit-based teams work together effectively. The skills the co-lead learns are discussed and agreements are made regarding implementation as he/she returns to the unit-based team.

Path to Performance

Levels 2, 3

Duration

Two 4-hour modules (8 hours total)

Who should attend

This course is the first of two workshops intended specifically for all labor, management or physician unit-based team co-leads. The workshop builds on previous LMP orientation training co-leads may have attended. Following this course, co-leads are encouraged to attend the advanced course titled: Team Leadership for Co-leads: Leading Your Team to the Next Level. 

Course requirements

• Labor Management Partnership Orientation
• Labor and management co-leads attend the training together

Requires basic knowledge of:

• Consensus Decision Making (CDM)
• Interest-Based Problem Solving (IBPS)

Course description

The training provides an overview of why the Labor Management Partnership is important to Kaiser Permanente and the Coalition of Kaiser Permanente Unions and how unit-based teams are transforming Kaiser Permanente. Topics covered are types of unit-based teams, roles and responsibilities of employees on unit-based teams and consensus decision making basics.

Path to Performance

Level 1

Duration

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

Who should attend

Employees within their first 120 days of employment at Kaiser Permanente should attend this course. Job categories who can take this class are labor, management and physician members of unit-based teams.

Course requirements

This is an introductory course. There are no prerequisites.

Course description

This course shows how to use consensus decision making in the partnership and unit-based team environment and explains the critical elements in a consensus decision.

Path to Performance

Level 1, 2

Duration

• 90 minutes (classroom)
• 30 minutes (online)

Who should attend

Anyone seeking a basic understanding of consensus and how the consensus decision-making process works. This includes labor, management and physician members of a unit-based team, Labor Management Partnership and unit-based team consultants, improvement advisors and Union Partnership Representatives.

Course requirements

Labor Management Partnership Orientation (LMPO)

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.”