Culture change

Asking Good Questions Kristi Mon, 05/31/2010 - 21:44
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Unit-based Teams
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Running Your Team
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When coaching or problem solving, ask thoughtful questions to engage the other person and help them increase their capacity for solving problems on their own. Thoughtful questions motivate the coachee to think, analyze, speculate and express feelings.

Asking Good Questions

When coaching or problem solving, ask thoughtful questions to engage the other person and help them increase their capacity for solving problems on their own. Thoughtful questions motivate the coachee to think, analyze, speculate and express feelings.

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New Book Spotlights Partnership Success

Submitted by Paul Cohen on Mon, 03/06/2017 - 15:51
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LERA book article_pc3.pw.cmo.doc
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A 2016 book published by Cornell University Press and the Labor and Employnent Relations Association includes three chapters on the Labor Management Partnership. Read excerpts and get a link.

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Leading Change Together

Read the chapter by Jim Pruitt, vice president of labor relations for the Permanente Federation, and Paul Cohen, LMP senior business consultant, that explains the conditions that gave rise to the partnership—and how partnership achieves results. 

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After 20 years, Labor Management Partnership still draws followers from health care and beyond
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When the leaders of Kaiser Permanente and the Coalition of Kaiser Permanente Unions shook hands on their Labor Management Partnership 20 years ago, they weren’t sure where it would take them. Today, it is the largest, longest-running partnership of its kind. It is also the most studied by university researchers.

A new book published by the Labor and Employment Relations Association (LERA) and Cornell University Press shows that the partnership remains a model for workplace innovation. “The Evolving Healthcare Landscape: How Employees, Organizations, and Institutions are Adapting and Innovating” devotes three chapters to LMP’s history, accomplishments and challenges.

Lessons for others

Adrienne Eaton and Rebecca Givan, professors at Rutgers University, and Peter Lazes, a director and researcher at The City University of New York, studied six health care partnerships, including LMP. They were struck by:

“…the extent to which unions have been proactive in driving [all] these efforts....Another development in health care partnerships has been a significant deepening of the role of labor relations staff in operational matters.

“It is [also] important to note that the cases described here have influenced one another because the key stakeholders have directly learned from each other....[For example,] union and management stakeholders in Los Angeles [Department of Health Services and SEIU Local 721] as well as union leaders from the University of Vermont Medical Center have looked to Kaiser for answers.”

Another chapter, by Jody Gittell of Brandeis University and KP Northwest staff members Joan Resnick, Sarah Lax and Eliana Temkin, reports on regional efforts to promote collaboration across work teams. KP was selected for the study in part for what the authors call its “record of leadership and innovation [including] in patient care delivery, health information systems and labor-management relations.” Several strategies, including “living room huddles”—an informal, building-wide get-together—and job shadowing across departments led to higher employee engagement and patient satisfaction scores.

An inside look

The chapter “Leading Change Together” by Jim Pruitt, vice president of labor relations for the Permanente Federation, and Paul Cohen, LMP senior business consultant, explains the conditions that gave rise to the partnership, the need to implement it consistently across the organization and the way it achieves results:

“By bringing together diverse points of view and providing a framework for joint problem solving, the Labor Management Partnership has helped Kaiser Permanente tackle difficult issues....The partnership formed because conditions demanded change. It has endured because it has achieved measurable results. And it continues to flex and grow because we follow a few key principles and practices [including] self-directed work teams, interest-based problem solving and honest conversations.”

All of which explains why outside experts continue to take an interest in the joint efforts of KP and the union coalition. Pruitt and Cohen quote Thomas Kochan, a professor at MIT's Sloan School of Management, who put it this way in a 2013 study:

“Kaiser Permanente is now one of the nation’s leaders in the use of frontline teams to improve health care delivery....The Labor Management Partnership continues to serve…as a model for health care delivery and improvement.”

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Leading Change Together

Submitted by Paul Cohen on Fri, 03/03/2017 - 17:02
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LeadingChangeTogether_LERA.pdf

This book chapter from "The Evolving Health Care Landscape" provides an inside view of the history, accomplishments and challenges of the Labor Management Partnership.

Non-LMP
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Format:
PDF

Size:
12 pages, 8.5" x 11"

Intended audience:
All workers, managers, physicians or others interested in the Labor Management Partnership

Best used:
This chapter from a Labor and Employment Relations Association (LERA) book on workforce innovation highlights the history and results of the Labor Management Partnership.

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A Little Communication Goes a Long Way
  • Communicating with the team
  • Asking how the team prefers to communicate or meet
  • Allowing team members to earn rewards for attendance

What can your team do to improve communication among its members? 

 

scarrpm Tue, 12/13/2016 - 17:34

From the Desk of Henrietta: "What About Me?"

Submitted by Andrea Buffa on Mon, 09/19/2016 - 16:10
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hank36_henrietta
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Henrietta, the regular columnist in LMP's quarterly magazine Hank, explains why unit-based teams are well positioned to handle the changes coming our way because of health care reform. From the Summer 2013 issue.

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Tyra Ferlatte
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Non-LMP
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Stories in the Spring 2013 Issue
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From the Desk of Henrietta: ‘What about me?’
Story body part 1

When discussing change, it’s a rare person who doesn’t have that question lurking at some level of consciousness. Since health care reform will bring change to just about every corner of Kaiser Permanente, it’s safe to assume a lot of people are wondering how their jobs will be affected.

The short answer is, no one exactly knows yet.

The better answer is, no one exactly knows and it doesn’t really matter.

Because the 130,000 frontline workers, managers and physicians who are engaged in the Labor Management Partnership already are on a path of continuous improvement, which means taking change in stride is becoming second nature to this crowd.

Doing better tomorrow what we did well today is the name of the game for unit-based teams. Team innovation, as this issue’s cover story notes, may result in a clinic making sure new members understand what they can do to ensure speedier service. It may result in new members getting the kind of attention on their first visit that impresses them and makes them want to stay with KP.

So the best answer to “what about me?” is: It doesn’t matter if a change arrives because a lab decided it wants to get results out faster or if change is a result of health care reform. Change is change. It isn’t out there waiting to roll over us, it’s already here. It arrived when UBTs began using the Value Compass as a guide to providing our members with the best service and quality of care at the best price, while creating the best place to work.

More members on their way because of health care reform? We’re already getting ready—it’s the same work we’re doing to serve our current members well.

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From the Desk of Henrietta: O Is for Ostrich tyra.l.ferlatte Mon, 09/19/2016 - 15:45
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hank39_henrietta
Long Teaser

Henrietta, the resident columnist for the LMP's quarterly magazine Hank, makes an argument for bringing a curious, flexible mindset to work. From the Spring 2014 issue.

Story body part 1

Take, if you will, the humble cell phone.

Oh wait. The cell phone may be ubiquitous, but it’s far from humble. Today’s smarty-pants phones have more power than the computers on the Voyager 1, which was launched in 1977 and 36 years later departed our solar system. Its three computers can process about 8,000 instructions per second. A smartphone swallows more than 14 billion.

The articles in this issue of Hank—articles about how technology is transforming care delivery and about how individuals and Kaiser Permanente are meeting the challenges that presents—would have overwhelmed the Voyager computers’ memory.

For communicating across distances, the string with two tin cans is humble. Even the rotary phone, patented in 1892, seems modest in comparison with today’s devices, which are used more for all manner of modern information sharing than for something as quaint as talking to another human being.

A rapid tech-based transformation, akin to the makeover of the old-fashioned phone, is already sweeping through care delivery. It’s hard to fathom the many ways technology will allow us to decentralize the delivery of health care while improving our connection with our patients and members. The changes will require new skills.

And starting today, the mindset we bring to the workplace is just as important as our skills. Without a willingness to explore new ways of doing our work, we are (to mix a metaphor) like an ostrich dialing the operator for help on a rotary phone, patiently waiting the long seconds for the 0 to return to its starting place while the future creeps up from behind. We’ll never know what got us.

Be bold. Be willing to go where no one has gone before.

Communicator (reporters)
Tyra Ferlatte
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Non-LMP
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Driving for Better Communication Leads to Better Courier Routes
  • Brainstorming ways to encourage use of email system, including instructing and coaching one another on the system
  • Diversifying its communication methods, including the creation of a communication board with information about the projects the team is working on, notes from UBT meetings and a copy of the department’s weekly e-newsletter, “Heads Up”
  • Changing from a representative UBT to a general membership UBT with regularly scheduled meetings throughout the region, so that all employees are able to participate​​

What can your team do to g

Laureen Lazarovici Fri, 09/09/2016 - 16:12
Team Makes Parent-Pleasing Improvements
  • Creating more space for storing breast milk
  • Forming a parent support group
  • Installing video cameras so families could see their babies from home 

What can your team do to include the voice of the patient in your improvement work? 

 

Laureen Lazarovici Fri, 07/08/2016 - 17:56

Creating A Contagious Commitment for Change

Submitted by Laureen Lazarovici on Fri, 05/29/2015 - 16:53
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ppt_Jackie Lynton 2015 slides

Change agent Jackie Lynton of the British National Health Service provides tips on how to catch the contagious commitment to change.

Laureen Lazarovici
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Creating A Contagious Commitment for Change

Formats:
PowerPoint and PDF

Size:
20 slides 

Intended audience:
UBT co-leads, sponsors, improvement advisors and innovation champions

Best used:
Integrate these curated slides into presentations aimed at making change in the workplace. Print out and post on bulletin boards.

 

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Why Partnership Is Good for Managers

Submitted by Laureen Lazarovici on Fri, 10/17/2014 - 10:59
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sty_Bernie Nadel_peer advice
Long Teaser

A top manager explains how working in partnership makes his job easier.

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Bernie Nadel says "partnership is a dance...and management has to take the first step."
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Bernie Nadel, Bernie.I.Nadel@kp.org, 626-381-4015

Physician co-lead(s)

 

 

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Why Partnership Is Good for Managers
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Working together produces a wealth of problem-solving wisdom, but is not optional
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Bernie Nadel is director of customer service and call center operations at Patient Financial Services in Southern California. He co-chairs the Regional Operations LMP Council, bringing together 27 business units, including the regional laboratory, central refill pharmacy and optical services.   

None of us was born into a unit-based team. Partnership is learned. Teams and their leaders need guidance and a playbook.

I tell other managers partnership makes my job easier. I have 10 other people helping to come up with solutions. I know some managers are uncomfortable with that approach. They act as though they can opt out of the Labor Management Partnership. It’s as if they said, “I know we have KP HealthConnect™, but I want to use this other computer program.” I say, if you don’t want the LMP, don’t work at Kaiser Permanente. You don’t get to opt out of the company’s policy.

Owning the work

Recently, our UBT went through a list of issues to work on. Call volume is up 30 percent, and we’re figuring out how to deal with that. We are going to do several tests of change. UBT members are gung ho about it. If I were to try to make those changes myself, I’d miss things. I would not get the insights of the people who interact with our members every day. And the people doing the work wouldn’t have the ownership and energy that comes with having a voice. Employees know I believe in partnership—and I give them the time to do it. That is a challenge. But you can’t solve the problems if you don’t invest.  

Not that long ago this call center was a toxic environment. There was low trust and low morale. All that has switched 180 degrees. A big step was my predecessor attending a sponsorship training class, which led her to involving UBTs more in day-to-day operations. I wanted to build on that.  

Taking the first step

LMP is a dance between labor and management, and management has to take the first step. When labor sees that management is serious, that’s when it changes. We’ve shown that you can change the culture.

Recently, we had a meeting with top executives about improving the consumer financial experience. Our UBT representative group prepared a report, and it gave our executives insights they couldn’t get any other way. It was not slick, it was real. I’m grateful to the group for the experience, commitment and knowledge they bring to this work every day.

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