Frontline managers

Linda J. Bodell has a simple formula for being a good sponsor of unit-based teams: Show up. Be of service. Clear a path. Bodell, a former clinical nurse specialist, spent much of her career in critical care settings where patient cases are often unstable and complex. She learned to be watchful and attentive. Today, those lessons define her as a sponsor of four teams at the Fontana Medical Center. She meets with her teams and her labor partners each month. Her personal goal is to understand what works and what doesn’t—and to get to the “why.” Bodell’s teams praise her for guiding them through facility and regional business goals, yet trusting the teams to find solutions that deliver needed results. She talked about being a sponsor with LMP senior communications consultant Anjetta McQueen.

Bodell was clinical director of Medical-Surgical Services at the time this article was written; she is now director of Clinical Care.

Q. Please share one of your best practices.

A. Show up at every team meeting, even if it’s only just one 15-minute window. It’s once a month per team. It’s essential. There is no substitute for being present. Let your teams tell you what they are currently working on. You tell them what’s going on…because they need it to complete their projects successfully. They haven’t had a bloodstream infection in 16 months? They need to hear where they are being successful.

Q. Would you describe an instance when you removed a barrier?

A year and a half ago, an RN and PCA (personal care attendant) from one of my teams asked to get a blood pressure machine that could stay in the patients' rooms. I did that—we had a department closing. I acquired a unit that could stay in one of the isolation rooms. It’s just those little things that make a difference in their work experience every day.

Q. Are there aspects of your past experience that have enhanced your sponsorship?

A. I have served on several nonprofit boards and as a volunteer, in different areas of health care and in Oman and South America, and that’s about taking a service to people, and it’s the same thing I do here as a sponsor. It’s my job to serve them so that they have everything they need to do their job the best they can. I know they care about their patients and their colleagues. They need to know that I care about them and what they do, and that it matters.

Q. Have your teams ever solved something you thought was unsolvable?

A. I would ask them! But the 4 West Med-Surg team was having a difficult time with workflows and getting to their supplies. They work where there are long hallways, where the 34 beds are arranged in a rectangular shape around the unit. This did not look like a process that could be fixed. They did the spaghetti diagram on how many steps nurses take. And the staff, together, made decisions about how to change, where they have their supplies, and how they were arranged. They worked on their workflow. Now the service scores are phenomenal.

Q. What inspires you each day in your duties as a sponsor?

A. So when you know what the goals are and what the actual plans are, and you go out and round on the department, and you can see those in living proof. It’s just exciting to see that this process really affects practice and activity at the unit level.

Words from the front line

“She really has an open door and an open heart. Linda has been a wonderful mentor. She is patient and stays calm under pressure. She knows how to lead you without just handing you the answers. She keeps you focused on what’s important.”—Letty Figueroa, RN, assistant clinical director and management co-lead, 4 East Med-Surg UBT, Fontana Medical Center

When your team is on the same page, you all succeed—individually and collectively. By using these team-tested best practices, you can create a proven unit-based team strategy.

1. Provide sponsors and teams with ample and frequent training.

Offer frequent refreshers on Consensus Decision Making, Interest-Based Problem Solving, and the Rapid Improvement Model and its plan, do, study, act steps.

2. Make good use of your local experts.

Work with your management and union leaders and your facility’s project managers to identify their areas of knowledge and assign them to teams needing that expertise.

3. Create one consolidated list.

Include all the just-in-time, classroom and web-based (KP Learn) courses that meet Path to Performance requirements. Make the list and course-request process easily accessible.

4. Involve sponsors and subject matter experts.

They should sit in on the LMP Council and require regular updates. Identify common issues and address them.

5. Have teams do a “project prioritization matrix.”

This should be done annually after year-end assessments. Download the tool at LMPartnership.org.

6. Distribute and use LMP and performance improvement tools.

Everyone should be looking to learn on a continual basis.

I am one of the chairs the LMP leadership team, along with a union colleague from UFCW and two management leaders. I’m also the co-lead of the Woodland Hills’ union coalition. In addition, I’m a full-time certified registered nurse anesthetist in the operating room. To be an effective labor co-lead takes three things: time, collaboration and planning.

Time

I have been doing partnership work at Woodland Hills for 10 years. People respect the time I’ve invested. You have to be on fire for this because it’s an enormous responsibility. It’s going to cost you time, angst and effort. And you can’t build relationships passing in the hall. You have to make the investment of face time. That means showing up at the LMP council meetings, monthly, from 8:00 a.m. to noon.

Planning Ahead

It is important to bring in and plan for new blood. At Woodland Hills, we rotate the labor co-chair in our leadership team every two years. I believe this allows everyone to have a say. It builds trust and experience. And it ensures buy-in from each union—and each segment of each union. We build-in mentorship. For three months, the new person sits in and the current co-lead shows that person the ropes.

We also did this in the Kaiser Permanente Nurse Anesthetist Association when I was president in 2006. I would go with new facility reps to meetings. 

Collaboration

We really foster union efforts at the medical center level. We’ve got a group of long-term union coalition people and our unions speak with a single, powerful voice. There have been issues between unions, and we had to work things out until cooler heads prevailed. People say ‘I’m sorry’ and move on.

Working with management is both easy and difficult. It’s easy because they are so partnership oriented and respectful of the unions, and they welcome input. They lead by influence—not by authority by virtue of where they are on the food chain—just like we do. It is difficult sometimes because it requires us to work hard as partners. Sometimes it would be easier to just go along with their recommendations, but then we wouldn’t really be doing our jobs as union leaders. At certain points, you have to say, ‘Well, let me think about that,’ and ask your constituents what they think.

Hospitals are traditionally very hierarchical. The partnership is such an opportunity to have a voice.