Individual unions

Doctor Makes House Calls to Help Teams Avoid Injuries

Submitted by Laureen Lazarovici on Thu, 10/06/2016 - 17:25
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Inspired by his father's workplace injury, a Southern California physician helps foster a partnership approach to reducing workplace injuries. 

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Sherry Crosby
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Doctor Makes House Calls to Help Teams Avoid Injuries
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Father’s trauma inspires joint effort to create safer workplace
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Quan Nguyen, DO, learned in seventh grade how devastating a workplace injury can be. His father, a carpenter, severed part of his thumb when he lost control of the power saw he was using. The accident put him out of work for a time and forced the family to stretch its skintight budget even further.

Years later, the memory inspired him to join Orange County’s Workplace Safety Steering Committee, says Dr. Nguyen.

“I’ve witnessed, firsthand, how things at work can lead to pain and suffering for the person and his family,” says Dr. Nguyen, a physical medicine and rehabilitation physician at the Chapman Medical Offices in Orange, California. “We’re like a big family at work and I don’t want to see people hurt.”

Team visits worksites to improve safety

As the sole physician on the 12-member committee, Dr. Nguyen uses his singular perspective to engage physicians and others to build a culture of workplace health and safety.

“He’s very unique,” says Jim Ovieda, assistant medical group administrator and the committee’s management tri-chair. “He brings another voice of authority to the conversation.”

Four years ago, Dr. Nguyen helped form the Tiger Team, a task force of union members and managers who visit units with high injury rates and offer expert advice on how to reduce risks. They developed a simple process to identify and address workplace hazards at the local level (see “Five Tips for Workplace Safety Site Visits”).

“It’s not a punishment. We’re there to help departments succeed and to help our staff and physicians to be safe,” says Dr. Nguyen, who named the Tiger Team in honor of “Tigger,” the fictional tiger character who bounces around and helps others.

Collaborating with frontline union members is vital to keeping everyone safe, says Dr. Nguyen.

“There seems to be two cultures inside the hospital – the physician and non-physician. We’re trying to bridge those two cultures by bringing together a diversity of voices to improve the culture of health and safety for everyone,” says Dr. Nguyen. 

Host teams say the visits and ensuing discussions help create an environment where everyone feels comfortable speaking up—essential to building safety into daily work.

Partnership approach gets results

The team aims for six site visits a year and had conducted 31 visits as of November 2015. Most of those departments reported significantly fewer injuries in the months after the visit; many reduced injuries by 50 percent or more. The approach has gained attention region-wide and other medical centers in Southern California are adopting the practice. The team also presented its partnership approach at the 2016 National Workplace Safety Summit.

“It’s a way of taking the pulse of the department,” Ronald Jackson, a medical assistant, SEIU-UHW member and the steering committee’s labor tri-chair, says of the team's site visits.

“We bring a fresh set of eyes to the department,” says Albert Alota, workplace safety coordinator for Orange County.

Three practical solutions

Recently, the committee’s labor and management members sat side by side reviewing workplace safety records for the Irvine Medical Center’s recovery room. The department had accrued nine injuries in as many months, three of them involving employees and gurneys. The team identified several hazards related to work space and storage and recommended ways to fix them. For example:

  • To address heavy traffic down narrow hallways and around blind corners: Provide standardized traffic flow for gurneys, mirrors at key intersections and a recognized verbal cue to alert bystanders to passing gurneys and equipment
  • To unclog crowded patient bays that forced staff to work at laptops in busy hallways: Install wall-mounted computers and exam stools to replace the office chairs in the room
  • To reduce injuries caused by incorrect use of new gurneys: Ask vendors to help train staff how to safely operate new equipment

Employees appreciate the attention. “It’s good to have the team come in,” says Sol Estrella, RN, a staff nurse and UNAC/UHCP member. “It shows that management and higher-ups are responding to our staff needs.”

 

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Team Learns "Bladder Bundle" to Protect Patient Safety

  • Using an evaluation checklist to determine whether the catheter is medically necessary and properly secured
  • Re-educating registered nurses and certified nursing assistants on catheter use and how to minimize factors that cause bladder infections
  • Encouraging physicians to refrain from administering a catheter when it wasn’t necessary and to take catheters out at the earliest opportunity

What can your team do to encourage each other to examine procedures and alter if necessary?

 

New (and Better) Workflow Improves Blood Pressure Control

  • Developing specialized scripts for clinical nurse assistants (CNAs), who make outreach calls to patients with hypertension, and for receptionists, who make reminder calls about check-up appointments
  • Refining workflow so CNAs consistently send patients with elevated blood pressure to nurse practitioners for management
  • Referring patients with complex blood pressure medication management for additional consultation

What can your team do streamline processes to meet patient care goals?

Transformed Team Tracks Kidney Transplant Patients Follow-up Care

  • Hosting a short-term special clinic for post-transplant patients, enabling them to get all their follow-up care in one visit
  • Creating an Excel spreadsheet of post-transplant patients and their follow-up needs
  • Making outreach calls to patients with care gaps

What can your team do to fill patient care gaps? What else could your team do to proactively meet patient needs?

 

When Every Day Is Partnership Day

Submitted by Laureen Lazarovici on Sun, 10/02/2016 - 13:55
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sty_Partnership Day wrap-up
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Wouldn't it be great if every organization and every union had a labor management partnership like ours? It could happen. The Federal Mediation and Conciliation Services hosted Partnership Day to explore the possibilities. 

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Laureen Lazarovici
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Robert Reich, Chancellor's Professor of Public Policy at the University of California, Berkeley, and former Secretary of Labor, made the economic case for worker engagement during his keynote address
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In addition to Kaiser Permanente and the Coalition of Kaiser Permanente Unions, the labor management partnerships presenting at the Partnership Day conference included:  

  • United Auto Workers (UAW) and Ford Motor Co.
  • International Paper Co. and United Steelworkers
  • SEIU Local 721 and Los Angeles County Health System
  • Berea City (Ohio) School District and the Ohio Federation of Teachers  
  • Energy Northwest Natural Gas and OPEIU Local 11

The following day, commenting on the success of the event, Alison Beck thanked KP for leading the way.

“They’re the gold standard of labor management partnerships,” she told attendees in her kickoff speech.

Check out more photos and insights from leaders of these organizations and unions on our Storify and on the FMCS Facebook page.

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When Every Day Is Partnership Day
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Organizations, unions from across the nation explore a more collaborative future
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What if every organization and every union had a labor management partnership like ours?

It’s not as far-fetched as it sounds. On Aug. 16, more than 250 union, business and government leaders from all over the United States gathered in Chicago for Partnership Day, a meeting hosted by the Federal Mediation and Conciliation Service at its biennial conference—and offered a realistic look at the ups and downs that occur in partnerships and what it takes to launch and sustain them.

“We know partnership can make a difference,” Allison Beck, FMCS director, told the gathering. “This is not some fantasy that happens in a make-believe world.” She should know. As leader of the FMCS, the federal agency that mediates labor disputes across the United States, she’s seen firsthand how acrimonious relationships can ruin companies and unions—and how more open and respectful ones can help them both succeed.

The partnership between Kaiser Permanente and the Coalition of Kaiser Permanente Unions is the longest-lasting and strongest one in the nation, so conference participants asked many questions about how it operates.

A race to the top

Dennis Dabney, KP's senior vice president of National Labor Relations and Office of Labor Management Partnership, told the packed room he spends a lot of time on the phone with leaders from other companies interested in starting and strengthening partnerships.

“I've seen so many companies engaged in a race to the bottom,” Dabney said. “I'd like to see more engaged in a race to the top.” If he has any regrets about Kaiser Permanente’s partnership, he said, it's that we didn’t create unit-based teams sooner.

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Couriers Steer Away From Outsourcing, Toward Savings

  • Reconfiguring routes and bringing contracted routes in house
  • Hiring an additional employee to reduce overtime and outside courier costs on the weekends
  • Purchasing new technology for central dispatching that enables better tracking of packages

What can your team do to evaluate where savings can be found? What else could your team do to be more productive and not have to use contractors?