LMP Focus Areas

The Family Practice unit-based team at the Sunset Medical Office in the Northwest was thrilled that its work to get members to sign up on kp.org was a success. But team members quickly grew dismayed when the onslaught of new signups had an adverse effect on patients’ experience.

The challenge began in 2014, when the team launched several projects to increase the number of Kaiser Permanente members signed up on kp.org, knowing that people who use kp.org usually give KP higher satisfaction scores. The office is located in Hillsboro, Oregon, near one of Intel’s campuses. Intel offers Kaiser Permanente as a health plan option, so the effort to get more people online made perfect sense.

But, on the flip side, the increased number of messages coming in through kp.org wound up increasing turnaround times for return emails and phone calls.

More than two-thirds on kp.org

The department now receives between 450 to 650 email messages per week. Seventy-one percent of its patients—29,000 members—are signed up on kp.org. The team sought to improve its turnaround time on messages by reducing the number of times staff members and physicians touched each message. Instead of multiple people working a message, each one is now triaged one time by either an LPN or RN. At the same time, the team decreased its time spent on messages per week from 13.6 hours to 10.9 hours.

Ed Vrooman, an improvement advisor and union partnership representative, coached team members on how to test and implement their improvements.

“We learned how to use process mapping, so we could identify where the holes were in how we were approaching the work,” says Eliseo Olvera, the assistant department administrator and the UBT’s management co-lead. “Ed knew where we could get the data we needed and help us understand it, so we could do the work.”

Vrooman also introduced the team to the 6S tool—sort, simplify, set in order, sweep, shine, standardize—to improve its work processes. The team broke into different workgroups and each group identified tests of change. Some of the ideas were abandoned, some were refined and adopted, and some still are being adapted.

Staying on track

“I tended to focus too much on the information and the numbers,” says Rikki Shene, a licensed practical nurse and SEIU Local 49 member who is the team’s union co-lead. “Ed helped keep us organized and simplified the data so that we could keep moving forward and accomplish something in our 45-minute UBT meetings.”

Vrooman’s role in the team has been critical for the team. He attends the co-lead planning sessions and UBT meetings. He stays in the background until needed—and then he speaks up.

“He’s part of our community,” says Olvera. “His expertise with data has been critical. It’s a gift.”

“I was almost devastated,” says Karen Cardosa, a grocery clerk in Albany, Oregon, “when UFCW told us they were no longer offering Kaiser Permanente as an insurance option.”

Cardosa and her family had been KP members for years through the union’s Local 555 Employers Health Trust. That changed when a variety of issues resulted in KP losing the account, which covered many Local 555 members. The union continued to represent nearly 2,000 Kaiser Permanente pharmacy and radiology employees, who—as KP staff members—continued to have KP health care.

But today, Kaiser Permanente is again an option for up to 15,000 UFCW members and dependents in the Northwest region who are covered by the health trust.

New way to compete

An affordable price, high quality, a new hospital, expanded clinics and a new billing system helped win back this account. But something else was also at play.

Thanks to the Labor Management Partnership, the Coalition of Kaiser Permanente Unions and Kaiser Permanente take a joint approach to winning and keeping health plan members that is almost unheard of elsewhere in this country.

Bringing together union members and KP sales and marketing teams, the campaign helped win, expand, win back or retain 33 accounts covering 125,000 KP members in 2014, with a focus on public-sector accounts.

A broad reach

The effort spans almost every level of the organization and the unions.

Leaders of the local and international unions that belong to the union coalition play an active role in advocating for KP as the preferred health care provider when negotiating contracts or benefit programs with employers.

In addition, some 45 frontline union ambassadors spoke to 25,000 KP members and potential members at outside union and community events in 2014. “I have enjoyed working side by side with the sales and marketing representatives to promote Kaiser Permanente,” says Sera Jordan, a medical assistant, union ambassador and SEIU Local 49 member in the Northwest. “It has enabled me to share my firsthand knowledge of Kaiser Permanente and the care we provide.”

UBTs are a selling point

And unit-based teams, by giving frontline workers a voice in improving quality, service and affordability, are a big selling point for union purchasers of care. UBTs launched more than 8,000 performance improvement projects last year at every point on the KP Value Compass, including thousands of affordability projects that saved, on average, more than $40,000 per project.

“Working with our union partners, we’ve been able to come to the table with customer solutions that meet everybody’s needs—including the unions that aren’t part of KP, who have tremendous influence in purchase decisions,” says Kate Kessler, a Member Sales and Service Administration director. “We are unique in having a strong labor partnership in our own business, and we can speak that language.”

Find out why record membership matters to our current and future members on InsideKP.

Finding ways to help Kaiser Permanente employees enjoy long, healthy, productive lives is the mission of the Total Health and Workplace Safety subgroup.

The subgroup, one of three in national bargaining this year, will expand upon the achievements of the 2012 National Agreement. It will also address how Kaiser Permanente and the Coalition of Kaiser Permanente Unions can partner to improve the total health of the communities we serve.

Delivering exceptional care and service and supporting a healthier, injury-free workforce go hand in hand. “We can’t provide quality, affordable care to our members and communities unless we first provide a safe and respectful environment that promotes the collective health of our workforce,” says Kathy Gerwig, Kaiser Permanente’s vice president of employee safety, health and wellness and the management co-lead for the subgroup.

Personal and collective health

In 2012, negotiators established the groundbreaking Total Health Incentive Plan. The wellness program encourages employees to assess their own health and aim for collective improvement in measures like cholesterol and body mass index. In addition, healthy employees can serve as role models for Kaiser Permanente patients.

This year, the parties will suggest ways to create a healthier, safer work environment by improving employee access to services such as wellness coaching and better understanding trends in workplace violence and prevention. Another goal is to encourage employees to eat healthily, exercise at breaks and prevent workplace violence and intimidation.  

Expanding wellness to communities

In a first for national bargaining, the subgroup will also suggest ways to bring a holistic approach to wellness into communities Kaiser Permanente serves, especially those with limited access to healthy food, affordable health services and places to exercise.

“Our union members tend to live in communities that have high needs around health or issues around violence,” says Meg Niemi, the president of SEIU Local 49 and also a union co-lead for the subgroup. “So our members have an interest in their communities being healthier and safer further upstream, before they need critical care.”

The other two subgroups tasked with crafting recommendations are Work of the Future and Operational and Service Excellence in Partnership. (For more on Work of the Future, watch this slideshow and read this article.) Negotiators are developing a tentative agreement that will become the National Agreement after it is approved by Kaiser Permanente leadership and ratified by union locals this summer.

Visit bargaining2015.org for more information, videos and slideshows, and to sign up for bargaining updates.