LMP Focus Areas

Good things happen when more members join Kaiser Permanente.

Kaiser Permanente and our unions gain strength and stability. Good jobs become more available and secure. More people in our communities benefit from KP’s affordable, quality care.

And all KP employees can help make those things happen.

For example, the Labor Management Partnership and KP’s sales and marketing organization work together in unique ways to build KP health plan membership. Thanks to their efforts, in 2014:

• 125,000 KP members joined or stayed with the health plan. 
• 100,000 KP members or potential members got letters from their local unions encouraging them to select KP during open enrollment.
• KP union ambassadors reached 20,000 potential KP members at worksite, community and union events in five regions.

Workers tell their story

In addition, thousands of KP workers, managers and physicians in unit-based teams win and keep KP members by delivering great care and service every day.

Louise Casa, a nurse practitioner, UFCW Local 400 member and union ambassador in the Mid-Atlantic States, says all workers have stories to tell about what makes KP a better place to give and get care.

“I share the story of being part of a partnership that values union workers and their ideas,” she says. “I talk about our unit-based team work on goals for care improvement, problem solving and workflow improvement in our departments. People in the community been very interested in the UBT process.”

What you can do

Everyone has a role to play in helping Kaiser Permanente grow and retain its membership. It starts with the work we do every day to serve members and patients:

• Deliver the best member experience. If you know someone is a new member, take an extra minute to explain how things work.
• Encourage members to sign up for kp.org. Surveys show that members who sign on are more likely to stay with Kaiser Permanente.
• Look for ways to improve work processes or cut waste, to help keep KP affordable for the people we serve.

Kaiser Permanente and the Coalition of Kaiser Permanente Unions have reached a formal agreement that ensures the safety and compensation of KP employees involved in caring for patients with the Ebola virus.

The agreement, reached December 15, 2014, clarifies questions coalition unions had about the engagement and protection of their members who may encounter or care for a patient with Ebola. It codifies standards outlined by the Centers for Disease Control around protective protocols and equipment. It also outlines training and support provided to employees, including for employees who may be unable to work during an isolation period for a possible Ebola exposure.

Safeguarding workers and patients

“As health care workers, we’re used to putting our patients first,” said Ken Deitz, president of United Nurses Associations of California (UNAC). “Because Ebola is an infectious disease, to maintain patient safety we also had to ensure our own safety.”

The parties came to agreement quickly and with little disagreement, with conversations focused on clarifying the practices KP facilities already are doing as outlined by Centers for Disease Control guidelines.

Union and KP leaders say it reflects their desire to work together—and to continue to focus on educating, protecting and preparing employees who may come in contact with Ebola patients.

“By working together, we have ensured that employees are prepared to care for patients with Ebola while keeping themselves and their colleagues protected from infection,” said Kathy Gerwig, vice president of Employee Safety, Health and Wellness for KP.

Education, training and protection

Specific provisions of the agreement include:

• All employees with the potential to interact with, treat, or do cleaning or waste handling for suspected Ebola patients will receive paid time for education and training in such areas as Ebola signs and symptoms; care and treatment; proper donning and doffing of personal protective equipment; proper cleaning of treatment rooms or areas; and proper disposal of the patient’s body fluids and wastes.
• Employees in key treatment or intake areas will receive sufficient personal protective equipment supplies.
• Ebola treatment teams would be staffed by volunteers. If there are not enough volunteers, local KP and union leaders would identify team members.
• If a coalition union-represented employee cannot work, or receives care as a result of work-related exposure to Ebola, the employee will receive paid time off, and all medical costs will be covered through workers’ compensation.

Read the agreement.

Do you doubt you can lead changes that make Kaiser Permanente a better—and safer—place to give and get care?

A small group of nurses at the San Diego Medical Center showed that leading change is, in fact, part of their job.

Brittni Demers, RN, and three of her colleagues spearheaded a successful effort to reduce needlestick injuries, and now their expertise is being tapped throughout Kaiser Permanente to bring the voice of frontline workers to safety initiatives.

Demers, a member of UNAC/UHCP, is on KP’s National Sharps Safety Committee. It is one of the many sourcing and standards teams that advises KP on everything the organization buys—and it is the only one with union representation. As such, it gives the caregivers who actually use needles, scalpels and other sharps a way to influence purchasing decisions. It also impacts workplace safety and tools workers use every day.

From July to December 2013, a huge remodeling project at the hospital shut down two medical-surgical units, leaving several nurses temporarily without anywhere to work. Demers and RNs Jessica Heffern, Leanne Vitacco and Lucas Pepin got together to tackle a problem that had been concerning them: needle and sharps injuries. By July 2014, the team’s project had led to an astounding 76 percent decrease in needlestick injuries in inpatient nursing units. There were similar improvements for all sharps injuries throughout the San Diego service area.

Here’s what the team did:

Peer-to-peer training

Only two years out of nursing school, Demers quickly saw that “real life” didn’t always comport with what she had learned in her classes. “You go to school, you learn correct techniques, then you go into a hospital and it’s different,” she says. “People like doing things their way.” The team devised a quick refresher for nurses, by nurses, that emphasized what the evidence and research said about safe needle handling. The nurses traveled from unit to unit in the hospital, and to some outlying clinics, to make their case. “When you emphasize safety—our own and the patients’—and provide the supplies, then people will do it,” she says.

“The peer-to-peer approach was effective because the team understood the nurses’ day-to-day concerns,” says Mark Trask, the director of environmental health and safety in San Diego. “There is empathy and understanding, which allows for more dialogue.” In addition, because the trainers were registered nurses, they could spell other nurses for the 10-minute refresher. More than 700 nurses, physicians and lab techs took the training.

Standardize supplies

While demonstrating safe needles to other units, the team members often would hear, “Oh, we don’t have that one.” So they got to work standardizing the needles throughout the medical center. “We went through every single medication room,” says Demers. “They became supply chain experts,” says Trask. By adjusting the types and amounts of equipment, they also reduced waste and saved money.

Share expertise

These nurses now participate in incident investigations when there is a needlestick injury, which is an important part of the region’s workplace safety program. Plans are in the works to spread the training to primary care departments in the ambulatory setting.

Identify resources

Demers’ participation on the National Sharps Safety Committee extended her reach system-wide. The committee field tests safety sharps in every KP region to identify products that most effectively prevent injuries. Based on user feedback, the committee selects the highest-rated safety sharps as KP’s national standard.

Why did the four frontline nurses step up? For Demers, the answer is easy: “You have to be focused on safety when you have a needle in your hand.”

Want a safer workplace served up on a silver platter?

Then stop by the operating room at Kaiser Permanente’s West Los Angeles Medical Center in Southern California. Surgeons and the other health care workers there pass sharp instruments to one another on silver trays—rather than passing them hand to hand—which reduced injuries related to handling sharp instruments during procedures by 34 percent between September 2013 and May 2014.

“We can see the results,” says Lisa Duff, a surgical tech and workplace safety champion at the facility. This success is part of a new emphasis at the facility on task standardization—analyzing each step of an activity, identifying the potentially hazardous steps, coming up with a safer way of doing things and then ensuring everyone follows the new process the same way, every time.

How to reduce risk

“Injuries occur when there is not consistency,” says Tracy Fietz, chief administrative officer for Southern California Permanente Medical Group at West L.A.  “If you break [a task] apart on a fishbone diagram, you can identify where the risks are. It is about removing variation.”  

Standardizing practices also has helped several departments reduce—and in some cases eliminate—sharps-related injuries for up to 17 consecutive months. It’s also helped reduce injuries to EVS workers by 75 percent when they clean floors.

Another practice that is improving safety at West L.A. Medical Center is regular monthly meetings between senior leaders,  including Fietz, and the labor and management safety leaders of targeted departments. Departments that have special line-of-sight safety goals (see below) in the region’s Performance Sharing Program get special attention. The gatherings are a space to analyze processes, see what’s working—and what isn’t—and collect information to share with others.

How partnership helps

“I work with managers and the workplace safety champions, because it’s a partnership,” says Nor Jemjemian, the chief administrative officer for Kaiser Permanente Hospital/Health Plan at West L.A., who also leads those meetings. “I want the employees doing the tasks to be part of the solutions.”

Union-represented employees, for their part, appreciate the crystal-clear message top leadership is sending.

“You need management to back you up when you speak up,” says Duff, a member of SEIU-UHW. “Employees know that our managers will back them up 200 percent.”

Open communication, trust and partnership processes are the foundation of a safer workplace, says Jemjemian.

“When I was an employee, there were [hazardous] tasks I did that my manager didn’t know about,” he says. Today, in contrast, “UBTs create a venue and a forum to discuss the everyday work.”