Path to Performance Dimensions

Use of Tools

 

To identify change they want to make in their departments and test them to see if they work, unit-based teams use tools such as the Rapid Improvement Model (also known as RIM+), process mapping and waste walks. Using these performance improvement tools has allowed UBTs throughout Kaiser Permanente to improve service, quality, affordability and the work environment. UBT Tracker is an online tool teams use to track their projects and tests of change.

Team Member Engagement

When UBT members are actively involved with their team, they speak up with their best ideas about how to improve the department. They take advantage of partnership processes like consensus decision-making and interest-based problem solving to make the department a great place to work. They look at how the department is doing on key metrics—like those around service and quality—and use that information to come up with ideas for improvement.

Connecting the Dots With Popular Education

Submitted by Laureen Lazarovici on Wed, 10/26/2016 - 00:51
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The LMP is using popular education strategies to improve business and economic literacy on the front line. Staff at the Woodland Hills Medical Center describe how the training brings potentially dry subjects to life.

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UBT consultants work together dividing beans into cups to illustrate wealth inequality in the U.S. as part of a workshop by United for a Fair Economy using popular education techniques
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Business and Economic Literacy

Because more health care expense is shifting to the patient, it's important to know what you can offer. As they spend more, they expect more.

Learn where Kaiser Permanente dollars come from—and where they go—so you can provide the best customer service.

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Receptionist Sam Eckstein encourages his co-workers at the Woodland Hills Medical Center lab not only to meet—but to exceed—patient expectations of excellent service. To back up his coaching, he’s using the knowledge he gained in a new LMP course on business and economic literacy.

During the course, Eckstein and about a dozen other workers and managers learned about the rising cost of health insurance in the United States and the trend toward businesses’ shifting more health care costs to employees.

Because patients are paying more, “Their expectations are higher,” says Eckstein, a member of SEIU UHW. “When patients come in without an order [for a lab procedure], we can’t just send them home,” and inconvenience them by making them come back another day, he says. “We have to help meet their needs.”

Eckstein took part in a pilot project to test the Labor Management Partnership’s new approach using popular education techniques to ensure frontline employees and managers have the context and know-how they need to continue improving team performance and keep Kaiser Permanente affordable.

What’s different about popular education?

Popular education turns the old-fashioned schoolroom model of teaching and learning on its head. It is ideally suited to the Labor Management Partnership, which is built on the belief that all employees, managers and physicians bring their expertise and experience to bear on improving service and care at KP. No longer is the teacher or trainer the sole expert in the classroom, there to fill students’ minds with information they passively receive, memorize and repeat.

Instead, popular education taps into participants’ experiences in their communities and workplaces and uses them to generate dialogue. It explores the social and economic context of students’ lives and asks probing questions: What are people happy about? Worried about? Fearful about? Hopeful about? Students are encouraged to analyze that information—and to take action.

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Training

Working in partnership and creating a collaborative, high-functioning team requires specific skills, and the LMP Learning program offers a variety of training opportunities—online and in person—to ensure UBT members, co-leads and sponsors can be successful. Different trainings are recommended at different levels of the Path to Performance and cover areas such as problem solving, decision making and performance improvement.

Poster: Supreme Sponsor

Submitted by Andrea Buffa on Mon, 10/10/2016 - 16:02
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This poster, which appeared on the back cover of the Fall 2012 Hank, is a fun take on sponsorship, featuring a "supreme sponsor" action figure.

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Poster: Supreme Sponsor

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8.5" x 11"

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Frontline employees, managers and physicians

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Share on bulletin boards, in break rooms and in other staff areas to provide a lighthearted look at sponsorship.

 

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Around the Regions (Fall 2012)

Submitted by Andrea Buffa on Mon, 09/19/2016 - 16:17
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Eight quick hits, one from each region, on work being done in partnership. 

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Sponsors Joseph Gonzales, senior radiology manager, and Rebecca Torres, pharmacy technician and SEIU Local 105 member
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Colorado

The Regional Imaging teams in Colorado are lucky to have two effective sponsors: Joseph Gonzales, clinical operations for Regional Imaging, and Rebecca “Becky” Torres, a pharmacy technician and SEIU Local 105 member. Part of their success, the pair says, is the emphasis they have placed on sharing information—with each other and with their teams. The pair also figured out a way to spread effective practices. Using a PowerPoint template, the sponsors asked co-leads to explain what they’re working on, how it supports regional goals, whether it worked and the outcome. Then, the teams came together for a UBT Fair and shared their PowerPoints.

Georgia 

David Jones, MD, has a title unique at Kaiser Permanente: assistant to the medical director for unit-based teams. He mobilizes his fellow physicians in the Georgia region to get involved with UBTs and unleash the power of partnership to improve performance and grow membership. “The first thing I tell physicians about the UBTs is that it is about improving the work that we’re already doing,” he says. “It’s not about adding more work, it’s about looking at the work you're doing and figuring out how to do it better.” Read more from Jones—including how his experience with UBTs has transformed the way he delivers care to his patients.

Hawaii

A small region, Hawaii needed a novel approach to sponsorship: Branch out rather than always branch up. Initially, a five-member unit-based team committee tried to troubleshoot issues for the region’s fledgling teams. Often, those committee members, who also had roles as team co-leads or contract specialists, were trying to wear too many hats and got jammed. So the region, which now has more than 40 teams, has tapped 19 people to receive sponsorship training. The group includes middle managers, directors and other executives, frontline nurses who serve on the Kaiser Permanente board of the Hawaii Nurses Association, OPEIU Local 50, and former labor team members and co-leads.

Mid-Atlantic States

While the Mid-Atlantic States region’s clinical unit-based teams have management and labor co-sponsors, large teams such as lab and radiology are sponsored in a different way: A UBT leadership group made up of labor and management from these area performs sponsorship functions as a united body. “We generated a vision of our UBT sponsorship. We got very specific on how we would work together,” says Jane Lewis, executive director of health plan regional services and a member of the group that sponsors eight pharmacy UBTs. The UBTs report their projects and team dynamics at monthly meetings. The leadership group reviews People Pulse, service scores, quality results and other metrics, identifies struggling teams, and recognizes teams that excel.

Northern California

The region has been on a roll with its “A Leader’s Role as UBT Sponsor” training. Launched in the spring, the tutorial gives management and labor leaders an easy-to-understand yet in-depth look at providing effective support to unit-based teams and their performance improvement work. The short, online training covers everything from outlining a sponsor’s role and how a sponsor can model partnership to tips on developing strong UBT co-leads and high-performing teams. Several facilities have combined the training with in-person, interactive exercises, and early feedback suggests the blended approach is striking a chord with sponsors. The online training can be found at KP Learn.

Northwest

“My role as a senior sponsor is to bring the message of UBTs to physician leadership,” says Rasjad Lints, MD, the region’s executive sponsor of UBTs. Lints is especially interested in helping teams focus on outcome metrics—a measure of the final result of something, such as how many patients with hypertension have their blood pressure under control—and to help everyone on the team understand that improving on process metrics often drives improvement on outcomes. It can be difficult to see the value in participating in process metrics if team members don’t see how it relates to the outcome measures. “At the end of the day, physicians have to drive the care,” Lints says. While working in UBTs presents physicians with some unique challenges, he believes that “if the physicians aren’t engaged, it’s a lost opportunity.”

Ohio

In an effort to improve the quality of team project information in UBT Tracker, the regional LMP support team solicited the help of the people who support the work of teams—sponsors. In June, an improvement adviser met with Ohio’s 20-plus sponsors and asked them to work with their teams to boost the input of that data. To illustrate the value and role of quality data in UBT Tracker, they used the data in Tracker to brief the sponsors on their UBTs’ projects and status. Their approach made an impact: The region has reported an increase in sponsor engagement, and several teams have reported performance and relationship improvements. 

Southern California

The regional Labor Management Partnership department is launching a new sponsor training curriculum that covers the nuts and bolts of what sponsors do and how they do it. Topics include: the responsibilities of sponsoring bodies (such as helping define how the teams should be structured and guiding selection of co-leads); coaching skills to help develop UBT leaders; the similarities and differences between labor and management sponsorship; how managing in partnership differs from traditional management; and how the sponsor role differs from that of facilitators, project managers, trainers and consultants. Also included in the course are basics of the Labor Management Partnership and unit-based teams, such as the key elements for UBT success, the roles and responsibilities of UBT co-leads and members, and consensus decision making.

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From the Desk of Henrietta: 180 Flavors Later

Submitted by Andrea Buffa on Mon, 09/19/2016 - 16:16
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Henrietta, the regular columnist in the LMP's quarterly magazine Hank, explains why it’s important for partnership advocates to support the increasing LMP focus on sponsorship.

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From the desk of Henrietta: 180 flavors later
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A friend of mine with a heart flutter had to spend a day in a Kaiser Permanente emergency room recently, and he asked one of the staff members helping him, “Are you in a unit-based team?”

“Oh, yeah,” the staff member said, without much enthusiasm. “We have one of those.”

The exchange may not have been altogether surprising, but it underscores the work that still lies ahead for those of us who believe—as I suspect most readers of this column do—that partnership and unit-based teams are the right way to do business.

Naysayers nurture the old arguments. Partnership means management caving in to the unions or, conversely, partnership means unions selling out to management. Some people just sit on the fence, dismissing partnership as a “flavor of the month” and apparently hoping that if they ignore it long enough, it will go away.

Fifteen years after the Labor Management Partnership’s founding agreement was signed—at 12 flavors a year, that would be 180 flavors later—what’s a partnership advocate to do?

Spread the word. Do what you’ve been doing: Acknowledge the challenges of working in partnership, and cite the considerable achievements being piled up by UBTs. And here’s one more: Do what you can to support the increasing LMP focus on sponsorship, which is the subject of this issue’s cover article and companion stories.

Active sponsors are an essential component of a high-performing team’s makeup—and active sponsors serve as bridges between teams. They are positioned to spread effective practices up, down and sideways. Looking back after another 15 years, we may see that active sponsors were the partnership ingredient that finally turned LMP doubters into players. 

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