Path to Performance

I have worked at Kaiser Permanente for 33 years, starting as a distribution worker in materials management. Being on the front lines helped me better understand the challenges staff face—and helped me, in my current role, see what it takes to spread and sustain change in a complex organization.

When we launched our first unit-based teams in 2007, I knew they could give our managers and teams a powerful tool for change. But to achieve their full potential, UBTs need the support of leaders at every level. In working with UBTs every day, I have found five practices that can help teams achieve their goals, and have helped me be a more effective leader.

Have patience

I’m not a patient person by nature, and it took a visit to the world-class health care system in Jonkoping, Sweden, for me to see that it takes patience to sustain meaningful change. When you’re solving problems in a team-based workplace, real systemic change takes time. But it also takes hold deeper into the organization.

Really see the work

Spend time with a UBT, or hear teams present their test of change, to understand what they’re working on and how you can support them. There’s no way you can feel the excitement and energy from the team members and not feel proud and motivated by their work.

Spread good work

In Orange County—which has two large hospitals, in Irvine and Anaheim—we expect all teams to continually test and then spread their ideas and successful practices. We call it “One OC” and we talk about it all the time. You’re never going to achieve greatness globally if you don’t spread good work locally.

Provide tools

Early on we formed an Integrated Leaders group of senior labor and management leaders who meet monthly to monitor and assist our 107 UBTs. If a team is struggling, the IL group doesn’t descend on them and try to fix the problem. We provide tools and resources that help the team work through a problem and get results. For instance, we put together a UBT Start-up Toolkit with information on everything from setting up teams to finding training. We’re also looking at toolkits on fishbone diagramming, conducting small tests of change and providing rewards and recognition. And we’re asking how to make it easier for teams to access resources quickly—for instance by identifying go-to people for questions on budgeting, patient satisfaction metrics and so on.

Then, get out of the way

 I have a saying: “Hire great people, give them the coaching and mentoring they need, then get the heck out of their way and let them do what they were hired to do.” I think that works at all levels of the organization, whether or not people are your direct hires. You don’t tell people to make a change or streamline a process without any encouragement or support, but you don’t need to micromanage them either. Delivering great health care is not just a job. It is a calling. Whether you’re a housekeeper preventing infection or a surgeon treating cancer, people’s lives are in our hands. That shared mission drives us to be the best.