Quality

Screenings for such diseases as colorectal and breast cancers, high blood pressure, diabetes and obesity help us proactively identify identifying health risks and early signs of disease Here are some ways everyone can help ensure our members stay as healthy as possible.

1. During a visit, print out and review with the patient any screening gaps that are identified on his or her Proactive Office Visit summary.
2. Use KP HealthConnect™ and/or panel management tools to identify and reach out to members who are due for a screening to check for high blood pressure or such diseases as colorectal or breast cancer.
3. Have receptionists keep an eye out for age- and risk-appropriate members during office visits and target them for follow up by care providers.
4. Create outreach scripting that personalizes the importance of preventive screenings.
5. Designate a staff member to contact members who received at-home fecal immunochemical tests (known as FIT kits), to remind them to return them.
6. Capture patients’ attention by posting or mailing brightly colored literature that explains how a test detects early signs of disease and can be life-saving.
7. Work with your local radiology department to identify the best days and times for same-day mammograms, so patients can get the scan without an appointment.
8. Contact hypertensive patients at pharmacy pick-up counters for blood pressure checks and consultations.
9. Have clinical assistants and/or medical assistants increase the number of outreach calls and blood pressure checks.
10. Invite a regional or local expert in prevention and screening to meet with your team to discuss how best to support regional and local initiatives without duplicating efforts.

When flu season arrives, it’s important to stay well. As a matter of patient and workplace safety and professional pride, we can take steps to protect ourselves, our families, co-workers, and members and patients from flu and other infectious diseases. Here’s how. 

Vaccinate yourself and others

• If you don’t get the flu, you won’t pass it on. The vaccine reduces the chance you will get the flu. Encourage others to get vaccinated, too.

Keep flu out of the air

• Limit the time patients with suspected flu spend in open waiting rooms; separate them from others.
• Offer surgical masks to people who are coughing or sneezing and encourage them to cover their coughs. Supply tissues, trash cans and hand sanitizer in waiting areas.
• Place patients with flu in a private room.
• Avoid unnecessary transport of infectious patients — and have them wear surgical masks outside their rooms.

Keep flu off of yourself. Follow standard and droplet precautions

• Wear eye protection, gown and gloves.
• Wear respiratory protection when in the room with the patient and until the air has cleared after the patient has left the room (about one hour), or if you are doing procedures that may aerosolize infectious particles.
• Wash your hands often. Use hand sanitizer or wash with soap and water before and after all patient care.
• Avoid touching your face, clothing or mask with your hands.

Keep the environment clean

• Focus cleaning on high-contact surfaces: door knobs, elevator buttons, reception desks, exam tables, pharmacy furniture. 

Beep! Beep! Beep! The electronic sound of Cary Brown’s alarm clock wakes him at 5 a.m.

The Kaiser Permanente member rises to shower and make breakfast, careful not to disturb his sleeping wife, Elissa, who is recovering at home after surgery on a broken leg at the Woodland Hills Medical Center in Southern California.

On top of completing household chores, the retired Hollywood TV director spends his day making sure Elissa is comfortable and pain-free.

The experience has taken a toll on him.

“The hours of staying awake and the repetitive nature of it—and not having any life at all outside of home—is very difficult,” says Brown, who worked on the hit TV series Doogie Howser, M.D.

Now he’s part of an ambitious effort by the Southern California region to enhance support for caregivers, who play a vital role helping to heal and comfort patients outside the hospital. By reducing caregivers’ social isolation, integrating them into the hospital care team and addressing their health needs, regional leaders hope to improve patient safety and quality in the home.

‘Human-centered design’

Under the initiative, frontline workers, physicians and managers are partnering with KP members and their families to design the ideal in-home care experience for patients and caregivers. Participants are using a creative approach to problem solving known as human-centered design, which starts with the people you’re designing for and ends with solutions that are customized to their needs.

“It’s a way to engage the folks who are most affected from day one,” said Dr. Nirav Shah, senior vice president and chief operating officer for Clinical Operations in Southern California. “No program that I could ever design will be as good as one that had the people who are most affected design it with us. It’s about empathy and understanding.”

Human-centered design is also an ideal tool for unit-based teams to use on performance improvement projects. It delivers on the fundamental concept of the Value Compass—to put the member and patient at the center of decision making—and both frontline workers and Labor Management Partnership leaders, from management and the Coalition of Kaiser Permanente Unions, have been supporting the caregiver project.

Reducing the overwhelm factor

At a meeting in Pasadena, the participants—patients and caregivers, KP employees and physicians—gathered in small groups to share personal tales and draw storyboards to help identify barriers, come up with potential solutions and provide insights to regional Home Health leaders.

Shawna Wallace, a senior physical therapist for Home Health and member of UNAC/UHCP, said the experience was eye-opening.

“I’ve gone into homes where caregivers really care about their loved ones, and they are extremely overwhelmed,” she said. “This is a great opportunity for us to see where we can make better programs for our caregivers and members in these scenarios.”

Brown is hopeful that the approach will give caregivers—and their loved ones—the emotional and physical support they need to thrive.

“If you take care of the family as a unit,” Brown says, “you make it possible for each individual in the family to be better.”

Emile Pinera, MD, a second-generation Kaiser Permanente employee, came to the company five years ago and immediately became co-lead of an adult medicine unit-based team in the Georgia region.

“I had the clinical part down,” says Pinera, who is now lead physician for diversity and inclusion in Georgia and an adviser on the region’s transgender task force. But being a co-lead and working in a UBT were unfamiliar. “I had to implement my medical knowledge in a team, as opposed to a top-down approach where the doctor tells everyone what to do.” 

He wasn’t convinced at first—but the partnership approach and physician participation helped elevate the team’s performance, and it posted some of the region’s highest quality scores for managing diabetes and blood pressure. 

“We achieved it through hard work and collaboration,” Pinera says. “I loved working with my management and labor co-leads. We were respectfully honest about what was achievable. Working in the UBT gave us the tools to effectively communicate, track, adjust and improve.”

Pinera currently guides and supports co-leads as a UBT sponsor for three teams and is lead physician for three adult medicine offices. His enthusiasm helps his teams, the members and the Georgia region. 

“I was skeptical at first about UBTs’ relevance, but we couldn’t achieve our success with hypertension and diabetes management without each other’s help. I’m a believer,” he says. “My tip for fellow providers is to be engaged as much as possible, because it will help us achieve better outcomes and help our patients thrive.”