Unit-based team concepts

As more and more unit-based teams answer the call to improve affordability for health plan members, they are finding new tools that can help manage their cost-improvement projects.

One such tool, a handy spreadsheet, can help teams track and report their cost savings.

Teams track own savings

Developed by UBT consultants and financial analysts in Colorado and later adopted by UBTs in the Northwest, the tool can help teams determine the economic benefits of a performance improvement project with little or no assistance from a consultant or sponsor.

“It’s a great add-on to teams’ reporting in UBT Tracker,” says Luanne Petricich, chief pharmacist, Pharmacy Professional Affairs, in Colorado and a sponsor of 12 UBTs in the region. “It can be a very impactful way for co-leads to show their teams and others what their savings were and how they achieved them.”

In addition, teams can now record their financial results directly into UBT Tracker thanks to a new data field, Annual ROI, that allows teams to share how much money a project saved or generated. The field can be found under the Project Details tab (see graphic below).

Click to enlarge.

Tool use spreads

Petricich sends the spreadsheet to any of her teams working on a cost-reduction or efficiency project to help them document their results.

One team that used the tool was the pharmacy UBT at Baseline Medical Offices in Boulder. The team had completed an inventory-reduction project that far surpassed its goal—which was to reduce its drug inventory by 10 percent, or $50,000, in three months. By adjusting order quantities to better match usage and returning overstocked medication to the mail order pharmacy for use before the expiration date, the team saved $143,000—nearly three times its original goal.

“It’s important to track your results, and this tool can help teams do that in a simple way,” says Don Larson, Baseline’s pharmacy supervisor. “It’s something we would use the next time we do a similar project.”

For at least one Colorado facility, workplace safety started with awareness. And building awareness was a team effort.

Wheatridge Medical Office, with about 140 employees, had three workplace injuries in the first half of 2013. The Wheatridge Safety team, representing departments across the facility, agreed that was unacceptable. But team members weren’t sure where to start, and the team lacked a management representative, making it hard to find time or resources to implement ideas.

That changed when Jeanne Kraft, RN, nurse manager for Internal Medicine, joined the safety team. The team adopted two ideas that had worked elsewhere. One was to host a safety fair, following a tried-and-true format: People visited several booths where they got information and answers to a quiz on basic safety practices. Everyone who completed the quiz then got a ticket for a barbecue lunch on the patio.

It’s one thing to identify effective practices in an issue as important as workplace safety. It’s another to educate and engage teams in adopting a consistent set of practices across a region.

The Northwest’s Employee Health and Safety Department has done just that—and earned program-wide recognition for its approach.

In November 2012, the department’s Labor Management Partnership Workplace Safety team issued a challenge to the region’s 16 facility safety committees. The committees, established to help identify and resolve safety issues at the facility level, often differed in their approach and results. The safety challenge provided a fun way for the local committees to get to know more employees in their facilities, follow a consistent protocol and improve safety.

Challenging teams to step up

“The Safety Awareness Challenge provides safety committees an opportunity to work together with their labor, management and Permanente partners to effect real change around workplace safety,” says Chris Mozingo, RN, workplace safety labor consultant for the NW Region.

The yearlong campaign challenged each facility to:

• submit monthly or quarterly safety meeting minutes, to help keep their work on track
• have physicians and dentists attend at least 80 percent of their facility’s safety meetings, to ensure widespread participation and leadership (nonclinical departments were asked to send representatives to each meeting)
• promote safety conversations (a blame-free approach for observing work practices) and ensure at least 25 percent of employees are trained to lead such conversations
• adopt and promote safety awareness plans to help teams identify and correct at least three different workplace hazards (for instance, trips and falls or sprains and strains)
• host a safety fair, safety barbeque or other facility event within the year

“The Safety Committee Challenge goes beyond recognizing achievement. It fosters and reinforces the relations between Regional Safety, management and frontline staff,” says Employee Health and Services Safety Specialist II Brian Cekoric.

Getting results, recognition

Nine facilities completed the safety challenge by meeting each of the five established criteria. These efforts helped the Northwest region—already a leader in some key measures of workplace safety—record a 4 percent decrease in injury rates compared with the previous year. Teams that met the challenge will receive additional funding to support safety awareness promotions in their facilities.

For its part, the Northwest Employee Health and Safety team won the 2013 National Workplace Safety Award for its work in engaging frontline teams.

“The simple focus on injury prevention and raising awareness goes a long way to changing the culture of safety,” says Rob Weiking, Employee Heath and Services program manager.

When the internal medicine UBT at the Los Angeles Medical Center decided to focus its efforts on African Americans with hypertension, not all team members initially were comfortable with targeting patients by race for special outreach. “We worried about how patients would react,” says union co-lead Marilyn Lansangan.  

However, when they invited African-American patients to a special clinic, they were thrilled with the results. Not only did patients show up, the team made progress toward its goal of closing the gap between African-American patients with their hypertension under control and those of other races. “The barrier was not the patients. The barrier was us,” says Lansangan.

Closing care gaps

Nationwide, nearly 45 percent of African Americans suffer from high blood pressure—a rate much higher than other racial and ethnic groups. The condition tends to develop earlier in life and is likely to be more severe for them. There is some recent research from the National Institutes of Health that suggests genetics may play a part. Such social and economic factors as discrimination and poverty also may contribute. Whatever the reason, health care organizations—including Kaiser Permanente—are working to reduce the disparity.

When Jose Saavedra, M.D., the physician champion on hypertension at LAMC , heard that colleagues at Downey Medical Center held a special outreach clinic for African-American members with high blood pressure, he encouraged the internal medicine UBT to try it as well.

Targeted outreach

Team members generated a list of their African-American patients with a certain threshold of uncontrolled hypertension. LVNs and social workers called patients every day, inviting them to the special clinic. The success of the outreach calls surprised everyone. “Even when we just left a message, people would come to our clinic,” said Elenita Petrache, assistant administrator and one of the management co-leads.

At the event, clinicians educate patients about hypertension, then take their blood pressure. Depending on the results, patients queue up for a short chat with either a doctor or a nurse, who can adjust their prescription or schedule a more in-depth appointment. Patients who successfully control their blood pressure get a certificate. Everyone gets a swag bag containing an apple, bottle of water, DVD about hypertension, and information about diet and sodium.

Improving teamwork

Gayle McDow, who attended the clinic in late April, says it make sense for KP to reach out to African-American patients. "The numbers suggest that this issue is more prevalent in our community," she says.

The project also built cohesion among UBT members who work on different floors, says Petrache. “It helped two parts of the department develop a better relationship because we have common goal,” she says. “There is communication between the teams. It’s a beautiful thing.”