Value Compass Concepts

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.”

“You have two ears and one mouth for a reason,” television’s Judge Judy frequently says, quoting an ancient Greek philosopher. “You should listen twice as much as you talk.” Successful co-leads realize that making a partnership work requires listening and learning from one another. 

Caroline Masikonde, RN, had been a management co-lead with the urgent care team at Largo Medical Center in the Mid-Atlantic States, an experience that helped her understand the importance of valuing her partner’s input. But when she accepted a new role as clinical operations manager in Northern Virginia Audiology in January 2016, she didn’t have any experience in audiology. So she’s relied heavily on her new labor co-lead, Lynn M. Reese, Au.D., a UFCW Local 400 member. Masikonde has learned why audiology UBT members escort patients outside (so they can try out new hearing aids in different conditions)—and her willingness to listen helped the co-leads bond quickly. 

“Lynn is very experienced,” says Masikonde. “I lean on her even now.” 

Reese, on the other hand, was new to the unit-based team structure, since the audiology UBT had just formed. That’s where Masikonde’s expertise came in. “We fit together pretty well,” says Reese. “Caroline is very open to listening and learning new things.”

Reese, too, expanded her knowledge, growing into an appreciation that she and Masikonde have equal say on what’s now a Level 4 UBT. “Everyone contributes,” says Reese. The ability to speak up led to Reese and the rest of the team requesting and receiving approval for an additional booth to test patients’ hearing. 

Relationship tested

Their new relationship was tested when a member—after waiting more than 12 weeks for a refund on a hearing aid that had cost more than $1,000—alerted them, loudly and angrily, to the problem. 

Instead of pointing fingers, UBT members figured out the issue: The refund request had to be processed through a department in Southern California, but the team had no way to follow up once the request was submitted. 

“This lady forced us to look at this and do better for our members,” Masikonde says. “It prompted us to come up with a better workflow,” and now the team has names and contact information for the people who work on the refunds.

“Even though it was a bad situation, she made us want to improve,” Reese says. 

Because the co-leads already were accustomed to relying on and listening to each other, they were able to quickly and calmly handle this tense situation with the unhappy member.

“We really learned our lesson,” Masikonde says. “Recently, we did a refund on a Monday—and by Friday, the member had the check. Lynn and I know our parts and do our dance.”

They finish each other’s sentences; they call each other “Mrs.”; they praise in public and correct in private.

Antronette Moore-Mohead and Joanna Harris are a model couple. They’d make a marriage counselor proud. 

They’ve been together for three years, but they’re not married (to each other, that is)—they’re the unit-based team co-leads in the National Claims department, based in Oakland. Since co-leads frequently move on to new positions, Moore-Mohead and Harris are a long-term couple in the world of UBTs. 

“We are all for the team,” says Harris, a national claims processor and OPEIU Local 29 steward, the UBT’s labor co-lead. “Praising workers’ effort or accomplishments helps keep morale up and folks engaged in their work.” 

“Being transparent is key to succeeding as a team,” adds Moore-Mohead, the department’s processing supervisor and the management co-lead. “Also, honest, clear, concise communication is a must. So is having fun.”

'Let's talk it out'

They share stories and photos of their families, they tease each other about maybe not needing that sugary snack, and they can tell when the other is “in rare form.” Even on days when stress is high, the two know when to give each other space or when to say, “Let’s talk it out.”

“We are free to bounce ideas off of each other, without fear of being shot down,” Harris says.

The positive vibe and mutual respect between the co-leads is apparent, but they are clear that they don’t mix outside of work time to alleviate any appearance of favoritism. 

“I love that Antronette is passionate about her work. She operates from the perspective of ‘there is no Big Me, little you,’” explains Harris. 

The department they lead is responsible for collecting fees and processing claims from services performed outside of Kaiser Permanente facilities. Last year, the high-functioning Level 4 team of 39 claims processors and examiners, who are represented by OPEIU Local 29, saved more than $6 million by negotiating better rates for services rendered outside of the network. 

“It’s important to pay it forward,” says Moore-Mohead. “We want to make sure we are growing our team and others have opportunities to learn.”

Workforce Planning and Development

Key accomplishments

• Program enrollments in Kaiser Permanente’s two education trusts grew from about 3,000 in 2007 to nearly 62,000 in 2016. 
• Tuition reimbursement course applications nearly tripled, from less than 20,000 in 2008 to more than 57,000 in 2016, largely benefiting members of unions in the Coalition of Kaiser Permanente Unions.
• Critical skills training launched in June 2017 with a Digital Fluency pilot program for more than 2,000 employees.

Going forward

• A top priority will be addressing the impact of economic, social and technological changes on care delivery and future KP staffing models. (Learn more at kpworkforce.org.)

Workplace Safety

Key accomplishments

• Since program inception in 2001, KP’s injury rate has been reduced by 69 percent.
• Injuries associated with patient handling and/or mobilization have decreased by 32 percent since 2011.
• The program-wide workplace safety strategy was strengthened in 2016, based on the National Safety Council’s model.

Going forward

• The strengthened safety strategy will be implemented, with the goal of closing the gap between KP’s injury rate and the Bureau of Labor Statistics adjusted injury rate for health care.

Total Health

Key accomplishments

• More than 76,000 employees have taken the Total Health Assessment (THA) since 2014.
• Ninety percent of eligible employees completed their recommended health screenings in 2014 and 2015, earning a $40 million payout under the Total Health Incentive Plan.
• More than 3,000 UBT health and safety champions helped teams across the organization conduct 1,756 wellness projects in 2016—a 45 percent increase from 2015.

Going forward

• New awareness campaigns, including one focusing on prediabetes education, will inform and empower employees to take charge of their own health and wellness.

Joint Marketing and Growth

Key accomplishments

• Helped secure more than $108 million in revenue for Kaiser Permanente in 2016.
• Supported the 20-year growth in the number of employees represented by a union in the Coalition of Kaiser Permanente Unions, from 57,000 to 116,000, and in Kaiser Foundation Health Plan membership, from 7.4 million members to 11.8 million. 
• Since 2012, mobilized 51 union ambassadors who attended more than 300 community events and engaged more than 70,000 KP members and potential members—many of them unionized—increasing community knowledge and understanding of KP.

Going forward

• Through the expansion of health plan membership, support job security and the continued growth of the coalition.

Attendance 

Key accomplishments

• Enhanced time-off benefits to provide incentives for appropriate use of sick leave.
• Developed the Time-Off Request Tracking System to provide greater flexibility and responsiveness in managing planned time off.
• Achieved 21 percent fewer lost workdays in high-performing UBTs. 

Going forward 

• Attendance data, systems and results will continue to be assessed and improved.

Where were you 20 years ago? The three of us were each on a different path—paths that crossed in unexpected ways, and changed the way we do our jobs.

Our Labor Management Partnership often is described as a journey, for good reason. It is ever changing. It can be difficult. And you never know where it’s going to take you next. But it also has a few rules of the road that help us find our way:

Understand and respect one another’s needs and interests. Listen openly and assume the best intentions of your counterparts. Ask questions, especially, “Why?” Create an environment where people feel safe speaking up.

Over the years, that approach has gotten positive outcomes for Kaiser Permanente, our unions, our workforce and, most important of all, our members and patients.

That doesn’t mean our partnership is perfect; it isn’t. Or that we always agree; we don’t. But we’ve tried the traditional ways of working, and the trip is much better on the high road that Kaiser Permanente and the Coalition of Kaiser Permanente Unions have chosen.

Thank you for your hard work and dedication. We invite you to join colleagues in your unit, department or region this fall to celebrate your accomplishments, reflect on our challenges, and commit to creating an even better future.