COVID-19 is testing partnership as never before.

Management and labor have had to work together quickly to retool the delivery system to support rapidly changing needs. Employees’ and physicians’ skills and talents are needed in new ways and in new places — so leaders from Kaiser Permanente and unions created labor pools to get KP employees to where they were needed.  

It’s one of dozens of innovations made to provide top-quality care at a time when every day is bringing new challenges. The swift work was possible in part because of the foundation provided by the relationships and values of the Labor Management Partnership.

In Southern California's Riverside service area, “It’s all-hands on deck,” says Jiji Abraham, area chief financial officer. “Even physicians are in the labor pool.”

As physician assistant Larry Rick, PA-C, made his rounds of the South Bay Medical Center one recent morning, staff stood at the hospital’s main entrance and screened members, patients, and employees for signs of cold- and flu-like symptoms. Like Kaiser Permanente facilities enterprise-wide, the Southern California hospital adopted the new procedure to protect patients and staff from COVID-19, the respiratory illness caused by the novel coronavirus.

A well-established approach is also helping: Frontline workers here say years of working collaboratively with managers as part of the Labor Management Partnership has better prepared them to fight the pandemic. The Partnership has saved money, improved care, and led to better service – and now will literally be saving more lives because frontline workers, managers, and physicians are working together.

An opportunity to speak up

“Partnership is a fantastic tool,” says Rick, a member of UNAC/UHCP, who has 34 years of experience fighting infectious diseases including H1N1, HIV, and sexually transmitted diseases to prevent the spread of HIV. “Every Kaiser Permanente senior leader has been responsive to our requests and has heard us. We’re working together and everybody is leaning in” to treat more patients now, while preparing for an expected surge. In response to unit-based team members’ concerns, for example, tape was placed in 6-foot intervals on pharmacy floors to help members and patients maintain social distancing while standing in line.

“We’re able to speak up as labor and help figure out the solution,” says Alejandra Navarro, a registered nurse in Maternal Child Health and a member of UNAC/UHCP.

Working in partnership together has also built trust between management and labor. That’s been key to maintaining open lines of communication now and helping counter misconceptions spread by social media, say frontline workers.

Education and support

“They’re educating us and giving us a lot of support,” said Lizz Burnett, a licensed vocational nurse in Geriatrics and a member of SEIU-UHW. “If I can help educate someone and they can tell their family, then maybe we can stop this.”

Tynikko Snyder, a registered nurse in Family Medicine at the Gardena Medical Offices, has 2 children with asthma and her mother suffers from chronic obstructive pulmonary disease. She is worried about the impact of her work on her family. “I am afraid, but I know that I need to step up to the plate and do what needs to be done,” says Snyder, who is a member of UNAC/UHCP. Rick says that can-do spirit is needed to combat the spread of the disease: “If we all do our jobs, we will save lives.”

Do teams get better results when frontline workers are engaged, free to speak and can influence decisions? Yes, say the people who know best — Kaiser Permanente workers and managers themselves.

Recent People Pulse surveys confirm that unit-based teams get positive results for health plan members and patients, the organization and workers themselves.

For instance, the 2017 People Pulse survey of more than 155,000 KP employees showed that when union-represented employees are highly involved in UBT activities, they get 29 percent higher scores on measures of their willingness to speak up — a key driver of patient and workplace safety and satisfaction. They also get 33 percent higher scores on questions regarding workplace health and wellness.

Improved safety and satisfaction

Further analysis, included in the 2016 People Pulse survey, showed that teams with high employee involvement have:

• 18 percent fewer workplace injuries
• 13 percent fewer lost work days
• 4 percent higher patient satisfaction

“Our findings show that employees who are highly involved in their unit-based teams feel more able to speak up and more encouraged to take care of their health,” says Nicole VanderHorst, principal research consultant with KP Engagement & Inclusion Analytics. “That makes them more likely to have better performance outcomes.” 

A better way to work

Workers’ greater propensity to speak up and look after their health when they’re involved in team activities covers several questions (see chart below). For example, workers who are highly involved in their UBTs are far more likely to say:

• The Labor Management Partnership has helped improve organizational performance and working conditions.
• They can influence decisions affecting their work.
• They’re comfortable voicing differing opinions.
• Management uses their ideas to improve care.
• They’re encouraged, and encourage others, to take care of their health.

Click to enlarge.

Roots of workforce engagement

All these factors contribute to a better employee experience as well as performance. And UBTs reflect KP’s unique history with the labor movement.

“Henry Kaiser was perhaps the 20th century’s most worker-friendly industrialist. He supported organized labor and knew that people step up when allowed to exert their job experience, as they do with UBTs,” says KP archivist and historian Lincoln Cushing.  “He trusted employees to make decisions that benefitted themselves and their organizations.”

If you belong to a unit-based team — and most union-represented employees do — talk with a team co-lead about ways to get more involved.

Alaine Lounsbury, RN, is proud of her nursing team at Downey Medical Center in Southern California. 4 West team members have worked together for decades, forming bonds that have led to high patient satisfaction rates and region-wide recognition.

Lounsbury, nursing assistant clinical director, attributes the team's success to rounding — the practice of engaging frontline workers in face-to-face conversations on the floor and listening to their concerns. Managers who round say it helps build a culture of engagement and dialogue, a key goal of the Labor Management Partnership between Kaiser Permanente and the Partnership unions. 

“It’s about making a connection,” explains Lounsbury, who rounds quarterly on 90-plus staff members using Kaiser Permanente’s Rounding Plus online tool [KP Intranet]. “You want to hear the good with the bad.”

Removing roadblocks

With the tool, managers can use their mobile device to identify, track and escalate issues surfaced during rounding conversations. Program-wide, nearly 10,000 leaders and managers use the program.

At Downey, nurses used rounding conversations to speak up about a workflow issue. Because 4 West is the only unit with nurses qualified to give chemotherapy to adults, it meant staff members sometimes had to leave their department to administer drugs to patients. Their frequent absences meant more work for others.

“I heard them in rounding say, ‘You need to figure this out,’” recalls Lounsbury. She and her team developed new protocols to enable others outside the unit to give the medication. “That was a big satisfier.”

Getting visual

To help her systematically follow up and act on her team’s questions and concerns, Lounsbury uses a colorful poster, called the Stoplight Report, that assigns green, yellow and red colors to track the status of issues.

The poster was conceived by Downey Quality Coordinator Suxian Hu, RN, based on the color-coded reports managers receive through the Rounding Plus program. Last year, all of Downey’s inpatient nursing units began using it.

In 4 West, the poster hangs prominently in the conference room, where everyone can see it.

“Staff members know something is being done,” says Donielle Tresvant, RN, a staff nurse and member of UNAC/UHCP, one of the unions in the Alliance of Health Care Unions. “They know they’re being heard.”

Nurses say the information shared on the poster also fosters team communication and collaboration. “It keeps us updated about things at work and it helps us improve our care by being focused,” says Brianna Schneider, RN, a member of UNAC/UHCP. “It makes for a cohesive atmosphere.”

Unit-based teams, or UBTs, are our engine for improving performance and creating the best place to work, and the partnership’s Path to Performance matrix helps guide teams’ development. Whether you’re new to the world of unit-based teams or a seasoned UBT consultant, the Path to Performance section of LMPartnership.org will give you the tips and tools you need to help your team succeed.

The ABCs of UBTs

If you’re new or need to explain UBTs to a new person, go straight to the UBT Basics page for an explanation of unit-based teams, information about roles and responsibilities, and more.

Already a superuser?

Go straight to any of the seven performance dimensions from the drop-down in the main navigation bar. You’ll get a thoughtfully chosen list of top resources as well as links to videos and stories that bring to life why the work matters.

Explore the Path to Performance

The Path to Performance matrix provides a consistent way for unit-based teams to continually improve their teamwork and how they do their work. It sets expectations for beginning Level 1 teams on through high-performing Level 5 teams in seven different performance dimensions. 

Everyone benefits from this progression, because as teams become high performing, they have fewer workplace injuries and better attendance, service scores and quality outcomes.

Sounds good, right? Help your team move from Level 1 up to Level 5 by visiting our Introduction to the Path page — it will lead you to recommended next steps, customized by team level and performance dimension.

Do you or your teammates want to shrink wait times? Save money on supplies? Reduce time wasters or roadblocks? Once you’ve identified a problem to solve, you may wonder where to start. No need to invent an improvement project from scratch. Visit the Team-Tested Practices section and see what’s worked for others. We’ve got short summaries of successes from every region and every type of work environment to give your team a kickstart.

1. What’s here? 

When you visit LMPartnership.org/team-tested-practices, you’ll find the first several “tiles” of the dozens you can choose from as you scroll through this section. Each tile will have a photo and short preview about a specific, measurable improvement a team has made.

2. Sharpen your search 

Want to narrow down what you see? Use the filters on the left side of the page. There are several to try, including:

• Topic. Choices include affordability, patient safety, service and more.
• Department. See what departments like yours have done.
• Region. Check out the projects done in your region.

Selecting more than one filter at a time works, too. And remember that you can get great ideas from departments very different from yours and regions other than your own. You’ll notice these filters throughout the website to help you focus your searches. 

3. Intrigued? 

See something your team might want to try? Click on the tile to get a more complete description of the challenge the team was facing — and the main tests of change that helped the team achieve its goal. And the measurable result: “Saved $40,000,” “decreased wait times by 11 minutes,” “69 percent drop in costs.”

4. No dead ends! 

So, maybe the practice you clicked on isn’t right for your team. Before you move on, check out the related tools and stories in the colorful columns farther down this page. Throughout the site, the color orange means, “Here are tools to get your team started on work like this.” Blue is, “Get inspired by stories and videos about teams working on similar efforts!” And, “Just for fun” — green will take you to puzzles, games and other light-hearted resources to kick off your improvement campaign on an upbeat note.

Let's be real: If everything is important, nothing is important. The prize for us is providing high-quality care and service at an affordable price to our members, patients and communities we serve — and the Focus Areas section of LMPartnership.org is a tool for helping unit-based teams prioritize their work and stay grounded.

What will you find here? Let’s start with the Value Compass. The Focus Areas section has pages that go in depth on each of the four points — Quality, Service, Affordability and Best Place to Work. You also can learn more about topics that are part of the National Agreement, including Total Health and Workplace Safety, Workforce Planning and Development (Workforce of the Future), and Union and KP Growth.

And then two pages are specifically for improving your team’s culture — which will in turn improve performance (we have the stats to prove it). The Join the Team, Be the Change page has tips and tools for improving team communication and engagement, while the Free to Speak page will help you build a Speak Up culture on your team.

Join the team, be the change!

How do you get your unit-based team to be excited about the work? Why would staff members want to be involved? How do you get those quiet people — who you just know have great ideas — to speak up?

Ideas to answer these questions and many more are found on the Join the Team, Be the Change page of the website. You’ll find tips and tools for improving team communication, the first step in getting employees interested and involved.

But it doesn’t stop there. As communication improves, it’s easier for the team to pull together and solve problems — which in turn raises morale and can foster a sense of joy at work. Teams with good communication have more fun, report higher engagement, have better People Pulse scores and are rated higher on the Path to Performance.

And when employees are happy and satisfied with their jobs, our members and patients feel the difference in the care we give. Have fun with your team and make things happen!

In a large library, visitors often need a map or librarian to help them find what they’re looking for. But the LMPartnership.org Library is easy to navigate: A quick click on the Library tab at the top of any page on the website takes you to a great collection of videos, all sorts of tools, stories, short profiles of colleagues, issues of Hank magazine, the eStore and more. Everything is in its own category — exactly like your local library — except you don’t have to be quiet.

Hot off the presses!

Want to know the latest? Always check the Library first. Interested in an inspiring video to open a meeting? The Library is your place. Each new video, story, tip sheet and profile is posted here. Be sure to check out the Humans of Partnership, a collection of short, heartfelt stories from people — like you — who make up our partnership. Read their own words about:

• how they used a partnership benefit
• a time they spoke up at work
• how their UBT handled a challenge

Share these stories and videos at UBT meetings and huddles — they provide a great lift. We’ve got dozens to choose from.

Get the right tool for the job

The Tools page in our electronic library is like the reference section of a brick-and-mortar library, with Tools to help you and your team complete successful improvement projects, conduct productive meetings and improve our workplace. Access the Tools page by clicking on the All Tools tile in the More to Explore band on the Library landing page, or click on Tools in the dropdown menu in the main navigation bar. Then use the filters on the left side of the page to zoom in on what you’re looking for:

• Need an activity that promotes health for a unit-based team? Use the topic filter and select Total Health.
• Looking for a simple way to explain interest-based problem solving? Use the topic filter and select LMP Processes.
• Find an engaging activity to kick off a meeting! Use the tool type filter and select Icebreakers and/or Puzzles and Games.

Consult the How-To Guides

Don’t overlook the 13 LMP How-To Guides, which provide smart collections of related tools to speed you from start to finish on an activity (planning a meeting, doing a performance improvement project, improving workplace safety and more):

• Use the tool type filter and select How-To Guide.