Receptionist Sam Eckstein encourages his co-workers at the Woodland Hills Medical Center lab not only to meet—but to exceed—patient expectations of excellent service. To back up his coaching, he’s using the knowledge he gained in a new LMP course on business and economic literacy.

During the course, Eckstein and about a dozen other workers and managers learned about the rising cost of health insurance in the United States and the trend toward businesses’ shifting more health care costs to employees.

Because patients are paying more, “Their expectations are higher,” says Eckstein, a member of SEIU UHW. “When patients come in without an order [for a lab procedure], we can’t just send them home,” and inconvenience them by making them come back another day, he says. “We have to help meet their needs.”

Eckstein took part in a pilot project to test the Labor Management Partnership’s new approach using popular education techniques to ensure frontline employees and managers have the context and know-how they need to continue improving team performance and keep Kaiser Permanente affordable.

What’s different about popular education?

Popular education turns the old-fashioned schoolroom model of teaching and learning on its head. It is ideally suited to the Labor Management Partnership, which is built on the belief that all employees, managers and physicians bring their expertise and experience to bear on improving service and care at KP. No longer is the teacher or trainer the sole expert in the classroom, there to fill students’ minds with information they passively receive, memorize and repeat.

Instead, popular education taps into participants’ experiences in their communities and workplaces and uses them to generate dialogue. It explores the social and economic context of students’ lives and asks probing questions: What are people happy about? Worried about? Fearful about? Hopeful about? Students are encouraged to analyze that information—and to take action.

Quan Nguyen, DO, learned in seventh grade how devastating a workplace injury can be. His father, a carpenter, severed part of his thumb when he lost control of the power saw he was using. The accident put him out of work for a time and forced the family to stretch its skintight budget even further.

Years later, the memory inspired him to join Orange County’s Workplace Safety Steering Committee, says Dr. Nguyen.

“I’ve witnessed, firsthand, how things at work can lead to pain and suffering for the person and his family,” says Dr. Nguyen, a physical medicine and rehabilitation physician at the Chapman Medical Offices in Orange, California. “We’re like a big family at work and I don’t want to see people hurt.”

Team visits worksites to improve safety

As the sole physician on the 12-member committee, Dr. Nguyen uses his singular perspective to engage physicians and others to build a culture of workplace health and safety.

“He’s very unique,” says Jim Ovieda, assistant medical group administrator and the committee’s management tri-chair. “He brings another voice of authority to the conversation.”

Four years ago, Dr. Nguyen helped form the Tiger Team, a task force of union members and managers who visit units with high injury rates and offer expert advice on how to reduce risks. They developed a simple process to identify and address workplace hazards at the local level (see “Five Tips for Workplace Safety Site Visits”).

“It’s not a punishment. We’re there to help departments succeed and to help our staff and physicians to be safe,” says Dr. Nguyen, who named the Tiger Team in honor of “Tigger,” the fictional tiger character who bounces around and helps others.

Collaborating with frontline union members is vital to keeping everyone safe, says Dr. Nguyen.

“There seems to be two cultures inside the hospital – the physician and non-physician. We’re trying to bridge those two cultures by bringing together a diversity of voices to improve the culture of health and safety for everyone,” says Dr. Nguyen. 

Host teams say the visits and ensuing discussions help create an environment where everyone feels comfortable speaking up—essential to building safety into daily work.

Partnership approach gets results

The team aims for six site visits a year and had conducted 31 visits as of November 2015. Most of those departments reported significantly fewer injuries in the months after the visit; many reduced injuries by 50 percent or more. The approach has gained attention region-wide and other medical centers in Southern California are adopting the practice. The team also presented its partnership approach at the 2016 National Workplace Safety Summit.

“It’s a way of taking the pulse of the department,” Ronald Jackson, a medical assistant, SEIU-UHW member and the steering committee’s labor tri-chair, says of the team's site visits.

“We bring a fresh set of eyes to the department,” says Albert Alota, workplace safety coordinator for Orange County.

Three practical solutions

Recently, the committee’s labor and management members sat side by side reviewing workplace safety records for the Irvine Medical Center’s recovery room. The department had accrued nine injuries in as many months, three of them involving employees and gurneys. The team identified several hazards related to work space and storage and recommended ways to fix them. For example:

• To address heavy traffic down narrow hallways and around blind corners: Provide standardized traffic flow for gurneys, mirrors at key intersections and a recognized verbal cue to alert bystanders to passing gurneys and equipment
• To unclog crowded patient bays that forced staff to work at laptops in busy hallways: Install wall-mounted computers and exam stools to replace the office chairs in the room
• To reduce injuries caused by incorrect use of new gurneys: Ask vendors to help train staff how to safely operate new equipment

Employees appreciate the attention. “It’s good to have the team come in,” says Sol Estrella, RN, a staff nurse and UNAC/UHCP member. “It shows that management and higher-ups are responding to our staff needs.”

Colorado

Employees in Colorado are well on their way to wellness. The region has had a wellness program since 2004, and for the last four years has had a cash incentive to encourage employees to participate in wellness activities. The results have been positive. From 2009 to 2012, employee obesity rates have dropped from 34 percent to 32 percent. In addition, the prevention index—a composite metric that reflects the percentage of employees who are tobacco free, up to date on preventive screenings for heart disease and cancer, and not obese—has risen, with women improving from a 46 percent rating to 52 percent, and men improving from 44 percent to 50 percent.

Georgia

The Georgia region used its social media channels, including Facebook, Twitter, Instagram and Pinterest, to showcase employees, physicians and executives who mobilized for the Atlanta 2-Day Walk for Breast Cancer in October. Photos of giant, costumed characters “Doc Broc” and “Nurse Blueberry” filled the region’s news feeds, along with pictures of KP’s walkers and supporters. By using hyperlinks and hashtags, KP’s teams could connect with others involved in the event to generate online buzz for the walk. “Doc Broc” also appears at the KP-sponsored farmers’ market at Piedmont Park and other events. When not tracking the cruciferous crusader, the social media pages keep a steady diet of healthy recipes, tips and links to blog posts by top executives to show KP and its partner unions’ joint commitment to total health.

Hawaii

Safety conversations are sweeping the islands, with every employee in the region striving for at least two conversations per month, thanks to an idea pioneered by the Ambulatory Surgery Recovery unit. Brightly colored “topic stimulator” cards encourage staff members to share tips in a safe, fun manner. “Sharp attack” cards keep safe needle-handling on point. “Whoa” cards steer employees toward safer patient transport and lifting. “I spy” cards safeguard confidentiality by prompting frank discussions about hallway conversations, snooping, unattended computers and the paper shredder. Christy Borton, RN, the regional workplace safety champion—and injury rates, which were already low, are staying that way “We never talked about safety. Now we do, all the time, in the most meaningful ways.”

Mid-Atlantic States

The region’s fourth annual Learning Conference will provide opportunities to enhance skills in education and learning. Two days of workshops will provide ways to help clinical health educators improve communication skills and leverage the latest patient education technology. Informed and educated patients can participate in treatment, improve outcomes, help identify errors before they occur and reduce length of stay. This free conference also is for anyone in the region who facilitates or supports learning, including those who will be involved in engaging staff in workforce wellness activities—technical and LMP trainers, consultants, managers and supervisors, and shop stewards. Sessions begin Friday, Nov. 1, in College Park, Md. To view the conference web page and register, go to learn.kp.org and search for KPMAS Annual Learning Conference.

Northern California

Marcus Barnes and Donna Norton have been named the region’s Total Health union champions. The Total Health positions help support implementation of the 2012 National Agreement. Barnes, an OPEIU Local 29 member, works in the regional Claims department. Norton, a member of SEIU UHW, is a licensed vocational nurse at the Vacaville Injection Clinic, serves as an executive board member of SEIU UHW for Vacaville and Fairfield, and is her facility’s union co-lead. The pair will work closely with local union leaders and managers to recruit and train local workforce wellness champions, help frontline employees understand the National Agreement’s Total Health Incentive Plan, and work to integrate workforce wellness and workplace safety at the front line.

Northwest

Staff in the Northwest are getting healthy and having fun at the same time. At the Beaverton Medical Office, staff members teamed up to lose weight and sweetened the deal with an informal competition. Those who met their personal goal then took part in a drawing for a prize. Overall, staff members at the medical office have lost 89 pounds. If you come by, don’t be surprised if you see staff doing Instant Recess®, push-ups in the back office or working in the community garden.

Southern California

Panorama City Medical Center has 52 busy “Thrive ambassadors,” who talk to their colleagues about Kaiser Permanente’s wellness programs. They also recently started one community walk per month, raising awareness and funds for Alzheimer’s disease, victims of violent crime and other causes. Holly Craft Moreno, who is quoted in the cover story of this issue of Hank, says the group is always recruiting new ambassadors—adding that it’s not necessary to be a “rock star who does a triathlon every day.” The willing are welcome, she says: “Some of us can’t walk as fast as others. There is always someone on our team who will slow down, too.”