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.”

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.