Chang­ing to­gether

Kaiser-union part­ner­ship gets re­sults

Modern Healthcare - - From The C-suite - John Au­gust and Bar­bara Grimm John Au­gust is ex­ec­u­tive di­rec­tor of the Coali­tion of Kaiser Per­ma­nente Unions. Bar­bara Grimm is a se­nior vice pres­i­dent at Kaiser Per­ma­nente, Oak­land, Calif.

How does an or­ga­ni­za­tion with a heav­ily union­ized work­force, spread over hundreds of lo­ca­tions in nine states, not only pro­vide high-qual­ity, af­ford­able health­care, but also con­tin­u­ously im­prove care de­liv­ery?

We do it by work­ing to­gether—25,000 man­agers, 15,000 physi­cians and 92,000 work­ers in 29 lo­cal unions—through Kaiser Per­ma­nente’s La­bor Man­age­ment Part­ner­ship, called “the largest, most com­plex, am­bi­tious and broad-based la­bor man­age­ment part­ner­ship in U.S. his­tory,” by Thomas Kochan, a man­age­ment pro­fes­sor at MIT.

Many things set Kaiser Per­ma­nente apart. We’re widely rec­og­nized for our model of care—com­pris­ing an in­te­grated de­liv­ery sys­tem, pre­ven­tive medicine and mul­ti­spe­cialty med­i­cal groups, all con­nected by an ad­vanced elec­tronic health-record sys­tem. We be­lieve the part­ner­ship is an in­dus­try model as well.

The La­bor Man­age­ment Part­ner­ship was born out of a de­ter­mi­na­tion to trans­form health­care af­ter the mar­ket chal­lenges and la­bor tur­moil of the 1980s and ’90s. Man­age­ment and la­bor agreed on the great­est chal­lenges fac­ing health­care: im­prov­ing qual­ity and re­duc­ing costs. The part­ner­ship gives man­agers, physi­cians and work­ers a way to jointly de­cide how to do so.

They do that through unit-based teams. These nat­u­ral work groups of staff, man­agers and clin­i­cians meet fre­quently to dis­cuss prob­lems, iden­tify so­lu­tions and set per­for­mance goals. Through these teams, em­ploy­ees have a mean­ing­ful voice in day-to-day op­er­a­tions, and ac­cess to team-based tools and train­ing for im­prov­ing per­for­mance.

With more than 3,400 teams and thou­sands of par­tic­i­pants, what guides the work of the part­ner­ship? The “value com­pass” does. De­vel­oped by the part­ner­ship, it pro­vides the frame­work for front­line de­ci­sion mak­ing. In graphic form, the value com­pass sets forth our shared strate­gic pri­or­i­ties. It places the pa­tient and health plan mem­ber in the cen­ter, with four strate­gic goals placed at the points of the com­pass.

Guided and em­pow­ered by the value com- pass, we are able to serve our mem­bers and pa­tients in ways that other or­ga­ni­za­tions can­not. It is help­ing Kaiser Per­ma­nente im­prove the qual­ity and af­ford­abil­ity of care for our 8.8 mil­lion mem­bers and is trans­form­ing the pa­tient and the work­place ex­pe­ri­ences.

Re­sults are ev­i­dent across Kaiser Per­ma­nente. For ex­am­ple, an out­pa­tient surgery re­cov­ery team in Hawaii tack­led prob­lems it was hav­ing with its in­ef­fi­cient in­ven­tory sys­tem for op­er­at­ing room sup­plies. Af­ter re­or­ga­niz­ing its sup­ply closet and com­put­er­iz­ing its in­ven­tory track­ing sys­tem, the team is sav­ing nearly $10,000 a month.

Our ap­proach is dis­tinc­tive: It was the whole team putting di­verse skills to work, cre­at­ing a plan, test­ing out­comes and own­ing re­sults. Teams are track­ing re­sults and mea­sur­ing their im­pact. Kaiser Per­ma­nente teams have com­pleted or are work­ing on nearly 10,000 per­for­mance im­prove­ment projects in ser­vice, clin­i­cal qual­ity, work­place qual­ity and af­ford­abil­ity.

To­gether, we mea­sure the per­for­mance of unit-based teams against five lev­els of ef­fec­tive­ness, based on train­ing, lead­er­ship and other cri­te­ria. We com­mit­ted in our national la­bor agree­ment to dou­ble the num­ber of high-per­form­ing teams within 12 months—a goal we will more than meet.

We be­lieve that health­care providers at ev­ery level want to make a dif­fer­ence. In­deed, our em­ploy­ees lead the in­dus­try on mea­sures of work­place en­gage­ment and or­ga­ni­za­tional align­ment, ac­cord­ing to Tow­ers Wat­son. Mem­bers of unit-based teams score even higher.

Or­ga­ni­za­tions that rec­og­nize em­ploy­ees’ po­ten­tial and cre­ate a cul­ture of mu­tual re­spect, in­di­vid­ual re­spon­si­bil­ity and per­sonal em­pow­er­ment can ex­pe­ri­ence trans­for­ma­tive changes. We know it can be done. Venues for work­place col­lab­o­ra­tion, such as the La­bor Man­age­ment Part­ner­ship, pro­vide a path­way to im­prov­ing pa­tient care and em­ployee sat­is­fac­tion.

Grimm

Au­gust

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