Labor Management Partnership:

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Labor Management Partnership Kaiser Permanentes
strategy for frontline engagement and
performance March 2014
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Our Labor Management Partnership

• Largest and most comprehensive labor-management
  partnership in the country
• 27 local unions representing 100,000 KP workers
  (including nurses, technicians, clerical and
  service employees)

• The partnership reflects a business strategy to
• Improve organizational performance
• Deliver high quality care and service to our
  members
• Involve the union and individual workers in
  decisions that affect the workplace
• Make KP the best place to get care and best place
  to work

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Core principles of partnership
Health care services and the institutions that
provide them are undergoing rapid change... Now
is the time to enter into a new way of doing
businessto unite around our common purposes and
work together to most effectively deliver high
quality health care and prevail in our new,
highly competitive environment. - National
Partnership Agreement, 1997
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Whats a unit-based team?

• Unit-based team A natural work group of
  frontline workers, physicians and managers who
  solve problems and enhance quality for tangible
  results. UBTs work together to
• Set goals
• Review and evaluate performance
• Identify and solve problems
• Contribute to decisions on budget, staffing and
  scheduling

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KP Value Compass
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UBT Path to Performance
Roadmap for team development
Level 1 Level 2 Level 3 Level 4 Level 5
Pre-Team Climate Foundational Transitional Operational High-Performing
Learning what a UBT is and how it works. Establishing structures and norms. Demonstrating progress. Joint leadership, improved performance. Full collaboration and measurable success.
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Growth of high-performing teams
3,345 unit-based teams were in place as of
year-end 2013. 1,675 teams, about 50 percent,
were high performing.
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Rapid Improvement Model Plan, do, study, act
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What teams are working on
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Ambulatory Surgery Recovery, Moanalua Medical
Center, HonoluluCutting costs, clutter in the OR
RESULTS The team saved nearly 10,000 per month
by reducing duplicate and overstocked supplies
for medical centers operating room.
WHAT THEY DID Team members created a more
organized supply room by clearly labeling shelves
and supplies, helping them keep better track of
their inventory. They are also maintaining the
inventory on a computer.
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Respiratory Care, San Jose Medical Center
Getting to zero pressure ulcers

• WHAT THEY DID
• To reduce reportable hospital-acquired pressure
  ulcers (HAPUs), the team set a goal of sustaining
  at least a 90 percent completion rate for patient
  skin assessments . They did this by
• Conducting four skin integrity assessments per
  patient during each 12-hour shift
• Documenting observations in patient charts
• Electronically tracking assessments weekly
• Auditing assessments monthly
• Posting results with names of corresponding
  respiratory therapists
• Providing counseling and encouragement for those
  not meeting the goal.

RESULTS Reportable HAPUs
Visit LMPartnership.org for ideas and tools for
your team.
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Telemetry, San Diego Medical CenterPatient
safety No one walks alone
WHAT THEY DID By viewing every patient not just
some as a fall risk, this telemetry UBT
successfully piloted a falls-reduction initiative
that has drastically decreased falls
hospital-wide.
RESULTS Falls in a month
Visit LMPartnership.org for ideas and tools for
your team.
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Infectious Disease/Oncology (Northern
California)Lab gets quicker on the draw

• WHAT THEY DID
• To shorten wait times for blood draws, this
  Gilroy Medical Offices UBT
• Shifted staff schedules so the lab opens earlier
• Staggered lunch breaks to spread out the loss of
  staff on the floor
• Educated physicians to improve the clarity of lab
  orders and reduce duplicative orders
• Cross-trained staff members so everyone can
  register patients and process specimens as well
  as draw blood. If eight or more patients are
  waiting to have blood drawn, the team goes into
  all hands on deck mode.

RESULT Average daily wait time (minutes)
BEFORE
AFTER
Visit LMPartnership.org for ideas and tools for
your team.
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A model for health care

• Kaiser Permanente is forging a strategy that
  brings together a comprehensive model of care,
  uses technology sensibly produces high quality
  health care and at the same time empowers
  employees.
• We know from other industries that you cant
  have high quality services in a service-oriented
  industry with a demoralized workforce. The LMP is
  showing theres a better way, and that way could
  be a model for health care.

Tom KochanInstitute for Work and Employment
Research Sloan School of Management, MIT