They finish each other’s sentences; they call each other “Mrs.”; they praise in public and correct in private.

Antronette Moore-Mohead and Joanna Harris are a model couple. They’d make a marriage counselor proud. 

They’ve been together for three years, but they’re not married (to each other, that is)—they’re the unit-based team co-leads in the National Claims department, based in Oakland. Since co-leads frequently move on to new positions, Moore-Mohead and Harris are a long-term couple in the world of UBTs. 

“We are all for the team,” says Harris, a national claims processor and OPEIU Local 29 steward, the UBT’s labor co-lead. “Praising workers’ effort or accomplishments helps keep morale up and folks engaged in their work.” 

“Being transparent is key to succeeding as a team,” adds Moore-Mohead, the department’s processing supervisor and the management co-lead. “Also, honest, clear, concise communication is a must. So is having fun.”

'Let's talk it out'

They share stories and photos of their families, they tease each other about maybe not needing that sugary snack, and they can tell when the other is “in rare form.” Even on days when stress is high, the two know when to give each other space or when to say, “Let’s talk it out.”

“We are free to bounce ideas off of each other, without fear of being shot down,” Harris says.

The positive vibe and mutual respect between the co-leads is apparent, but they are clear that they don’t mix outside of work time to alleviate any appearance of favoritism. 

“I love that Antronette is passionate about her work. She operates from the perspective of ‘there is no Big Me, little you,’” explains Harris. 

The department they lead is responsible for collecting fees and processing claims from services performed outside of Kaiser Permanente facilities. Last year, the high-functioning Level 4 team of 39 claims processors and examiners, who are represented by OPEIU Local 29, saved more than $6 million by negotiating better rates for services rendered outside of the network. 

“It’s important to pay it forward,” says Moore-Mohead. “We want to make sure we are growing our team and others have opportunities to learn.”

Su-Xian Hu and Runeet Bhasin make partnership look easy. The telemetry team co-leads at Downey Medical Center in Southern California share a relaxed rapport that belies the time, planning and occasional friction that are part of running a busy inpatient unit. 

Together for more than a year, the pair attribute the success of their budding relationship to communication and a commitment to partnership principles—especially consensus decision making. Those core values came in handy recently when a disagreement arose about the best way to educate patients about medications. 

Nurses preferred a less overwhelming one-page sheet, but managers wanted to switch to a detailed three-page form that had been adopted by other units in the hospital. 

“It was a major issue,” says Bhasin, RN, a staff nurse and member of UNAC/UHCP who is the team’s labor co-lead. “We had to come up with a solution to fulfill management’s needs and labor’s needs.”

At the time of the disagreement, UBT members turned to consensus decision making to determine next steps they all could support. A subsequent test of change resulted in a short-term fix: Nurses used the short form with patients, while the longer handout was provided as a resource guide in patient rooms.

New to partnership

Managing in partnership was a new experience for Hu when she joined the team in April 2016 as assistant clinical director and became a co-lead. She previously had overseen a Kaiser Permanente inpatient nursing unit that was not part of the Labor Management Partnership. Bhasin, a co-lead with two years of experience, served as mentor and coach.

“Runeet was wonderful with helping to bring me onboard,” says Hu, who is also an RN. 

Both say LMP training has given them a shared understanding of their roles as co-leads, the purpose of UBTs and how to use consensus decision making. A business literacy class both took proved especially fruitful: With the information they brought back, the team tackled an affordability project that reduced overtime costs by more than $95,000 last year. 

“The UBT classes,” says Bhasin, “made me realize the real meaning of partnership, the collaboration of labor and management to work toward the same goal to provide high-quality care and to have a great work environment.”

The pair’s approach seems to be working. Their 75-member UBT is at Level 4 on the five-part Path to Performance, and it has earned accolades for outstanding patient care and gains in workplace safety and affordability. 

“We want what is best for patients and for staff,” says Hu. “We might have differences, but we always come together with open and professional communication, sitting down together to solve those issues.”

Make the most of LMP Videos

Thank you for watching our video! The LMP communications team created it with the hope that you would watch and be inspired to share it with your coworkers and friends.

Videos are one of the most popular and effective ways to educate, entertain and inspire. (YouTube gets more than 1 billion unique visitors every month!)

You have the power to inspire your colleagues and help spread the word about the work that’s being done in partnership by posting a video to your Facebook page or showing it at your next meeting. 

If you are a team co-lead, show it at your next unit-based team meeting. If you are a manager, play it at your next managers' meeting. Facility and regional leaders—share it with other leaders.

Afterward, spend a few minutes asking for viewers' reactions and dicussing takeaways from the video. Are there practices that you or you team can copy?

Videos are time well spent in a meeting. You’ll engage your audience in a way that live presentations often don’t.

And you will have helped strengthened our Labor Management Partnership.

Instructions for handling zipped files

1. Click on the "Download MP4" link.
2. A "File Download" window should pop up asking "Do you want to save or open this file?"
3. Choose "Save."
4. File will be saved as "zipped" file that is your video compressed into a zip archive.
5. Right-click on the file and choose Extract All, then save that WMV file to your computer.
6. Click on WMV to play the video.

The word “affordability” can be a lightning rod. Union members often think it is a code word for layoffs and cutbacks. They might question why it is suddenly up to them to sweat every paper towel and latex glove and wonder if higher-ups are pitching in. 

Managers might wonder how in the world they are supposed to squeeze more out of their already-tight department budgets. 

If everyone suits up for battle every time the word is mentioned, then progress on saving money becomes harder, if not impossible. 

Luckily, at Kaiser Permanente, our values create value. After all, Henry J. Kaiser and Dr. Sidney Garfield founded KP to be an affordable (there’s that word again), high-quality health plan for working families, with incentives to keep our members healthy (rather than profit when they got sick or injured). 

With the advent of the Labor Management Partnership 20 years ago, we cemented another core value: Listening to the voices of frontline workers, managers and physicians, who do the work and are closest to the patients. They know where the waste and inefficiencies are. And addressing inefficiencies goes hand in hand with improving care.

In 2005, the National Agreement negotiated by KP and the Coalition of Kaiser Permanente Unions further refined these values by laying the groundwork for unit-based teams. UBTs emphasize performance improvement and, more importantly, ensure everyone at every level of the organization has access to PI methods and tools so they can contribute. 

Read this issue of Hank, and make peace with “affordability”—confident that our values create value.

“The No. 1 reason for the success of our teams has been personal engagement,” says Alan Kroll, a primary care area administrator in Colorado who co-sponsors nine unit-based teams with his labor and physician partners. “Everyone needs to buy into the process to make partnership work.”

Building engagement and ensuring a consistent work experience have been goals of the Labor Management Partnership since the beginning. But, at the same time, there’s been a good deal of variation around these efforts from location to location across Kaiser Permanente, to the frustration of many managers, workers, and KP members and patients.

That’s why the 2015 National Agreement mandates partnership training for everyone, including the mid-level managers and union leaders who guide others. Early versions of the partnership training for mid-level leaders, which will be available this year, have gotten high marks from UBT sponsors and other leaders who have taken it. 

Consistency counts

The agreement calls for “a learning system that supports sustained behavior change, partnership and performance.” This includes joint training and refresher courses—delivered in-person
and/or online—to “achieve the same partnership and employment experience wherever one works in KP.” 

The new training for mid-level leaders will include segments on: interest-based problem solving examining the forces that support or undermine partnership core partnership behaviors and principles the strategic importance of the LMP 

Joint training is key 

The programs are designed to develop successful leaders who can model partnership and spread successful practices—and to ensure that the managers or union representatives helping teams have what they need to support those teams.

“It is very powerful for managers and union leaders to be in training together,” Kroll says. “It sends the message that everyone is important, and sets a foundation to work from when an issue gets stuck.”

The training served as a reminder that good partnership practices also are good leadership practices. 

“People want to hear from their leaders,” he says, and to “know what issues we are dealing with and that we can help remove obstacles.”

See the 2015 National Agreement, section 1.E, Education and Training (pages 31–33) for additional information.

Budget-savvy shoppers know you can save money by buying in bulk—even, it turns out, when you’re buying pharmaceuticals. Just ask the team members of the Zion Outpatient Pharmacy in San Diego.

The unit-based team was able to save more than $1 million over five months by buying drugs in quantity and managing specialty medications better. And, adopting a practice that would make Goldilocks happy, the pharmacy now keeps just the right amount—no more, no less—of high-cost meds in stock. Managing costs helps keep expenses down for members, and the team’s improved communication means better service for patients, whose medications are there when they need them.

Not so long ago, the financial picture looked bleak for the 24-hour pharmacy, which serves discharged hospital patients and other members at the bustling Zion Medical Center. Inventory had swollen to more than $3 million. It was a signal the pharmacy had too much stock on hand and wasn’t turning it over frequently enough. 

“We realized that we needed to do something,” says Nathan Close, outpatient pharmacy supervisor and management tri-lead of the 45-member team, which is at Level 4 on the five-point UBT Path to Performance.

Honest assessment

Team members set a five-month goal to reduce their bloated inventory by $600,000, from $3.2 million to $2.6 million, starting in January 2016. 

Their first step was to review the pharmacy’s ordering and inventory practices. Team members quickly realized they were overstocking oral chemotherapy, Hepatitis C and antiviral medications. At $10,000 a bottle, rarely used pharmaceuticals suck up resources when they sit on shelves. Worse, if they aren’t used or returned to the manufacturer before they expire, they’re a costly mistake.

To get a better handle on prescription trends, team members reached out to ambulatory care pharmacists, who are part of a different team and who collaborate with physicians to treat members with cancer or chronic conditions. By partnering with the pharmacists, the team was able to plan ahead better.

“Once we know what patients are going to need, we make sure that we have that in stock,” says Wesley Frani, a pharmacy assistant and UFCW Local 135 member who is one of the team’s labor tri-leads. 

Key to the team’s success is another labor tri-lead, Jane Corby, an inventory control assistant and also a UFCW Local 135 member. She carefully monitors stock levels to ensure that when patients present their prescriptions, the right medications are on hand.