Labor Management Partnership Primer : A Better Way to Work

1. Labor Management Partnership Primer:A Better Way to Work February 2017

2. Labor Management Partnership A shared strategy for change • Established 1997 as a strategy for frontline engagement, workplace innovation and performance improvement • Jointly led and funded by Kaiser Permanente and the Coalition of Kaiser Permanente Unions • 28 local unions in 11 internationals • 115,000 union members • Largest, longest running and most comprehensive partnership in the U.S.

3. 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 business…to 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

4. A Winning Strategy for Kaiser Permanente Kaiser Permanente has gained: • Continuous improvement in service, quality, affordability • More than 5,400 team-led improvement projects in Q4 2016 alone; 1,664 projects to reduce costs • Employee engagement and commitment • Operational stability and health plan membership growth Focus areas for improvement projects,Q4 2016

5. A Winning Strategy for Labor Coalition union members have gained: • Industry-leading wages and benefits • Employment and income security • A voice for patients, a voice for workers • Card-check organizing neutrality; union membership growth 115,000 82,000 57,000 Membership Growth in Union Coalition 2005 2017 1996

6. Outside Experts Recognize LMP Success “LMP is showing there’s a better way, and that could be a model for health care.” - Tom Kochan, Sloan School of Management, MIT

7. Most day-to-day work in partnership happens in self-directed teams called unit-based teams—natural work groups of frontline workers, physicians and managers who jointly identify and solve problems, set goals and measure results. More than 3,500 unit-based teams lead change across Kaiser Permanente. Self-Directed Teams Lead Improvements ?

8. Positive Work Settings Bring Results • Work environments associated with high-performing UBTs have: • 60 percent fewer patient falls with injuries • 38 percent fewer workplace injuries • 21 percent fewer lost work days • 13 percent improvement in patients’ overall hospital satisfaction Source: Kaiser Permanente Organizational Research, 2016

9. Targets for Team Development All unit-based teams are rated on a 5-point scale of performance 78 percent of teams rated high performing (Level 4 or 5) as of December 2016

10. Rapid Improvement Model Rapid Improvement Model: Plan, do, study, act Using the “Plan, Do, Study, Act” cycle, teams set goals, establish metrics, identify and test changes, then spread successful practices.

11. KP Value Compass The Value Compass guides decision making by reminding teams what creates value for Kaiser Permanente members and patients.

12. Performance Improvement Project QUALITY: Making Early Detection Easy Eye Care Services, Redwood City Medical Center (Northern California) This team uses prompts in the KP HealthConnect electronic health record to book cancer screenings for eye-care patients identified as overdue for a screening.

13. Performance Improvement ProjectSERVICE: Team Boosts Capacity • Mt. Scott Pharmacy (Northwest) • Hit by high patient volume and glitches with a new software system, the team: • jointly reorganized schedules • used performance improvement tools to improve workflow • made stress-busting, wellness activities part of their routine

14. Performance Improvement Project AFFORDABILITY: Cutting Supply Costs • Linen Team, Kaiser Sunnyside Medical Center, Northwest • The team asked units across the hospital to help reduce the cost of their scrubs linen inventory. To meet its goal, the team: • gave units that were high linen users a review of par levels to ensure they had what they needed on hand • tracked each unit’s preferred scrub sizes and stocked par level accordingly, so the unit gets only what it needs

15. Performance Improvement Project BEST PLACE TO WORK: Engaging for Safety • West Los Angeles AmbulatoryCare Pharmacy • After a series of injuries, the team made changes to encourage people to speak up about safety concerns. Changes included: • monthly rounding by team co-leads • ergonomic training for all • quick resolution of problems

16. A Competitive Advantage “We have tapped into the potential of smart people all over the organization who come here every day and try to figure out, ‘How do I improve quality, how do I improve service, how do I improve affordability?’ That’s an incredible competitive advantage to our organization.” Bernard J. Tyson, Chairman and CEO, Kaiser Foundation Health Plan and Hospitals