The incredible energy of unit-based teams

UBT Consultant Niambi Lincoln and National Coordinator Andrea Dooley, both of the Northern California region, urged me to visit a physical therapy unit-based team in South San Francisco. I was able to make the visit recently.

After greeting me at the main medical center campus, Niambi drove me a few miles to the Bay Hill Center to meet with the PT team.

She introduced me to Bernie Weslow, PT, the manager; Senior Physical Therapist Monico Tangaan; Senior Staff Assistant Craig Takeda, and UHW member and lead receptionist Cathryn Galicia.

The group let me know that a culture of collaboration between the PT providers and the UHW support staff at the PT offices in South San Francisco had been in place since the mid-1990s. They also let me know that despite their collaborative efforts, for many years they had been frustrated by their low service scores. In fact, as recently as Q1 2008, the South San Francisco PT team had one of the lowest scores in the region. 

The team was perplexed: Though they had a spirit of collaboration, a great work environment and the successful implementation of service initiatives, they were not able to improve their service scores.  They were disappointed and wanted to make a change.

The Director of Service for South San Francisco made some suggestions to their service champion group (part of their department’s UBT)—and they started to focus on the needs of the patients and the business case for improvement.

The team developed new and consistent communications with patients and families upon arrival and upon departure from the unit. Additionally, the team paid close attention to communication with the referring physician, something that is not easy for the patients to do.

The team committed to staying grounded in their goals, and in less than one year, by the end of 2008, the team improved their service scores 10% (from the bottom tier to the top tier)!

To maintain their enthusiasm and success, the team finds rewards for continuing good scores. They role play with one another to sharpen communication skills, and they stay grounded in the patient-oriented goals.

It was clear to me that the team made a big shift through their unit-based team. While they had gotten along very well and their work environment was excellent, the focus of their efforts had not been fully grounded on the patient. As a result, a troubling factor had nagged at them: How could they have a great place to work, but with less-than-acceptable service to the members?

What was evident in meeting with the team was actual joy that they had discovered their path to better service scores. Their collaboration was now making demonstrable improvement for their patients and thereby making their work experience even better.

I told the team that they reminded me of the PT team that I met in Jonkoping, Sweden, in 2007. There, I asked the team members what their job was; their answer was, “to provide the best care possible for the population.” It was the experience in Jonkoping that brought the Value Compass to KP. We discovered that balance of outcomes is far more powerful than instituting initiative after initiative!

I will never forget that. A systems approach to improvement—as opposed to an initiative or project-driven approach—actually changes the way people see their work, their relationship to the workplace, the organization and to one another. The South San Francisco PT team learned about the business and some improvement skills on their own. They applied them together. No one told them to do it.

Our teams in KP, like the PT team in South San Francisco, like the teams in Jonkoping, are creating a learning system. We have hundreds of examples like these in our midst. These learning microsystems that we call high-performing unit-based teams are the path to building a learning system throughout the organization.

We can have ongoing innovation throughout the frontlines that will deeply transform the way we deliver care. This is what our National Agreement is all about.