Earlier this month, I spent the day with teams, co-leads and union and management leaders at the Los Angeles Medical Center (LAMC).  It is clear that the sun is rising at LAMC, formerly known as “Kaiser Sunset.”

LAMC, a huge campus in the City of Los Angeles, is an exciting and bustling place situated between urban commercial and apartment properties and not far from Hollywood. It includes a large medical center, medical office buildings, and other services

In-Patient Pharmacy

I was accompanied by UBT Consultant, Heddy Steinman, a member of UFCW and an enthusiastic and knowledgeable improvement leader and seasoned facilitator.  She is part of a cadre of union members who are essential to the success of our systemic performance improvement at Kaiser Permanente.

We visited the In-Patient  Pharmacy team, composed of  registered pharmacists, pharmacy technicians, inventory clerks, and managers and supervisors. When it was pointed out that sharps disposal receptacles were filling up and overflowing quickly during the day, creating a dangerous hazard, the team decided to do a rapid improvement model discussion on the spot.

Heddy suggested that the team establish a SMART goal.The team agreed on a test of change which would remind all members of the department to empty the receptacles regularly during the day rather than wait for EVS staff to do it at the end of the day. Sounds simple, right?  Not really, because typical protocols do not involve the whole department in addressing the hazard. Team members suggested that they educate the staff and get cooperation to eliminate the danger.

The team then took on a difficult matter: how to assign the production of an important and often-used chemotherapy drug. Producing this medication requires quite a bit of time, so the team had to analyze the workflow of what is already a very busy department. They decided to poll all members of the department to get maximum input so a recommendation on assignments could be made. 

This kind of discussion exemplifies the essence of unit-based team power: all the knowledge rests with the frontline, and when they put that knowledge to use to resolve problems, the entire dynamic of the workplace changes for the better.

Internal Medicine

I also visited the Internal Medicine UBT which included UNAC RNs, UHW LVNs and receptionists as well as the department ddministrator and manager. The team  reviewed  its success with pro-active office encounter (POE).  The POE is a region-wide program designed to get members to schedule preventive screenings when they register for unrelated appointments.  Many teams intitally struggled with the demands of the POE because it was perceived as adding duties to receptionists and others. Yet, like most teams, these Internal Medicine employees made it a success because they realized that scheduling preventive screenings is important to Kaiser Permanente members.

The team ran a pilot where receptionists booked mammogram appointments  with great success. This led to regular recognition for the receptionists who scored in the top three for booking mammograms. This is not a radiology department, it is a general adult medicine department that sees members for a whole host of reasons. The pride written across the face of the receptionist telling the story was moving.

Meanwhile, the team reports that there have been zero injuries for a year and the team will hit the attendance threshold for PSP (Perfomance Sharing Program).

LAMC on the rise

Mark Costa, the executive director of LAMC  was effusive about the medical center’s future. LAMC won the Leapfrog Award as one of the top 56 hospitals in the nation. Costa attributes this achievement to the remarkable turnaround at LAMC in the past few years, in no small measure due to the deepening of success among unit-based teams.

Yes, the sun has risen over KP Sunset!