The July-August, 2011 issue of the Harvard Business Review is devoted to the study of collaboration, and a lead article in the issue, “Building a Collaborative Enterprise,” by Paul Adler, Charles Heckscher and Laurence Prusak, cites the Kaiser Permanente Labor Management Partnership as an important example of how collaboration works successfully.

Professor Paul Adler, of the Marshall School of Business at the University of Southern California, is well known to us in the Coalition of Kaiser Permanente Unions, the Partnership and Kaiser Permanente.  He co-authored the definitive book (thus far) on the history of the LMP, Healing Together. More recently, he worked with the Union Coalition to help develop our new learning academy for union leaders.

Shared purpose

Adler and his co-authors cite four organizational efforts that are keys to success in 21^st century enterprise:

1. Defining and building a shared purpose
2. Cultivating an ethic of contribution
3. Developing processes that enable people to work together in flexible but disciplined projects
4. Creating an infrastructure in which collaboration is valued and rewarded.

WOW! That sounds very much like the transformative goals of our National Agreement and our Partnership. Our foundational documents are always worth going back to because they remind us that we have committed to a shared purpose. In so doing, we have devoted ourselves to transform our relationships throughout the organization, to collaborate and to learn in the interest of service to our patients, members and our communities.

This is what Adler says about us:

“Kaiser Permanente’s Value Compass, for example, succinctly defines the organization’s shared purpose this way: 'Best quality, best service, most affordable, best place to work.’ … It’s a description of what everyone in the organization is trying to do. It guides efforts at all levels of Kaiser: from top management’s business strategy, to joint planning by the company’s unique labor-management partnership, right down to unit based teams’ work on process improvement.”

Perhaps most important, Adler reminds us that:

“The Value Compass is less a vision than a recognition of the challenges that every member of the group has the responsibility to meet every day.”

Irvine medical center recognized

The article describes a “Collaborative Dance at Kaiser Permanente,” a real-life accomplishment at Kaiser Permanente’s Irvine Medical Center. It reports the efforts at Irvine to streamline the costliest surgery there: total hip and knee-joint replacements. The article recognizes that union cooperation was necessary and that neither top-down administrative mandates nor a surgeon-driven approach was feasible. The authors show why a partnership approach was key to success and how the voices of all employees and physicians involved played a role in getting to the improvements sought. Cycle times for surgeries were reduced, and the approach has spread to other Kaiser Permanente facilities. (See "OR teams with all the right moves.")

New ways for new times

We must recognize that old ways of doing things will not work in the new world of health care or business in general. As Adler writes: 

"Karl Marx, Max Weber, Emile Durkheim and Talcott Parsons also inform our work. These classic figures were trying to make sense of broad economic and social changes during times when capitalism was mutating from small-scale manufacturing to large-scale industry. Our era represents just as momentous a shift, as we make the transition to an economy based on knowledge work and workers."

We must challenge ourselves in the unions, management and physician groups to continuously improve our ability to collaborate if we are to achieve true health care reform, universal care and equity for our patients. It is not easy to achieve the “shared purpose” that is essential for the creation of a truly collaborative work environment. We are reminded that to attain and have individuals internalize that shared purpose requires time for widespread discussion throughout the organization. We are on the right path. 

Let’s all reflect on how we are supporting this path.