It is difficult to overestimate the impact and dedication of unit-based team consultants, improvement advisers, union partnership representatives and others who coach UBTs. In just a few short years we have developed an in-house performance improvement corps that is unique in U.S. health care. These unsung heroes deserve full support from regional leadership. Unfortunately, they don’t always get it. Let’s support and empower them!

Who are these wonderful people?

Kaiser Permanente and the union coalition have developed a body of leaders in health care improvement who have been recruited from the front lines. Many are union members; others are managers, most of whom come from the ranks of frontline health care delivery. They have studied health care improvement with the KP Performance Improvement Institute and have been deeply immersed in the science of unit-based team development.

What do they do?

Their job is to make all UBTs high-performing. They work in our facilities, coaching, monitoring, encouraging, teaching and helping build momentum for teams to move forward on the Path to Performance. They are well-schooled in team dynamics. They assist teams in establishing their charters, understanding and using data, and mastering the Rapid Improvement Model.

What are they up against?

UBT coaches face time constraints, lack of sponsorship and leadership from senior union, health plan, and physician leaders, entrenched hierarchy and stewards and managers who “can’t let go.”  It’s a work in progress. At a recent meeting I attended, one manager said: “I am a great leader, and I can’t help but lead in my unit. I guess I find it very difficult to give way to the decision-making power of the team”.

This manager’s honesty and frankness is the first step in letting go. Her team will appreciate it.

Thrilled to be out in the field

Observing our frontline leaders in action is an overwhelmingly emotional experience for me. What a thrill it is to see a unit-based team made up of physicians, department heads, managers, supervisors and frontline employees listening to a union member who is a medical assistant, or a pharmacy tech, or a social worker, or an RN or a receptionist. An engaged team of professionals in rapt attention, following the UBT leaders’ guidance on how to achieve success is the best example of how we are transforming the front lines of the organization. The culture change is profound. The learning environment is there. The hierarchy has been replaced by a collective spirit of facilitated learning. Ending top-down execution and learning is very hard, but we developed the leaders to help do it.

Catching up to our Swedish colleagues

When I visited Jonkoping, Sweden, a few years ago, I met nurses and others who had been recruited to be improvement leaders in their facilities. I remember being stunned at the resources that were devoted to this effort and at the commitment of these leaders themselves. Having worked on the front lines gave them a deep understanding of the needs of team members and a huge advantage in leading success.

In a few short years, the Labor Management Partnership, the KP Peformance Improvement Institute, the Boston-based Institute for Healthcare Improvement and our own unions and managers have developed our own cadre of frontline improvement leaders.

It is powerful. It is wonderful. It is essential.

Let’s provide with them with the time, sponsorship, understanding and thanks they deserve. As we do, more and more high-performing teams will become intuitively self-reliant and will help make Kaiser Permanente the best health care system in the world.