It is expected that Unit Based Teams are the operating model for Kaiser Permanente. (Page 6, 2010 National Agreement)

Integration of labor into the normal business structures of the organization does not mean co-management, but rather full participation in the decision-making forums and processes at every level of the organization (Page 6, 2010 National Agreement)

There is general agreement about these important concepts around the program. It is also true that understanding, implementation and overall support for these concepts continue to vary. This is natural given the size and scope of the organization. At the same time, we need to achieve broader  and more consistent implementation of unit-based teams (UBTs) and partnership. What are some of the attitudes that stand in the way?

• Some question the time and resources that should be devoted to partnership and UBTs.


• Some question the sustainability of UBTs and partnership in daily practice.


• Some continue to see these concepts as initiatives that stand on their own.


• Some believe that UBTs are a delivery mechanism for certain specific outcomes.


• Some believe that UBTs are nothing new, that Kaiser Permanente has always operated in team care.


• Some see partnership and unit-based teams as “labor’s” initiatives.

Partnership is for everyone

It is critical for everyone in the organization to understand that the Labor Management Partnership is a comprehensive strategy for all of us. It is not a labor relations strategy. It is an operating strategy.

Continuous improvement and innovation are possible only if we take the time and effort to invest in our organization’s front-lines teams and enable them to become thousands of learning modules. We want everyone at the front line to have the intuitive capability of improving everything that they work on all the time. We cannot achieve this if we see UBTs as a thing. Instead, UBTs should be the place that encourages people to ask the fundamental question: “What am I a part of?”

In the LMP, everyone works for Kaiser Permanente and employees are union members. “What am I a part of?” is not meant as a simple question. Our LMP requires all of us to look at our shared interests and achieve outcomes that serve those shared interests. It is a delicate balance and requires patience.

Why unit-based teams?

Our National Agreement sets forth an incredible challenge to everyone in the organization. It asks us to become facilitators and leaders, to learn to find answers to the challenges of our shared interests as established in the Value Compass.

Successful UBTs are solving many problems and creating more value all the time. Collectively achieved performance improvement creates the conditions for good attendance and improved worker and patient safety. But the teams must be afforded the ability to become truly functional teams. Teams need to take the time and effort to deal with the emotional, practical and historical barriers to “teamness.” Our curricula and our Rapid Improvement Model help create this necessary atmosphere.

Everywhere I go, I see joy where we have high-functioning teams. Why? It is because people have creatively overcome the barriers that not only stood in the way of high performance, but also stood in the way of feeling whole at work!

The union movement has always stood for achieving that sense of wholeness at work. Kaiser Permanente’s model of care empowers members and patients to understand their own health, prevent disease and injury, and thereby achieve wholeness as individuals.

Both of these missions run counter to the dominant culture, which tends to force us into an “everyone for him- or herself” dynamic.

Why unit-based teams? It is our operating strategy to create a culture of wholeness, trust and learning—not, as some believe, a specific outcome at a specific time.