In Healing Together: The Labor Management Partnership at Kaiser Permanente four experts describe LMP as a breakthrough in terms of its size, scope and ambition, and a qualified success in terms of results. Their conclusions about what works and what doesn’t for the partnership as a whole can help managers and team leads in their day-to-day work—especially as KP moves toward full implementation of unit-based teams.

“What we’ve learned is that by engaging the frontline and distributing power and leadership you can get results that could not be achieved in traditional ways,” said Thomas A. Kochan, lead author of Healing Together: The Labor Management Partnership at Kaiser Permanente in a recent interview. “But to get results you have to be very pragmatic. You have to improve the flow of work and get better outcomes. You can’t expect physicians, for instance, to allocate time for training in teamwork and joint problem solving in the abstract; it has to be grounded in achieving outcomes for their units and their patients.”

The KP advantage

A grounding in goals, metrics and outcomes is a strength of the unit-based team concept, says Kochan, and should help Kaiser Permanente enhance quality, affordability and workforce cohesion—all of which will be necessary under health care reform, he adds. “The evidence is clear that teamwork, coordination and worker engagement are keys to achieving cost and quality improvements.”

By distributing power and leadership you can get results that could not be achieved in traditional ways.

But how to get there? “Partners must be flexible and not take a cookie-cutter approach,” said Kochan. “What works in a hospital unit may not work in a clinic, or a call center or some other setting. But there also needs to be alignment with some core principles—engaging the knowledge and insights of everyone and working in cooperative ways to improve performance and make the best use of limited resources.”

Spreading best practices

Other lessons from the history of LMP are also relevant to the day-to-day work of managers, co-leads and their teams. “We found tremendous variation in how well the Partnership is integrated,” he said. “Spreading best practices—clinical or organizational practices—across such a large and complex organization is a must…Progress can be slow in the beginning. You first have to repair broken relationships. Then you can shift your sights to operational performance. When you get results there, work becomes much more satisfying, productive and secure for everyone.”