If there was one message that prevailed at the 2009 Union Delegates Conference, it was the call to be a leader of change.

And the 500-some delegates in attendance appeared to be up for the challenge-and more engaged than ever.

"You all are leaders," Tom Jackson, a KPNAA past president said, addressing the plenary session closing the mid-April weekend conference at the San Jose Convention Center. "Our role is to lead, for everyone to lead-that's how we're going to change."

With an increasing number of employees in unit-based teams (UBTs) that are achieving measurably better outcomes in service, quality and affordability, the delegates had plenty to talk about, and used the opportunity to compare their hard-won lessons. Conversations about unit-based team work have evolved from the theoretical discussions of years past to the practical and nitty-gritty.

UBTs driving transformation

Among the conference highlights, Kaiser Permanente's chairman and CEO George Halvorson on Saturday reminded delegates that the value compass should guide them-with the patient as true north-as they work to transform KP into the health care delivery system that offers the best service, highest quality and most affordable care in the United States.

Listening to the delegates, it was clear that UBTs and partnership are what give workers the power to drive that transformation of Kaiser Permanente.

"The delegates conference came at just the right time," said Joanie Greco, an organizer with SEIU UHW-West in San Jose and Gilroy.  "We're at a crossroads, and I think the conference will point us in the right direction."

Health care reform discussed

With Washington, D.C. focused like never before on health care reform, Halvorson told the delegates that the time is ripe for KP to become a model for the nation.

"We take care of our patients first," he said. "Then we can go and show the world it can be done, and we can create expectations and standards and put pressure on everybody else to go where we go."

Among those presenters who resonated strongly with delegates was guest speaker Helen Bevan from the National Health Service Institute for Innovation and Improvement in England. She inspired the crowd with stories of change she helped lead in England's national health care system-and the challenges faced in leading such change.

"If we look at the history of revolution in the world, every kind of revolution….they always begin in the same place-they always begin with a transformation of consciousness, when a small group of people start to think in fundamentally different ways," Bevan said. "And I'd say our revolution, the health care revolution…begins with each of us starting to think differently about what change means, thinking differently about our role as a union activist, thinking differently about our role as a leader in change."

Impact of economic crisis

John August, executive director of the Union Coalition, welcomed the delegates and spoke about the economic crisis and its impact on KP and the partnership-and noted that frontline workers, managers and physicians are in a historically momentous position, able to affect the future of health care in this country.

"If we're going to transform Kaiser, we have to understand not just 'how' and not just 'what,' but 'why.' Why. And the reason why is because by doing this work at the front line, everywhere, workers have a responsibility to be able to create a new economy. That's what we're doing in health care…. And all of us are the leaders of that transformation."

With the just one year left under the 2005 National Agreement, the potential for the economic crisis to affect contract negotiations was not lost on attendees. But having experienced firsthand how UBTs help Kaiser Permanente run more efficiently and improve service and quality, many are hopeful this will give them leverage when it comes time to negotiate a new contract.

"Hearing George talk about the financials, it really drives home what our purpose is," said Rose Popovich, a senior LVN at Santa Clara Medical Center and member of SEIU UHW-West. "Over and over we heard you have to work smart and make smart choices, especially in these economically difficult times."

Esmeralda Gomez, a labor liaison for OPEIU at Oakland Medical Center,  echoed the sentiment.
 
"The message is that Kaiser Permanente is not in a safe zone," she said. "It's important that we engage frontline in the reality of the economic crisis. We all have a part in the value compass."

Barb Grimm, senior vice president of the Labor Management Partnership, commented, "The delegate conference was ostensibly a conference about performance improvement, people, power and ownership. Anyone walking in would have seen a confluence of leaders without any labels of managers or union.  Patients and KP members were at the center.

"I was humbled," she said, "by the laser focus on the big picture."

Physician involvement addressed

Jack Cochran, executive director of the Permanente Federation, moved the delegates with a dynamic talk about the importance of physician involvement in the partnership.

"The role of leader is not just the physician," Cochran said. "It's all of us as parts of health care teams. The best teams I've seen have multiple people who function seamlessly, interacting as leaders and profoundly capable of being partners."

While some may argue the level of physician involvement in partnership work, Cochran reminded the delegates that everyone on the care delivery team, from physician to ward clerk to nurse, share a common thread-the patient at the core.

"As you know (doctors are) a very individualistic breed, and that's good in some ways, but we also have to be on the journey of understanding the power of teams. Most of us understand it. But the thing we should never deny is the patient and member are at the center. That's what we're about, that's what everyone in this room is about."

Workshops geared to immediate needs

A particular hit among delegates was the expanded range and selection of workshops offered at this year's conference. The wide variety of seminars gave delegates tools for leading change, improving service and communicating effectively. Other sessions included tips for how to build high-performing teams, career advancement and strategies for reducing workplace stress.

"The workshops have been helpful, especially the ones on change, stress and depression," said Ida Aria, pharmacy stock clerk in Garden Grove in Southern California, and a member of UFCW Local 324.  "We have a lot going on at our facility, and there's a lot of anxiety. My favorite part (of the conference) is meeting people and having this common bond with them. I feel privileged I was picked to come."

In a special two-hour session, Helen Bevan expanded on the ideas in her plenary talk, sharing what she and others have learned as leaders in change.

She left delegates with a parting thought that summed up the recurring theme that everyone is a  leader: "It starts with me."