By working through tough issues at the front line, unit-based teams are building greater capacity for learning, leadership, and change across Kaiser Permanente.

But if you’re one of the thousands of managers, workers, or physicians who co-lead UBTs, time isn’t always on your side.

In fact, as unit-based teams accelerate their work in improving patient care, one of the biggest hurdles co-leads face is carving out time to meet for strategizing and prioritizing the work of the team. Co-leads often must use creative juggling to squeeze UBT meetings into their regular work schedules, much less finding time to meet separately, in advance, with their co-lead partners. Still, most co-leads agree that focused, regular meetings with their partners are a must.

“You have to take key people and start somewhere,” explained Chicquita Nelson, management co-lead for Ohio’s Bedford Medical Center primary care team. Nelson meets weekly with her labor partners Dylan Frith, OPEIU local 17, and Montipa Nelson, Ohio Nurses Union, and her physician partner, Martine Binstock, MD. “It’s a time to really accept that you’ve got problems or things to improve, and somewhere you’re going to have to start communicating and working through them.”

Co-lead meetings allow you to:

• Outline and prioritize department goals
  “We talk about things we need to work on,” says Barbara Bell, team lead manager of Ohio’s OBGYN UBT. “We’re looking at the dashboard and where our numbers are. Then we go to the team meeting and talk about it there and get their input.” It ensures a cohesive, streamlined and strategic approach to the work of the larger UBT, she adds.
  
  
• Brainstorm performance improvement efforts
  Once they settle on which projects to work on, Nelson says their core team starts brainstorming small tests of change to pitch at the larger team. Brainstorming continues with input from entire UBT.
  
  
• Problem-solve issues
  Weekly co-lead meetings provide a more intimate setting to air sensitive issues that people may not want to air in the larger group. “It’s easier for one person to bring up the issue,” Nelson says. “If labor has problems or concerns they usually take it to Dylan, and he then has a direct line to Dr. Binstock and me. Every complaint is a request for a solution.”
  
  
• Build consensus among leadership, to create more staff buy-in
  “When you go to the (UBT) meeting, you want to look like a unified leadership group,” Barbara Bell explained. “Otherwise you look like a bunch of jackals who haven’t agreed on anything.”
  
  A cohesive, high functioning leadership that agrees on priorities leads to an equally cohesive, high functioning team, Bell says.
  
  
• Ensure more structured and productive UBT meetings
  Creating agendas in advance prevents meetings from veering wildly off topic or devolving into complaining sessions. Then, says Bell, “It’s not just a free for all. You’re actually working on something. Whereas before, you would just sit and listen to one person who would go on and on.”