Health care executives and policymakers around the world recognize something about Kaiser Permanente that people working inside the system sometimes lose sight of—that we provide a different and better model of care, and engage workers in performance improvement and innovation in ways that others do not.

KP’s distinctive approach was highlighted at the Institute for Healthcare Improvement’s national conference in December, where several KP and Labor Management Partnership leaders presented a day-long workshop on organizational change and performance improvement.

Their message was well-received by the 80 administrators, physicians and quality leaders attending the workshop—and provide a refresher course for KP managers, staff and physicians.

“People at the front line have enormous capacity to understand what’s going on,” Barb Grimm, senior vice president of the Office of Labor Management Partnership, told the workshop attendees. “We eschew the notion of centralized brilliance.”

People at the front line have enormous capacity to understand what’s going on. We eschew the notion of centralized brilliance

Keys to leading change

In their session, Grimm and co-presenter John August, executive director of the Coalition of Kaiser Permanente Unions, described the principles of unit-based teams and how they can align the work of frontline teams with the goals of the organization. They described several success factors, including

• Understanding context— providing the background for change, including the business, economic, and workplace drivers of change
• Frontline engagement—involving people intellectually and emotionally in the change process
• Systems thinking—making clear how people’s work fits into the larger goals and processes
• Performance-improvement tools—providing the frontline tools for rapid improvement
• Continuous learning and honest dialogue—creating a culture of learning and honest dialogue
• Clear goals and metrics—setting clear goals and measuring results
• Relentless patience—building on success one day at a time, supporting your champions, and keeping at it.

"Frontline engagement is critical to performance improvement," said August. "We have to find commitment, not just compliance.”

Teaching from experience

Other leaders teaching Kaiser Permanente’s team-based model of care and performance improvement were:

• Lisa Schilling, vice president of Health Care Performance Improvement: How to develop a plan and use tools for performance improvement at the system level.
• Dennis Deas, senior director of Performance Improvement, and Shawn Dufford, MD, medical director of Perioperative Services for Exempla St. Joseph’s Hospital (which serves KP members in Colorado): Hands-on exercises for setting priorities and determining what drives a system’s patient-care goals.
• Michael Hurley, the Union Coalition’s national coordinator for education and training, and Bridget Hurley (no relation), oncology pharmacist and performance improvement consultant: How systems can improve team communications and training.