When Terri Imbach, Family Practice manager at Mt. Scott Medical Office in the Northwest region, and labor co-lead Christina English, a licensed practical nurse and a member of SEIU Local 49, began to work together as UBT co-leads several years ago, they knew they needed to shake things up with the department’s unit-based team. 

The staff worked hard to meet the demanding needs of the fast-paced medical office, but morale wasn’t great—and team members weren’t taking ownership of improvement work. UBT meetings were poorly attended and often turned into complaining sessions.  

The co-leads’ first move was to go to UBT training classes together. That experience gave them an idea for their next move—which was to shake things up between the two of them by stepping away from work and getting to know each other outside the office. 

“Getting out of the work environment is a good way to get away from the stress of the department,” explains English. This mindset set the tone for how they would operate together and helped them sustain a good relationship over time.

The co-leads also adopted “fun” as part of their regular UBT agenda, and meetings now are attended by nearly 100 percent of the staff.  

“We think of fun ways to get to know each other in and out of the office, and we work to include fun elements in all of our meetings,” Imbach says. During the holidays, team members played relay games at their UBT meeting, and they participated in a fundraiser for a local youth organization that included playing basketball on donkeys. 

The creative energy of the co-leads has helped engage all 40 members of the Level 5 team, who are juggling more than a dozen quality projects. 

“Team members step up to take on projects now,” English says, “and there are friendly competitions to meet our goals.”

Patient transportation workers at Sunnyside Medical Center in Portland were in a tough spot: No matter how hard they scrambled, they were constantly running late to pick up patients. 

Some of the challenges were clear. The transport workers, members of SEIU Local 49, are qualified to backfill certified nursing assistant positions—and short-staffed nursing units were calling on them to do just that. 

In addition, a new computer-based dispatch system had automated patient transfer requests but required fewer dispatchers. The resulting staff upheaval, along with rumors about changes to their certification requirements, threw the unit-based team into turmoil. 

Delays and frustration

Amid frustration and mounting delays—the team was only infrequently meeting its goal of getting to the patient within 15 minutes—improvement advisor Lolita Burnette worked with the team to resolve its issues. To better understand its challenges, she created a process map of the team’s workflow. That turned up a variety of obstacles that were thwarting efforts to improve times. 

“Shadowing the team was an eye-opener. We discovered issues that were immediately actionable,” says Burnette. Because of the complexity of the situation, team members called for an issue resolution to identify solutions.

“My staff are really concerned about their patients. They had valid concerns about what was hindering our on-time performance,” says Marta Witsoe, the team’s management co-lead.

The issue resolution took place from July to September last year and helped further identify issues that were impacting on-time performance, as well as showing how delays affected imaging appointments and patient satisfaction.

As it tracked the source of delays, the team discovered that often, the patient was not ready to be moved when transporters arrived. The patient might need a different gown for imaging, or needed to take medications before being moved. Making matters worse, nurses and other staff members had gotten accustomed to transport arriving late and often put in orders ahead of time. But if the transport person arrived on time, the resulting delay had a domino effect, making it more difficult to be on time for subsequent transport requests.

New equipment, new hires

As a result of the issue resolution, the team is partnering with other units to become more efficient. Several improvements are being worked on simultaneously to increase productivity and overall satisfaction—and the team is confident the changes will lead to improved metrics. 

In perhaps the most significant change, hospital leadership agreed to hire additional transport staff. The new positions are dedicated to support the Emergency Department, a frequent source of patient transfer requests.

“With time and commitment,” says Esther Logan, the team’s union co-lead, “we agreed upon issues that needed to be addressed within the department.”

Olivia Devers, a labor partner with SEIU Local 49, added, “This IR process was the most positive that I have witnessed in many years—the team and management worked in true partnership from start to finish.”