I have worked at Kaiser Permanente for 33 years, starting as a distribution worker in materials management. Being on the front lines helped me better understand the challenges staff face—and helped me, in my current role, see what it takes to spread and sustain change in a complex organization.

When we launched our first unit-based teams in 2007, I knew they could give our managers and teams a powerful tool for change. But to achieve their full potential, UBTs need the support of leaders at every level. In working with UBTs every day, I have found five practices that can help teams achieve their goals, and have helped me be a more effective leader.

Have patience

I’m not a patient person by nature, and it took a visit to the world-class health care system in Jonkoping, Sweden, for me to see that it takes patience to sustain meaningful change. When you’re solving problems in a team-based workplace, real systemic change takes time. But it also takes hold deeper into the organization.

Really see the work

Spend time with a UBT, or hear teams present their test of change, to understand what they’re working on and how you can support them. There’s no way you can feel the excitement and energy from the team members and not feel proud and motivated by their work.

Spread good work

In Orange County—which has two large hospitals, in Irvine and Anaheim—we expect all teams to continually test and then spread their ideas and successful practices. We call it “One OC” and we talk about it all the time. You’re never going to achieve greatness globally if you don’t spread good work locally.

Provide tools

Early on we formed an Integrated Leaders group of senior labor and management leaders who meet monthly to monitor and assist our 107 UBTs. If a team is struggling, the IL group doesn’t descend on them and try to fix the problem. We provide tools and resources that help the team work through a problem and get results. For instance, we put together a UBT Start-up Toolkit with information on everything from setting up teams to finding training. We’re also looking at toolkits on fishbone diagramming, conducting small tests of change and providing rewards and recognition. And we’re asking how to make it easier for teams to access resources quickly—for instance by identifying go-to people for questions on budgeting, patient satisfaction metrics and so on.

Then, get out of the way

 I have a saying: “Hire great people, give them the coaching and mentoring they need, then get the heck out of their way and let them do what they were hired to do.” I think that works at all levels of the organization, whether or not people are your direct hires. You don’t tell people to make a change or streamline a process without any encouragement or support, but you don’t need to micromanage them either. Delivering great health care is not just a job. It is a calling. Whether you’re a housekeeper preventing infection or a surgeon treating cancer, people’s lives are in our hands. That shared mission drives us to be the best.

Managers newly charged with co-leading unit-based teams sometimes need to build team cohesion before diving into the nitty-gritty of setting goals and improving performance.

Brenda Johnson, optical site supervisor at the South Bay Medical Center in Southern California, has found a way to do just that—and improve her staff’s eating habits at the same time.

Inspired by a presentation at a regional leadership conference hosted by Jeffrey Weisz, MD, executive medical director of the Southern California Permanente Medical Group, she launched a healthy eating club in her department. Every week, staffers chip in $12 each—and get four healthy, fresh-cooked meals in return.

At the early spring meeting, Dr. Weisz discussed Kaiser Permanente’s Healthy Workforce initiative and distributed a booklet listing the calorie count of hundreds of food items.

Making change easier

“I looked at the book, and I thought, ‘Oh, my goodness,’” said Johnson, shocked at the number of calories in some of her favorite foods.

“I looked around at my employees,” she said. “Some have health issues. Some drink sodas by the 32-ounce cup every day.” The medical center is ringed by mini-malls with fast food restaurants. “We’ve been eating the same stuff for years,” she said. “The only question was who’s going to go pick it up.”

Gil Menendez admits he was one of the 32-ounce-cup soda drinkers—a habit he gave up when he joined the club. Menendez, an optical dispenser, SEIU UHW member and  labor co-lead of the UBT, was so motivated by the changes in his lunchtime habits that he also began a strict diet and exercise routine. He’s lost 20 pounds.

New ways to work together

Johnson cautions that the healthy eating club isn’t a diet club. She picks recipes out of a pamphlet produced by the California Department of Public Health, Champions for Change, and prepares the ingredients at home. Others sometimes prepare recipes from their families and cultures. She combines ingredients in the morning, steams them in a slow cooker the staff keeps at work, and a meal is ready by lunchtime.

“I have to cook for my family anyway,” says Johnson. At home, “We’ve changed our habits because of high blood pressure. I prepare this food with love because I’m preparing it for both of my families: my family at home and my family at work.” 

About 15 to 20 people participate in the club each week, up from 10 when it first began in May 2010. In addition to its health benefits, the club has helped her department be more productive and collegial, says Johnson.

“It’s going strong,” adds Mendez. “It brings us together.”

Looking for ways to make the Sand Canyon Surgicenter in Irvine more efficient, Albert Olmeda wound up learning a lot about blue wrap—like the fact that it makes up nearly 20 percent of the waste generated by hospital surgical services. 

The lead Central Services technician and SEIU UHW member also learned that this heavily used hospital product, an industrial strength plastic used to maintain the sterility of medical and surgical instruments until opened, is not biodegradable and persists in the environment. 

But recycled blue wrap can be sold as raw material for use in the production of other plastic products. Today, the surgicenter’s unit-based team has gone green with a blue wrap recycling project that is not only saving money and protecting the environment, but also aiding the community. 

“The biggest problem with the blue wrap is when we throw it in the landfill, it’s there forever,” says Olmeda. “That’s a big concern especially considering how much blue wrap we use.” 

How recycling works

About 600 pounds of blue wrap is collected every week from the center’s six operating rooms. It is picked up free of charge and sorted by Goodwill of Orange County, which sells it to a Houston recycling services company. The company reprocesses the plastic into beads that are used in various products, including railroad ties, pallets and artificial siding for decks, docks and houses. 

The surgicenter has been recycling its blue wrap and plastic bottles since September 2009, reducing the facility’s solid waste disposal fee by 10 percent annually. The savings amount to a modest $5,880—but there’s a greater payoff. Proceeds from the sale of blue wrap and other recyclable products enable Goodwill to provide education and training programs for developmentally and physically disabled adults, including a state-of-the-art fitness center. 

Peter Bares, business development manager for Goodwill of Orange County, says the relationship with Kaiser Permanente has gone beyond expectations. “It is kind of the perfect storm because of the nature of what we do and why we do it and the materials that the hospital generates,” he says. 

Getting buy-in

As the frontline staff person responsible for the surgery center’s blue wrap disposal, Olmeda—and his fellow UBT members—championed the recycling cause, educating the staff at weekly in-services and UBT huddles.  The team got the rest of the department on board by integrating the blue wrap recycling process without creating additional tasks. 

“We figured if we changed workflows, staff wouldn’t want to do it.” says UBT co-lead Nicole Etchegoyen, a surgery scheduler and SEIU UHW steward. “But if we asked them, ‘How would this work best for you?’ then everyone would get involved, and they did.” 

The team members designated a single container for blue wrap in each operating room. They also placed a larger bin for collecting multiple bags of discarded blue wrap near the soiled utility room, where the trash is taken on its way out of the surgery center. 

“It’s not a big deal,” EVS worker and SEIU UHW member George Sollars said, hoisting bags. “We just carry it over here on our way out this door. It’s one of the easiest jobs. And it’s for a really good cause.” 

No trash, just recycling 

The hardest part was making make sure that other trash didn’t make it into the blue wrap recycling containers accidentally. Labeling the containers with signs reading ‘Recycling Blue Wrap Only’ helped, as did regular reminders by UBT members. 

Now, everyone in the operating rooms—from doctors, nurses and surgical techs to nursing assistants and EVS workers—makes sure that the blue wrap containers aren’t contaminated with other trash, Etchegoyen says. 

Olmeda does periodic spot checks. “Everybody who plays a role in the operating room has to look out to make sure no trash is going inside the containers,” he says. “It’s a team-building thing.” 

“If it wasn’t for the UBT, this wouldn’t be happening,” said Ramin Zolfagar, MD, department head and UBT member. “We are helping the environment by ‘going blue,’ so to speak, and the end result is gym equipment for the disabled—which makes it all the more worthwhile.” 

After learning about the project at a recent Orange County UBT fair, other departments are thinking about emulating it. 

Visit the Goodwill of Orange County website to find out more about their work.