Emile Pinera, MD, a second-generation Kaiser Permanente employee, came to the company five years ago and immediately became co-lead of an adult medicine unit-based team in the Georgia region.

“I had the clinical part down,” says Pinera, who is now lead physician for diversity and inclusion in Georgia and an adviser on the region’s transgender task force. But being a co-lead and working in a UBT were unfamiliar. “I had to implement my medical knowledge in a team, as opposed to a top-down approach where the doctor tells everyone what to do.” 

He wasn’t convinced at first—but the partnership approach and physician participation helped elevate the team’s performance, and it posted some of the region’s highest quality scores for managing diabetes and blood pressure. 

“We achieved it through hard work and collaboration,” Pinera says. “I loved working with my management and labor co-leads. We were respectfully honest about what was achievable. Working in the UBT gave us the tools to effectively communicate, track, adjust and improve.”

Pinera currently guides and supports co-leads as a UBT sponsor for three teams and is lead physician for three adult medicine offices. His enthusiasm helps his teams, the members and the Georgia region. 

“I was skeptical at first about UBTs’ relevance, but we couldn’t achieve our success with hypertension and diabetes management without each other’s help. I’m a believer,” he says. “My tip for fellow providers is to be engaged as much as possible, because it will help us achieve better outcomes and help our patients thrive.”

“You have two ears and one mouth for a reason,” television’s Judge Judy frequently says, quoting an ancient Greek philosopher. “You should listen twice as much as you talk.” Successful co-leads realize that making a partnership work requires listening and learning from one another. 

Caroline Masikonde, RN, had been a management co-lead with the urgent care team at Largo Medical Center in the Mid-Atlantic States, an experience that helped her understand the importance of valuing her partner’s input. But when she accepted a new role as clinical operations manager in Northern Virginia Audiology in January 2016, she didn’t have any experience in audiology. So she’s relied heavily on her new labor co-lead, Lynn M. Reese, Au.D., a UFCW Local 400 member. Masikonde has learned why audiology UBT members escort patients outside (so they can try out new hearing aids in different conditions)—and her willingness to listen helped the co-leads bond quickly. 

“Lynn is very experienced,” says Masikonde. “I lean on her even now.” 

Reese, on the other hand, was new to the unit-based team structure, since the audiology UBT had just formed. That’s where Masikonde’s expertise came in. “We fit together pretty well,” says Reese. “Caroline is very open to listening and learning new things.”

Reese, too, expanded her knowledge, growing into an appreciation that she and Masikonde have equal say on what’s now a Level 4 UBT. “Everyone contributes,” says Reese. The ability to speak up led to Reese and the rest of the team requesting and receiving approval for an additional booth to test patients’ hearing. 

Relationship tested

Their new relationship was tested when a member—after waiting more than 12 weeks for a refund on a hearing aid that had cost more than $1,000—alerted them, loudly and angrily, to the problem. 

Instead of pointing fingers, UBT members figured out the issue: The refund request had to be processed through a department in Southern California, but the team had no way to follow up once the request was submitted. 

“This lady forced us to look at this and do better for our members,” Masikonde says. “It prompted us to come up with a better workflow,” and now the team has names and contact information for the people who work on the refunds.

“Even though it was a bad situation, she made us want to improve,” Reese says. 

Because the co-leads already were accustomed to relying on and listening to each other, they were able to quickly and calmly handle this tense situation with the unhappy member.

“We really learned our lesson,” Masikonde says. “Recently, we did a refund on a Monday—and by Friday, the member had the check. Lynn and I know our parts and do our dance.”

For customer service representatives, the role of “chat captain” is a plum post—a leadership position that allows a rep to develop expertise and offers a break from the phones. But at the Member Service Contact Center (MSCC) in Denver, uncertainty about how the captains were chosen was breeding low morale.

The chat captains specialize in a range of topics, from Medicare and Medicaid to specific health plans for regions including Colorado, the Northwest, and Northern and Southern California. When a co-worker is on the phone with a member and doesn’t have an answer to a question, he or she can message a chat captain and get information quickly, before the call ends—helping provide great service to that member.

But the process managers used to select the 25 chat captains wasn’t clear, so the 400 customer service representatives didn’t know what they needed to do to qualify for the position.