Alaine Lounsbury, RN, is proud of her nursing team at Downey Medical Center in Southern California. 4 West team members have worked together for decades, forming bonds that have led to high patient satisfaction rates and region-wide recognition.

Lounsbury, nursing assistant clinical director, attributes the team's success to rounding — the practice of engaging frontline workers in face-to-face conversations on the floor and listening to their concerns. Managers who round say it helps build a culture of engagement and dialogue, a key goal of the Labor Management Partnership between Kaiser Permanente and the Partnership unions. 

“It’s about making a connection,” explains Lounsbury, who rounds quarterly on 90-plus staff members using Kaiser Permanente’s Rounding Plus online tool [KP Intranet]. “You want to hear the good with the bad.”

Removing roadblocks

With the tool, managers can use their mobile device to identify, track and escalate issues surfaced during rounding conversations. Program-wide, nearly 10,000 leaders and managers use the program.

At Downey, nurses used rounding conversations to speak up about a workflow issue. Because 4 West is the only unit with nurses qualified to give chemotherapy to adults, it meant staff members sometimes had to leave their department to administer drugs to patients. Their frequent absences meant more work for others.

“I heard them in rounding say, ‘You need to figure this out,’” recalls Lounsbury. She and her team developed new protocols to enable others outside the unit to give the medication. “That was a big satisfier.”

Getting visual

To help her systematically follow up and act on her team’s questions and concerns, Lounsbury uses a colorful poster, called the Stoplight Report, that assigns green, yellow and red colors to track the status of issues.

The poster was conceived by Downey Quality Coordinator Suxian Hu, RN, based on the color-coded reports managers receive through the Rounding Plus program. Last year, all of Downey’s inpatient nursing units began using it.

In 4 West, the poster hangs prominently in the conference room, where everyone can see it.

“Staff members know something is being done,” says Donielle Tresvant, RN, a staff nurse and member of UNAC/UHCP, one of the unions in the Alliance of Health Care Unions. “They know they’re being heard.”

Nurses say the information shared on the poster also fosters team communication and collaboration. “It keeps us updated about things at work and it helps us improve our care by being focused,” says Brianna Schneider, RN, a member of UNAC/UHCP. “It makes for a cohesive atmosphere.”

If you're covered by one of the national agreements between Kaiser Permanente and the Partnership unions, you may be eligible to convert your unused banked sick leave to a Health Reimbursement Account (HRA) when you retire from Kaiser Permanente. You can use the Sick Leave HRA to help pay for eligible out-of-pocket medical, dental, vision and hearing care expenses on a tax-free basis.    

The Sick Leave HRA gives you a strong incentive to bank your unused sick time and helps ensure that you will have sick time when you need it. This benefit is separate from and in addition to the Retiree Medical HRA established as part of the retiree medical benefits package in the 2021 Alliance National Agreement and the 2019 Coalition National Agreement.  

See the Retirement Programs section of your Summary Plan Description on MyHR for details:

• Select your region.
• When the Benefits by Employee Group page opens, click on View under Summary Plan Description.
• Once the file opens, click on Retirement Programs from the menu on the left.
• Look for details for the Sick Leave Health Reimbursement Account.

If that benefit is not included in your Summary Plan Description, you are not covered by the benefit.

Managing in partnership is different from traditional management. You still have responsibility for managing employees’ performance, but when it comes to your department’s performance, the whole team plays a role in making the department a great place to work and to receive care. Frontline employees know where the problems are and have great ideas for solutions. Research shows that managers who engage their teams get better results, and team members are more enthusiastic about implementing the solution because they helped come up with it.

1. Be knowledgeable about the National Agreement. Download the National Agreement or get from your local human resources representative.
2. Get trained on the Labor Management Partnership. See your local learning and development website or our list of regional training contacts.
3. Proactively develop relationships with your union partners. Get to know your shop steward, union representative and other local labor leaders. Check in with them on a regular basis to share information and get their ideas.
4. Model partnership with your union partner. Treat each other with mutual respect. Attend LMP trainings together. Jointly develop meeting agendas and share meeting facilitation responsibilities. Share information, identify problems and develop possible solutions in collaboration.
5. Be accessible to staff. Spend time visiting with people on the front lines. Roam the department on a regular basis. Eat in the lunch room. Implement an “open door” policy for staff members who come by and want to talk.
6. Be open to the ideas of all employees. Encourage people to share ideas and have input on procedures or work flow. Create an environment in which people feel comfortable speaking up. And be open to trying new ways of doing things.
7. Create a structure for dialogue and engagement. Make sure time is set aside for partnership meetings, huddles and training.
8. Tell it like it is. Be open and honest in your communication and transparent with information. Share your department’s budget with team members to get their ideas on reducing costs.
9. Recognize and value employees’ contributions. Go out of your way to acknowledge someone who comes up with or implements an idea that has made the department a better place to work and provide care.
10. Develop employees to become department leaders. If union partners or other team members want to help the department succeed by polishing their problem-solving, meeting management or other skills, encourage and support them in their efforts.

Want to take your team to the next level? Make good things happen for yourself, your co-workers and your members and patients? Collaboration is one of the four critical skills needed to meet future challenges with ease. Use these 12 team-building tips to make every month count.

1. Par-tay

Celebrate your team’s successes and acknowledge — even celebrate — failures. Failures are great opportunities for learning if you focus on where the process (not the person) needs improvement. After each test of change, recognize and reward contributing team members at huddles and meetings. Use small wins to keep the momentum going.

2. In and out

Help employees track their sick days and time off by printing out and distributing our colorful, always popular attendance calendar.

3. Follow the money

Learn your department’s budget as a team and get everyone’s ideas on how to reduce costs. Sign up for a business literacy training. 

4. Track it in tracker

Document your team’s work regularly, accurately and concisely in UBT Tracker. It will let others see and learn from your team’s accomplishments.

5. Stop the line

Ask for help or call a stop to the work when you see an imminent danger or need help to safely complete a task. Then look for system improvements and root causes of problems — ask not just what happened, but why.

6. Grow leaders

Rotate responsibilities for leading meetings and managing improvement projects among all team members. This will build your team’s skills and strengths.

7. Two words

Huddle daily. It works. Watch the video “Huddle Power” and use the tools there to get you started huddling with your team.

8. Clean up your act

Become supply savvy. Make a full assessment of supplies — track inventory, tidy up storage areas and streamline ordering. Simple changes can save thousands of dollars. Download our 6S tool to make this work a snap. 

9. Take a (waste) walk on the wild side

Perform a waste walk. Impartially observe a work area or work process to identify waste or inefficiency. Get walking with our online Waste Walk toolkit. 

10. Save a tree

Go paperless. Don’t print out agendas and documents. Send them out via email or use a projector instead.

11. Get online

Help patients sign up on kp.org. Remind them they can securely view their medical records and most lab results, email their doctors, schedule appointments and refill prescriptions online. Bonus tip: Encourage tech-savvy members to download the kp.org app so they can access these features on their phones. Check out how one team got 90 percent of its patients signed up.

12. Spread and borrow

Did something work for your team? Spread the word to others. Need inspiration for your next improvement project? Look for other teams that have succeeded. Work with your UBT consultant or union partnership representative to spread your successes. Visit our Team-Tested Practices section to get ideas you can try with your team!

Kaiser Permanente and the Coalition of Kaiser Permanente Unions resolve most differences involving our Labor Management Partnership through interest-based problem solving or interest-based bargaining. 

But when the process bogs down, the 2015 National Agreement provides a way for managers, physicians, union leaders and frontline workers represented by a coalition union to move it forward: issue resolution. 

Section 1 of the National Agreement covers a number of topics: how the partnership operates, unit-based teams, and such programs as Total Health and Workplace Safety. The most common disputes encountered are covered by this section. A new issue resolution process, one of three related provisions in the agreement, covers such disputes.

The process starts at the level at which an issue arises; so, for example: 

• When disagreements arise at the facility level, the parties directly involved meet and use interest-based problem solving to try to resolve the issue themselves.
• If they cannot do that within 30 days, the issue may be referred to the local LMP Council.
• If there’s still no resolution, the next step is the Regional Council, and then national LMP leadership. Each body has 30 days to resolve the issue, using interest-based problem solving.
• If no solution can be reached, the question may be decided by a joint panel that includes a neutral designee.

This process is an alternative to, but does not replace, existing grievance procedures. It offers another approach to problem solving. 

“It’s easy for people to get dug into their own place on an issue,” says Denise Duncan, president of UNAC/UHCP. “Partnership and the National Agreement commit us to spending the time to figure out jointly how to resolve problems and do the work.”