LMP News

Partnership Beats the Odds

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Kaiser Permanente and Coalition of KP Unions celebrate 20 years of partnership

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Forty percent of U.S. marriages end in divorce after an average of eight years. Most business partnerships fail to meet expectations. And most campaigns end when they achieve their goals or the world moves on.

But the Labor Management Partnership between Kaiser Permanente and the Coalition of Kaiser Permanente Unions has beaten the odds: October 2017 marks the 20th anniversary of the partnership’s founding, making it by far the largest, longest-running and most sweeping such partnership in the country.

We’ve accomplished a lot together. And in a world of change, sustaining a healthy long-term relationship is an achievement in itself. A key to our success has been the willingess to honestly reflect on our successes, failures, and opportunities to improve. 

By working in partnership, says Kaiser Permanente Chairman and CEO Bernard Tyson, “We have tapped into the potential of smart people all over the organization coming here every single day trying to figure out, ‘How do I improve quality, how do I improve service, how do I improve affordability?’ That’s an incredible competitive advantage for the organization.”

Marking a milestone

This fall Kaiser Permanente and the union coalition will be celebrating those achievements with special events and employee outreach. It won’t be all cake and balloons, however. LMP regional councils, unit-based team sponsors and co-leads, and others will host reflection sessions where workers, managers and physicians can share their experiences, pain points and suggestions for the future of partnership. Participants will consider three questions:

  • What is different since we created partnership? (Or, what do you see as the top accomplishments of partnership?)
  • What are the greatest challenges it faces today?
  • How might we address those challenges, to strengthen partnership now and in the future?

Getting results

Partnership is not easy, and the parties don’t always agree on things. So what’s kept it going?

“It’s nice if we can all get along,” says Tyson. “But most important, we’re here to get results.” Here are some of the results achieved in partnership:

  • Performance improvement: More than 50,000 team-led improvement projects since 2007, with measurable gains in quality, service, the work environment—and cost savings exceeding $148 million in 2016.
  • Best place to work: Industry-leading wages and benefits, a voice in decision making, and an Employment and Income Security Agreement providing retraining and redeployment for displaced workers.
  • Joint marketing: Strategic engagement brought strong gains in KP membership, union coalition membership, and more than $108 million in revenue for Kaiser Permanente in 2016.
  • Job training and career advancement: More than 300,000 professional, academic and skill-enhancement courses taken by 104,000 coalition-represented employees since 2007.
  • Systems collaboration: Joint implemention of multiple complex programs and systems, including KP HealthConnect, Claims Connect, ICD-10 and call center reorganization.

Lessons for success

All of the above have garnered attention from business, union and academic leaders over the years.

“The Labor Management Partnership is a shining example of how you bring labor and management together to produce results,” said Liz Shuler, secretary-treasurer of the AFL-CIO. “What I love about this model is the notion that, no matter where you work in the system, you have a place at the table and your voice is heard.”

Working in partnership also holds lessons that apply outside of work—including lessons that might have saved some of those failed marriages.

“If you are going to be a good partner and have a successful relationship, with a partner, kids, friends,” says Michael Belmont, a former KP administrator now working for the consulting firm that helped the LMP get started, “you have to have your partner’s needs in mind as well as your own.”

To learn more about LMP anniversary activities, visit the 20th Anniversary How-to Guide.

Meet Your National Agreement: New Standards for All

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Teams, facilities and regions all play a role in improvement

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Last year, the outpatient procedure unit-based team at Capitol Hill Medical Center rewrote the instructions it sends to patients scheduled
for a colonoscopy. A patient who found the earlier directions confusing played a leading role in the process.

The new instructions helped reduce by 20 percent the number of colonoscopies that needed to be repeated. Involving the patient was “a transformational experience
for the team,” says Jennifer Walker, RN, lead UBT consultant and improvement advisor in the Mid-Atlantic States region.

It also showed the power of a new provision of the 2015 National Agreement. 

TOOLS

What the New LMP Website Can Do for You

Format:
PPT

Size:
7 slides 

Intended audience:
Unit-based team consultants, union partnership representatives, UBT sponsors and co-leads. 

Best used:
To learn about the new features of the revamped LMP website. 

TOOLS

Highlights of the 2015 National Agreement

Format/sizes:

  • PDF (two pages, 8.5" x 11")
  • PPT (18-slide deck)
  • Small infographic (sized to print on 8.5" x 14" paper)
  • Large infographic (sized to print on 11" x 17" paper)

Intended audience:
Frontline workers, managers and physicians 

Best used:
Brief text and graphics give an overview of key provisions of the 2015 National Agreement. Choose the format that works best for you!

TOOLS

Coalition Union Members' Views

Format:
PDF

Size:
8.5" x 11"

Intended audience:
LMP and union staff and leaders

Best used:
This scientific survey from 2005 shows high and growing job satisfaction, mixed but improving attitudes toward KP, positive attitudes toward unions and optimism about the LMP.

FAQs About the New LMPartnership.org

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Check out what's new and locate your old favorites

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Q: What’s new?

  • Our new Team-Tested Practices toolkits bring together all the ingredients you need to help your team succeed. Find out what other teams have done to improve, click to get the tools like the ones they used—and download a few fun goodies.
  • We’ve made finding exactly what you need as easy (and fun!) as shopping for shoes online. Use our new navigation to filter by region, topic, department, format and team level.
  • Our search engine is better, faster and more streamlined. Find what you need—without having to wade through a bunch of stuff you don’t want.
  • The new site is fully responsive—so you can access it from any smart phone or tablet, at work or on the road.
  • See it in action on this WebEx and download the accompanying presentation

Q: Where did my region’s page go?

A: Our new region page is still under construction. When we launch in November, you’ll find a page that links to each region's website, intranet page or SharePoint site.  

Q: Where can I find tools?

A: Under the new Gallery tab—at LMPartnership.org/tools, and from a prominent link on the home page. Take advantage of the improved navigation and filter by topic, team level, dimension, role, tool type and format.

Q: Where did the videos go?

A: Find videos under the new Gallery tab. Or go directly to LMPartnership.org/videos. Zero in on exactly what you need by filtering by topic, region, team level and dimension.

Q: Where are the stories?

A: You’ll find most of our stories under the Team-Tested Practices tab. These toolkits pair stories of teams with the kinds of tools the teams used to improve performance and meet their goals. This will make it easier for your team to follow in their footsteps for success.  Stories you’ve read in Hank are under the Gallery tab and at LMPartnership.org/hank.

Q: Where is the UBT section?

A: The new Path to Performance section has most of the material you used to find in the UBT section; click on the tab or go directly to LMPartnership.org/path-to-performance. Find a customized kit of tools and materials tailored to any team level and P2P dimension. Or explore everything available for any one of the seven dimensions of performance (sponsorship, leadership, training, team process, team member engagement, use of tools, and goals and performance).

Q: Where is the Path to Performance toolkit?

A:  To access most of the materials that used to be in the Path to Performance toolkit, visit the new Path to Performance tab or go directly to LMPartnership.org/path-to-performance. With just a few clicks, find a customized kit of tools and materials tailored to the team level and P2P dimension you want. Or explore everything available for any one of the seven dimensions of performance (sponsorship, leadership, training, team process, team member engagement, use of tools, and goals and performance).

Q: Where did the toolkits go?

A: These are now our new How-To Guides. They're linked to from our LMP Focus Area pages, in the Path to Performance section, and elsewhere. To get a list of them all, go to LMPartnership/tools and then under the "Tool Type" option, select "How To Guides." 

Q: Where can I send feedback? 

A: See that little blue “got feedback” tab on the right side of the page? Just click on that! We need to hear from you, especially if you encounter something that is broken or isn’t working the way it should.

What's Changed in the Path to Performance?

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The 2015 National Agreement includes changes to the Path to Performance (P2P) that:

  • clarify language that wasn’t clear before
  • incorporate health and safety in UBT work
  • and add new challenges for Level 5 teams

For example, in the sponsorship dimension, it was unclear in the earlier version of the Path to Performance what was intended in the requirement sponsors should “regularly communicate with co-leads.” There were many different interpretations of how often communication needed to take place to be considered “regular.” Now the Path to Performance specifies that communication needs to take place at least once a month.

In another change, health and safety were incorporated into the Path to Performance requirements. Previously, the Coalition of Kaiser Permanente Unions and Kaiser Permanente were trying to have partnership help achieve health and safety for the KP workforce by relying on parallel structures—structures that didn’t take advantage of the UBT framework. UBTs are the way we get things done in partnership, so this move means that health and safety will be prioritized and will be built into our daily work.

The new challenges for Level 5 teams were added because of a desire to make a clearer distinction between Level 4 teams and Level 5 teams. Those bargaining the contract felt that a Level 5 team should be able to take on sophisticated performance improvement techniques such as incorporating the voice of KP members and patients into UBT work as well as spreading or adopting successful practices.

Significant changes

Here’s a list of the most significant changes to the Path to Performance that came out of 2015 National Bargaining:

  • Sponsorship: Added the requirement of a sponsor agreement at Level 2; included detail about how often sponsors should communicate with teams at Levels 3 and 4.
  • Team member training must be completed at various levels of the P2P, not “completed or scheduled.”
  • Health and safety: Level 1 teams must identify a health and safety champion; Level 5 teams must demonstrate a culture of health and safety.
  • UBT Tracker must be updated every 90 days for a team to be rated a Level 4.
  • Level 5 teams: Member-facing teams must get direct input from Kaiser Permanente members and patients; teams must spread or adopt a successful practice.

Please see the Path to Performance document to  familiarize yourself with all of the changes.

New UBT evaluation process

According to the 2015 National Agreement, all unit-based teams must be evaluated by a UBT consultant or union partnership representative at a face-to-face meeting. This was already taking place at some facilities, but it is now being implemented in all facilities and all regions. The face-to-face assessment process is expected to improve the accuracy of team ratings.

Level 1, 2 and 3 teams will be evaluated every quarter. Level 4 and 5 teams will be evaluated at least once a year.

Revised UBT performance targets

Because of these changes, modifications were made to the annual UBT performance targets. Here are the new targets: 

  • 2016: 75 percent of teams at Levels 4 and 5
  • 2017: 80 percent of teams at Levels 4 and 5
  • 2018: 85 percent of teams at Levels 4 and 5
  • 2019: 87 percent of teams at Levels 4 and 5

 

Where No One Has Gone Before

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How interest-based bargaining and our new National Agreement set us apart from the crowd

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Many of the several hundred health care workers who gathered at the Manhattan Beach Marriott on May 10 are used to working through the night—it goes with their jobs. But they aren’t used to waiting. By midnight, some were napping on the couches in the lobby. Others milled about in small groups, talking quietly. And some retired to their rooms and asked friends to call them if and when anything happened.

Finally, around 2 a.m., the news came: A subgroup had ironed out the final details. By 3 a.m., the hotel’s central ballroom was filled with cheering, hugging workers—and supervisors, middle managers and senior vice presidents. The 140 management and union negotiators who formed the Common Issues Committee (CIC) gave their unanimous thumbs-up to a new National Agreement that will guide the work of some 130,000 workers, managers and physicians in the nation’s largest private health system.

“It was like we had just won the World Series,” says Alan Kroll, director of the Clinical Contact Center in Colorado and a first-time member of the CIC. “We’d had our ups and downs as a team, but in the end, we all came through as a team. The energy and camaraderie was tremendous.”

R-E-S-P-E-C-T

“The energy of the room was not because we liked each other. It was because of the respect that partnership had brought,” says Ashwin Deo, an orthopedic technician in Sacramento and SEIU UHW member who served on the CIC.

The agreement, reached in the course of five three-day sessions from March to May, is the largest private-sector labor agreement negotiated in the United States this year. Like previous National Agreements, it covers not only wages and benefits but also goals related to service, quality, affordability, workforce and community health, and more. (For highlights of the agreement, please see the 2012 National Agreement Overview insert.)

Yet how the CIC reached the agreement is even more remarkable than the agreement itself. Rather than engage in a power struggle, the negotiators used interest-based bargaining to solve problems. That process allowed it to focus on solutions to the biggest issue facing health care today—that it costs too much, and too few Americans can afford it—while maintaining Kaiser Permanente’s industry-leading wages and benefits.

Rather than chopping care or benefits to control costs, says John August, executive director of the Coalition of Kaiser Permanente Unions, the agreement “provides union members with the tools to tackle cost by improving care and efficiency. Improved care and efficiency, delivered by workers at the front line, are the key to extending quality care to every person in our country.”

“Our national bargaining is unique,” says Dennis Dabney, the senior vice president of National Labor Relations and the lead management negotiator. “There is not only a group of labor negotiators at the table, but a broad cross-section of our employees providing recommendations on how to better deliver high-quality, affordable care and ensure Kaiser Permanente is a great place to work well into the future.”

Moreover, the outcome is a testament to the interest-based approach to partnership, not just interest-based bargaining.

“As our facilitators told us, economic issues are tough to resolve in interest-based bargaining,” says Adam Nemer, care delivery finance officer in the Northwest and a member of the bargaining subgroup that focused on benefits. “In the end, we met both management and labor's key interests. But I suspect that was not just because of what happened at the benefits table. It was also the result of an open and honest dialogue on benefits between senior labor and management leaders over the past few years. It was about trust and transparency. In my view, we didn’t reach a solution just because of interest-based bargaining—but we couldn’t have gotten there without it.”

Revolutionary healthy workforce plan

As part of the solution to controlling costs, the agreement includes a revolutionary plan to create the healthiest workforce in the health care industry. Beginning in 2013, the agreement will reward the collective workforce achievement of reduced health risk factors, measured by body mass index (BMI), cholesterol levels, blood pressure levels, smoking rates and workplace injury rates.

“Unions and management agreed that health improvement is an essential strategy for reducing chronic conditions—one of the leading drivers of rising, unsustainable cost,” says SEIU UHW President Dave Regan. “This is a high-road, long-term strategy for the common good.”

Those involved in the process say it’s unlikely that the high road would have been taken had these been traditional, adversarial negotiations. As Joan Mah, an optometrist at San Rafael Medical Center in Northern California and a first-time observer representing her ESC-IFPTE Local 20 colleagues, put it: “Traditional bargaining is really about what I want and not about what is right….When you take the time to allow management and labor to surface their interests, it’s really looking for a global solution.”

“At times it was frustrating, but it was also interesting to see how the interest-based process led us to options we could work with,” says Jean Melnikoff, a senior director of human resources for Southern California, one of the management co-chairs of the workforce of the future subgroup.

Opening doors—and minds

Her sentiment was echoed by members of every subgroup. But that is not to say the process is easy.

“When things get difficult, you need to regroup and work your way through it,” says Arlene Peasnall, senior vice president of human resources in Southern California. “But you end up with better results and stronger relationships.”

“The people who’d done it before said, ‘It’s OK, it can be done,’” says orthopedic technician Deo. “Don’t be afraid of the tension in the room. Don’t be afraid of emotions, because that’s what gets creativity out….When labor and management are at the table, talking to each other as equals, and the ideas are valued equally—I think that opened a lot of doors. And minds, too.”

When Every Day Is Partnership Day

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Organizations, unions from across the nation explore a more collaborative future

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What if every organization and every union had a labor management partnership like ours?

It’s not as far-fetched as it sounds. On Aug. 16, more than 250 union, business and government leaders from all over the United States gathered in Chicago for Partnership Day, a meeting hosted by the Federal Mediation and Conciliation Service at its biennial conference—and offered a realistic look at the ups and downs that occur in partnerships and what it takes to launch and sustain them.

“We know partnership can make a difference,” Allison Beck, FMCS director, told the gathering. “This is not some fantasy that happens in a make-believe world.” She should know. As leader of the FMCS, the federal agency that mediates labor disputes across the United States, she’s seen firsthand how acrimonious relationships can ruin companies and unions—and how more open and respectful ones can help them both succeed.

The partnership between Kaiser Permanente and the Coalition of Kaiser Permanente Unions is the longest-lasting and strongest one in the nation, so conference participants asked many questions about how it operates.

A race to the top

Dennis Dabney, KP's senior vice president of National Labor Relations and Office of Labor Management Partnership, told the packed room he spends a lot of time on the phone with leaders from other companies interested in starting and strengthening partnerships.

“I've seen so many companies engaged in a race to the bottom,” Dabney said. “I'd like to see more engaged in a race to the top.” If he has any regrets about Kaiser Permanente’s partnership, he said, it's that we didn’t create unit-based teams sooner.

Videos

Reaching a National Agreement

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This video captures the moments leading up to and just after Kaiser Permanente and the Coalition of Kaiser Permanente Unions reached a new three-year national contract. 

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