The hospital workers from Kaiser Permanente that I met at IHI all seemed so proud of the work their unit-based teams are doing.

A good example are the three co-leads of a unit-based team from the OB/Gyn clinic of Kaiser Permanente Los Angeles Medical Center: Richardson, the manager; Brittanye an LVN (Licensed Vocational Nurse, like our LPNs); and Marcia, a Nurse Practitioner. Brittanye and Marcia are both union leaders, from 2 different unions.

How Unit-Based Teams Change the Day-to-Day Experience at Work at Kaiser

When I asked how the unit-based team changes work for her, Brittanye told me, “You have more input. It makes us feel better because our voice is heard. When we are asked, we feel we are going to be listened to…. It’s more collaborative, not management saying ‘this is how it’s going to be.’ We can make it better and get the job done.”

Richardson, the clinic manager, said their unit-based team collapsed the first time they tried to get it going, but now it's thriving. “Finally we have a team where we all listen to each other. We aren’t just talking at each other… We respect each other. I want our department to shine. I have pride in my department, and I trust my employees. I have pride in what we work on together. I listen to what they say. It fills me with joy to see them thinking outside the box, and to see how much they care about the patients.”

Harvesting Old IUDs to Improve Work and Patient Care

One of this unit-based teams projects was setting up a process to return unneeded IUDs, which are worth about $500 each when returned to the company. Creating a new, and smooth, process to make sure the IUDs didn’t get trashed involved the front desk, the Medical Assistants, the physicians, and the LVNs. As Richardson said, “It wouldn’t be successful if we didn’t have the engagement of everyone.”

Over 11 months, the OB/Gyn clinic saved $47,000 by returning IUDs. Brittanye said they were able to buy 5 new ultrasound probes with the money they saved last year. “That increases access for our patients, and they have to wait less. The staff is happier and it’s not as stressful.”

Why Kaiser and the Unions Created Unit-Based Teams

The coalition of unions at Kaiser and Kaiser Permanente management negotiated to put in their contract a system of unit-based teams in every department. Unit-based teams tap into the knowledge and experience of front-line staff, managers and physicians. According to the Kaiser Permanente Labor Management Partnership website, “These teams are transforming Kaiser Permanente by changing the roles of union members and managers and creating an environment in which all employees are encouraged to think critically about problem solving and work innovations.”

SHARE and UMass Memorial senior management have invited a union and a management representative of the Kaiser Permanent Labor Management Partnership to visit UMass Memorial, to explain how their unit-based teams work.

(The first 2 pictures show the OB/Gyn Unit-Based Team at a celebration of unit-based teams' work. The 3rd picture shows the three co-leads that I met at IHI -- Brittanye, Richardson, and Marcia. -- Janet Wilder)