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EDITOR’S LETTERAt Your ServicePublished by Kaiser Permanente andCoalition of Kaiser Permanente Unions888 LMP AT KP (888-567-2857)Communications DirectorsMaureen AndersonMichael DowlingStaffPatty Allison, Janet Coffman,Paul Cohen, Jennifer Gladwell,Vince Golla, Kyra Kitlowski,Julie Light, Chris Ponsano,Neal Sacharow, Gwen E. ScottWorksite Photos: Bob GumpertCover Photo: Getty ImagesGraphic Design: Stoller Design GroupAt Kaiser Permanente we have what it takes to lead essential changes in the U.S. health care system—an integrated modelof quality care, a skilled and committed workforce, and a Labor Management Partnership that puts decision making in thehands of frontline employees, managers, and physicians to serve members. But to lead change in the face of growing financialand competitive pressures, we have to grow our membership, continuously improve service and quality consistency, andsee things from our members’ point of view.That service challenge is the focus of this issue of Hank.KP employees want to serve others—that’s why we choose to work here. But any large, complex system is bound to haveservice breakdowns and system stresses (as service guru Len Berry notes in these pages, health care delivery is “morestressful and more demanding” than other service work). Fortunately, we have Partnership tools for use in unit-based teamsto serve, innovate, and fix breakdowns when and where they happen.Partnership tools for change also are front and center in “Rx for Uncertain Times” (page 8). Simply put: Large, for-profit competitorsare competing fiercely with KP on every front—price, quality, technology, branding, service—and we have to respond.Leading the change are shop stewards (“Stewards of Change,” page 6) and frontline managers, whom we profiled last issue.These frontline leaders describe what it takes to serve the multiple demands of today’s health plan members, union members,and their departments.And our office wag, Henrietta (page 10), challenges us to not just follow our calling but to sound the call for others.Taken together, these articles show what KP can do, in Partnership, to better our members’ lives, advance our model ofcare, and lead change in a broken U.S. health care system. It’s up to us to prove there’s a better way.CONTENTS3Cover story: Great Service—It’s no MysteryKP people have the commitment to serve—and are creating workplace teams and toolsto put that commitment to work. Here are four examples of how they’re doing it.6810Stewards of ChangeWhat it takes to represent employees, partner with managers, and stilldo a full-time job.Rx for Uncertain TimesWith tough times ahead in U.S. health care, teams throughout KP arefinding ways in Partnership to do more for members, more efficiently.From the Desk of Henrietta:LEADING THE CHARGEWe know we’re good, so why don’t we act like it?10 Letters to HankAnother look at the roles of managers and stewards.1011 Hank Survey ResultsWhen it comes to Partnership, frontline managersand stewards see eye to eye—almost.12 A Tear-Out PosterRip, Post, and Go Ergo!Hank December 2006 | No. 11www.lmpartnership.org
Cover storyGreatService—it’s noMysteryWorking at KaiserPermanente is about morethan collecting a paycheck; it’sabout serving members and makinglives better. “People at KP want to do theirbest with every member they encounter,”says Shernida Wheeler, a surgery schedulerat Glenlake Medical Center in Atlanta. “I trynot to let much get in the way. When I hita barrier, the Partnership helps me finda way through it.”That kind of commitment runsdeep at KP. According toProject Looking Glass, a 2004survey of more than 10,000KP employees, the top threemotivators across KP are jobsecurity, making a differenceto members, and recognitionfor a job well done. “KPemployees have a strongsense of personal mission,”says Deborah Konitsney, directorof organizational research. “Theywant to contribute to a larger ideal.”Those high aspirations meet reality at thefront line—increasingly in self-directed, unit-basedteams—where the quality of members’ service experienceand employees’ workplace experience are determined. In a competitivehealth care marketplace, those experiences matter.“The quality of our patients’ experiences, and how they perceivethe quality and competence of the care they receive, is basedlargely on the attitudes, behaviors, and service styles of the peoplewho deliver their care,” says Leonard Berry, author of several bookson service and a Texas A&M professor of marketing and of humanitiesin medicine. Berry conducted a six-month study of servicequality at the Mayo Clinic, observing and interviewing more than1,000 patients, doctors, and staff members.“Health care delivery is more stressful and more demanding—bothphysically and emotionally—than any service work I’ve studied,” hesays. “Health care organizations have to recognize that and createan environment that allows people to work together and rise totheir highest level.”KP and the Union Coalition are attempting to do just that. The2005 National Agreement commits KP and the Union Coalitionto “working together to make Kaiser Permanente the recognizedleader in superior service.”Yet we know that service inconsistency is a problem. The 2006Consumer Assessment of Healthcare Providers and Systems(CAHPS) shows that, compared with competitors across mostregions, KP service quality is better in some measures (includinggetting help from member services departments), worse in others(including staff courtesy and helpfulness), and in most respects haschanged little in the past year. Likewise, PeoplePulse survey resultsfor 2005–2006 show mixed results on employee perceptions ofKP service quality.But the service improvement commitment cannot fall on theshoulders of individual providers or staff. Service failures usually areoperational failures. That’s where Partnership comes in. “Havinglabor and frontline management support for service quality helpspush things from the bottom up as well as the top down, and that’swhere it needs to happen,” says Kate Dougherty, RN, nationalservice quality consultant and co-lead of the Service Quality ActionTeam. “People want to do the right thing for the patient.”It’s important to see things from the patients’ point of view—andmost employees don’t have to look far to get that perspective.“Frontline workers are closest to our members,” says David Shapiro,chapter president of the Medical Social Workers, SEIU Local535, and co-lead of the Service Quality Action Team. “Most of usare KP members as well. So it’s obvious to us when we’re nottreated as we’d like to be, as members or employees.”The solution, he says, “cannot be imposed from above. Solutionshave to be developed in Partnership and work for the people doingthe work in each department—from EVS, to call centers, to doctorsand nurses.”As you’ll see in the stories in this issue, people across KP are takingup that call: Nursing and psychiatry departments in SouthernCalifornia, materials handlers in South Sacramento, and pharmacyand member-service teams in Colorado are just a few examples ofpeople making changes, in Partnership, to serve members better.Read on to see how they’re solving the mystery, and how you can, too.Psyched for ServiceWhen it comes to changing the way we dothings, it pays to speak up—especially if youhave the tools to make things happen.At the Psychiatry Department in the Fontana(Southern California) Medical Center,the impetus for change came from a 2003grievance from clerks regarding excessiveworkloads. Managers and staff addressedthe concern through the Issue Resolutionprocess, focusing on solutions that wouldimprove service as well as work processes.All agreed that clerks’ jobs, which includedchecking in patients and setting up appointments(then handled separately at each facility) were overloaded. Today,call-handling times and patient scheduling have improved dramatically—thelatter by using a centralized appointment center for allfour psychiatry units in the Fontana area—while the number ofmissed appointments has fallen. Both member and employee satisfactionscores have increased.PROBLEM:Overloadedstaff membersSOLUTION:Redesigned workprocesses andincentives(continues on page 4)www.lmpartnership.orgHank December 2006 | No. 11
Page 1: DECEMBER 06 | ISSUE No.11FRONTLINE
Page 6 and 7: Stewards ofC HANGEWhat it takes to
Page 10 and 11: From the Desk of Henrietta: LEADING

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