Beep! Beep! Beep! The electronic sound of Cary Brown’s alarm clock wakes him at 5 a.m.

The Kaiser Permanente member rises to shower and make breakfast, careful not to disturb his sleeping wife, Elissa, who is recovering at home after surgery on a broken leg at the Woodland Hills Medical Center in Southern California.

On top of completing household chores, the retired Hollywood TV director spends his day making sure Elissa is comfortable and pain-free.

The experience has taken a toll on him.

“The hours of staying awake and the repetitive nature of it—and not having any life at all outside of home—is very difficult,” says Brown, who worked on the hit TV series Doogie Howser, M.D.

Now he’s part of an ambitious effort by the Southern California region to enhance support for caregivers, who play a vital role helping to heal and comfort patients outside the hospital. By reducing caregivers’ social isolation, integrating them into the hospital care team and addressing their health needs, regional leaders hope to improve patient safety and quality in the home.

‘Human-centered design’

Under the initiative, frontline workers, physicians and managers are partnering with KP members and their families to design the ideal in-home care experience for patients and caregivers. Participants are using a creative approach to problem solving known as human-centered design, which starts with the people you’re designing for and ends with solutions that are customized to their needs.

“It’s a way to engage the folks who are most affected from day one,” said Dr. Nirav Shah, senior vice president and chief operating officer for Clinical Operations in Southern California. “No program that I could ever design will be as good as one that had the people who are most affected design it with us. It’s about empathy and understanding.”

Human-centered design is also an ideal tool for unit-based teams to use on performance improvement projects. It delivers on the fundamental concept of the Value Compass—to put the member and patient at the center of decision making—and both frontline workers and Labor Management Partnership leaders, from management and the Coalition of Kaiser Permanente Unions, have been supporting the caregiver project.

Reducing the overwhelm factor

At a meeting in Pasadena, the participants—patients and caregivers, KP employees and physicians—gathered in small groups to share personal tales and draw storyboards to help identify barriers, come up with potential solutions and provide insights to regional Home Health leaders.

Shawna Wallace, a senior physical therapist for Home Health and member of UNAC/UHCP, said the experience was eye-opening.

“I’ve gone into homes where caregivers really care about their loved ones, and they are extremely overwhelmed,” she said. “This is a great opportunity for us to see where we can make better programs for our caregivers and members in these scenarios.”

Brown is hopeful that the approach will give caregivers—and their loved ones—the emotional and physical support they need to thrive.

“If you take care of the family as a unit,” Brown says, “you make it possible for each individual in the family to be better.”

Twenty years ago this fall, Kaiser Permanente and the Coalition of Kaiser Permanente Unions formed the innovative Labor Management Partnership—a new way of working that now includes more than 150,000 managers, physicians and union-represented workers across Kaiser Permanente.

To commemorate this event, California Governor Jerry Brown has issued a proclamation congratulating Kaiser Permanente and the Coalition of Kaiser Permanente Unions for 20 years of successful partnership and collaboration.

“This model has resulted in improved patient outcomes, workplace innovations, process efficiencies, and measurable service and quality enhancements while creating a safer, healthier work environment with opportunities for health care workers to improve their skills and advance their careers,” said Governor Brown, “I commend all of the organizers and participants in this process for making the Golden State a better place to live and raise our families.”

The Labor Management Partnership is proof that labor unions aren’t just about making things better for workers, but improving outcomes for everyone. In just the first six months of 2017, partnership teams launched nearly 10,000 self-directed projects to improve Kaiser Permanente’s quality, service, and affordability. Departments with strong employee engagement report:

• 60 percent fewer patient falls with injuries
• 38 percent fewer workplace injuries
• 21 percent fewer lost work days
• 13 percent improvement in patients’ overall hospital satisfaction

In 2016, the partnership also helped Kaiser Permanente to keep costs down, with teams working together to save more than $48 million, on top of $35 million saved in 2015. 

More than 74 percent of Kaiser Permanente’s workforce is unionized. By contrast, 6.4 percent of private-sector workers nationwide belong to a union, according to the Bureau of Labor Statistics. Union representation is supported by a growing number of Americans, an August 2017 Gallup poll suggests. Sixty-one percent of adults surveyed say they approve of labor unions, the highest percentage since the 65 percent approval recorded in 2003.

Working together, Kaiser Permanente and the Coalition of Kaiser Permanente Unions will continue to improve health care for members and the community overall. Together we thank our workers, managers and physicians for their dedication, and appreciate Governor Brown’s recognition of their accomplishments.

As we celebrate the 20th anniversary of the Labor Management Partnership, Hank would like to call out the tens of thousands of individuals who have made partnership a success: the frontline workers, managers and physicians who have believed in our ideals and taken the time to build the positive working relationships that are the backbone of this groundbreaking endeavor.

Visit Humans of Partnership to read their stories—and look through their eyes into our past, our present and our future. 

When Terri Imbach, Family Practice manager at Mt. Scott Medical Office in the Northwest region, and labor co-lead Christina English, a licensed practical nurse and a member of SEIU Local 49, began to work together as UBT co-leads several years ago, they knew they needed to shake things up with the department’s unit-based team. 

The staff worked hard to meet the demanding needs of the fast-paced medical office, but morale wasn’t great—and team members weren’t taking ownership of improvement work. UBT meetings were poorly attended and often turned into complaining sessions.  

The co-leads’ first move was to go to UBT training classes together. That experience gave them an idea for their next move—which was to shake things up between the two of them by stepping away from work and getting to know each other outside the office. 

“Getting out of the work environment is a good way to get away from the stress of the department,” explains English. This mindset set the tone for how they would operate together and helped them sustain a good relationship over time.

The co-leads also adopted “fun” as part of their regular UBT agenda, and meetings now are attended by nearly 100 percent of the staff.  

“We think of fun ways to get to know each other in and out of the office, and we work to include fun elements in all of our meetings,” Imbach says. During the holidays, team members played relay games at their UBT meeting, and they participated in a fundraiser for a local youth organization that included playing basketball on donkeys. 

The creative energy of the co-leads has helped engage all 40 members of the Level 5 team, who are juggling more than a dozen quality projects. 

“Team members step up to take on projects now,” English says, “and there are friendly competitions to meet our goals.”