Employees who feel free to share their ideas and concerns help keep our patients safe and make Kaiser Permanente a better place to work. Managers can help team members feel comfortable speaking up by creating a “psychologically safe” work environment—one where no one is afraid they will be embarrassed, rejected or punished for speaking up. Here are four tips from supervisor Nee Tang, Pharm.D., Ambulatory Care Pharmacy, West Los Angeles, on how to help workers make their voices heard.

Follow up and take action. “When an employee brings up something, look for the solution and be accountable. Make sure things are done. Having that accountability is really crucial to employees.”

Be authentic. “Having a manager who is open-minded and who truly, genuinely wants to create a safe environment for everybody, that’s the key.”

Be patient and persistent. “In the beginning, people may not be as comfortable speaking out. But once they see we’re coming every month no matter what [to do peer safety rounding], they’re speaking out. We’re really getting the equipment that is needed and reminding everyone about the proper ergonomic positions. People know we’re serious about making an environment that is safe for everyone.”

Find people who want to share their passion with others. “Another key is to have people who are passionate. Angie Chandler, our labor co-lead, is really passionate about ergonomics. I’m passionate about eating healthy. We have another employee who is passionate about exercise. Everybody wants everyone to be safe and healthy and to work well together. We’re passionate about what we do and want to spread that to everybody.”

I’m in a UBT, you’re in a UBT, we’re all in a UBT! Hooray! Let’s start our performance improvement project, collect our data and make a PowerPoint presentation to explain our results.

…Whoa. Not so fast. Unit-based teams were launched as part of the 2005 National Agreement, but we all still hear stories about frontline union members, managers and physicians who don’t realize they’re on a UBT. This is a big deal. When people don’t know they’re on a UBT, they’re missing out on an opportunity to take part in improving service and quality for our members and patients.

That’s why negotiators hammering out the 2015 National Agreement added a requirement: In order for a UBT to move up to Level 3, it has to have “a communications structure to reach all members of the department” in place.

Over time, this will help everyone in the department realize they’re part of the UBT—and will lay to rest the myth that “the UBT” is a small group of people who lock themselves in a meeting room, drink coffee and eat doughnuts and solve problems for everyone else. Your team needs you contributing ideas; our members and patients need you.

It took a whack on the head—literally—for Tedros Tecle to learn the importance of speaking up.

Tecle is a rad tech at our Santa Rosa Medical Center. Because of a less-than-ideal setup, he banged his head on a mobile X-ray machine. He wasn’t hurt, just really embarrassed. Enough so that he didn’t say anything.

You can guess what happened next: Another tech did the same thing and was injured. The experience motivated Tecle to become a facility workplace safety tri-chair and a champion for speaking up.

Keeping employees, managers, physicians and patients free from injury requires a #FreeToSpeak culture, one where halting work to address a safety concern is a cause for gratitude, not—as in some workplaces—scorn.

In fact, a #FreeToSpeak culture is the foundation for being able to do what we value most at Kaiser Permanente and in the Coalition of Kaiser Permanente Unions: providing high-quality care and service at an affordable price and the best place to work for our employees.

To do that, everyone on our unit-based teams—no matter their role or job title—must feel free to chime in with suggestions about how to make things better, no matter how wacky or inconvenient their ideas might seem. That’s not yet the case; responses to KP’s annual People Pulse survey show the need for improvement.

Creating a speaking-up culture takes time. In this issue of Hank, you’ll find tips and tools to get started and keep going, whether you’re a frontline manager or a union-represented employee. And you’ll hear from the Humans of Partnership who are, more and more, #FreeToSpeak.