March 6, 2012

Kaiser Permanente a model for labor-management partnership

Kaiser Permanente’s Labor Management Partnership has shown other health care organizations a way to improve patient care, affordability and the work environment, according to a new study by Cornell University’s School of Industrial and Labor Relations.

Kaiser Permanente’s San Diego and San Rafael medical centers are featured in case studies of the Cornell report, titled “How Labor-Management Partnerships Improve Patient Care, Cost Control and Labor Relations.”

The national study, which included Montefiore Medical Center’s Care Management Company in New York and Fletcher Allen Health Care in Vermont, concluded that labor partnerships helped their organizations develop “innovative ways to improve the quality of the services that they provide while simultaneously controlling costs.”

The report identified results across all systems in four areas: clinical processes, the work environment, labor relations and cost savings. According to the report, joint labor-management activities at Kaiser Permanente medical centers in San Rafael and San Diego have resulted in:

  • Improved turnaround time for test results
  • Increased awareness about workplace safety
  • Improved patient satisfaction scores
  • Quicker access to home-care services

Specific examples from Kaiser Permanente San Diego Medical Center included an improvement in the percentage of home-care patients seen within 24 hours — to 83 percent in November 2010, from 44 percent in January 2010.

Also, Kaiser Permanente San Rafael’s clinical lab was cited for achieving a 45-minute turnaround in its stroke-alert tests; zero workplace injuries reported in 2010 (and just two in the first five months of 2011); and a $51,000 reduction in backfill costs in just one department.

At Kaiser Permanente, a strong Performance Improvement process has also played an important role in the successes of the Labor Management Partnership. Kaiser Permanente’s Performance Improvement process is clearly working to reduce variations in quality, safety, service and efficiency across its medical centers. In 2011, Kaiser Permanente received No. 1 rankings in 11 effectiveness-of-care measures, more than any other health plan in the nation.

“Over the past several years, Kaiser Permanente has focused on the pursuit of being the highest quality delivery system by being the best at getting better,” said Lisa Schilling, vice president of National Health Care Performance Improvement for Kaiser Permanente. “To achieve what we have it has taken everyone from our front-line staff and unit-based teams through senior leadership to align and focus on improving our system to achieve better care quality, safety and experience for our members.”

The researchers also lauded both Kaiser Permanente facilities for their “embrace of partnership as ‘the way things work’ at all levels of the organization.” Such front-line collaboration is essential in implementing and sustaining change in complex systems, they noted.

Unit-based teams — Kaiser Permanente’s strategy for front-line performance improvement and engagement, established through its Labor Management Partnership — were key to implementing this strategy.

“This study validates what we have seen in unit-based teams across every region of Kaiser Permanente,” said Barbara Grimm, senior vice president, Office of Labor Management Partnership. “As UBTs have developed, thanks to our front-line managers, staff and physicians, they have taken on significant improvement projects in areas like quality, service and affordability that enhance care and outcomes to our members and patients. In the process we are co-creating the best place to work in the health care industry.”

John August, executive director of the Coalition of Kaiser Permanente Unions, said, “The results we are getting in partnership really set Kaiser Permanente apart from other organizations anywhere in this country. And these results transcend the work of individual teams. They are part of a bigger cultural change that is spreading learning, best practices and new ways of working together across KP.”

The study also lists eight best practices to support partnership. These include having strong union and management leadership, a clear partnership structure and well-defined goals.

“Reforming our health care system to be accessible and provide high-quality services has been at the core of many recent national and state initiatives,” said Peter Lazes, director of Cornell’s Healthcare Transformation Project and lead researcher in the study. “Kaiser Permanente’s union-management partnership shows how health care quality and costs can be improved through collaboration.”