ILPC 2027

 While the Labor-Management Partnership (LMP) agreement between Kaiser Permanente and the Coalition of Kaiser Permanente Unions was signed in 1997 it was only in 2005 that the parties negotiated a new collective bargaining agreement which called for systematically, rather than sporadically, bringing the partnership to the frontline of healthcare delivery.  Specifically, the agreement called for the creation of Unit Based Teams (UBTs) as the platform for improving organizational performance.  The contract set an ambitious timetable with 15% of workforce in UBTs by the end of 2007, 40% by 2008, 70% by 2009 and 100% by 2010.

By summer of 2010, 94,000 KP employees were working in 3,200 UB Ts, a small but growing percentage of which had been labeled as “high performing”.   We conducted case studies of 16 high performing KP teams in 2009 and 2010.  The teams we studied had achieved improvements in both organizational performance and indicators of employee well-being.   We found a set of common enablers of success across the teams.  Consistent with earlier work on Kaiser we found successful teams to have participation by physicians, committed labor and management co-chairs, and strong sponsorship.  Other factors enabling success included 1) a clearer picture of the organization’s goals and the connection of the team’s work to those goals; 2) systematic use of metrics and organizational support in accessing, analyzing, and reporting metrics; 3) the use of explicit performance improvement models along with process skills; and 4) other infrastructure support such as training and facilitation.  A final striking finding from this qualitative work is the degree of flexibility, particularly in structures, processes and methods, shown by these successful teams.   We hope also to have results from qualitative analyses linking team process data to clinical outcomes.