Unit-Based Teams Are Getting Results

1. Unit-Based Teams Are Getting Results How UBTs Are Improving Quality, Service and Affordability for Kaiser Permanente Members and Patients December 2015

2. SERVICE: Super UBT Models “One KP” Customer & Member Services, Mid-Atlantic States, Colorado and Southern California • To improve service during busy Open Enrollment periods, a 40-member team of member-service employees in three regions: • works across functional and geographic lines to share ideas and test solutions • uses a “one-and-done” approach to prevent unnecessary hand-offs of customer calls • spreads the single best service practices across Kaiser Permanente

3. AFFORDABILITY: Simple Is Better – and Cheaper • Central Refill Pharmacy, Downey, Southern California • This team improved service and reduced costs by agreeing to: • assess workflow and identify bottlenecks • reduce excessive overtime by improving and adjusting shifts and expanding the night shift

4. AFFORDABILITY: Taking the Guilt Out of Co-Pays • Orthopedics-Podiatry, South Bay Medical Center, Southern California • To improve co-pay collection, capture lost revenue and help keep rates affordable for all members, this team: • created a check-in sheet • redesigned its workflow • tracks missed payments and reviews data at monthly UBT meetings

5. BEST PLACE TO WORK: Engaged Teams Are Safer • Environmental Services, San Leandro Medical Center, Northern California • To build employee engagement and reduce workplace injuries, this team: • reorganized the department’s 138 employees into smaller teams • encourages team members to speak up about safety hazards or concerns every day

6. SERVICE: Making the Most of Every Visit • San Jose Medical Center, Northern California • Genetics team wanted to reach more patients with smoking cessation information. Two simple fixes: • Print out registration slips with questions regarding smoking, so smokers can identify themselves up front • Attach the registration slips to clipboards, so the genetics counselors can provide smoking cessation information

7. QUALITY: Rethinking How Work Is Done Rock Creek Medical Offices, Colorado Cardiology team reduces waste and speeds service with a new process: • Have physicians highlight significant events that need to be in the patient’s medical record • Scan only the pages with pertinent results generated by a patient’s heart monitor

8. QUALITY: Making Prevention Easy Lakewood Medical Office, Colorado Imaging and flu clinic teams link up to increase mammography screening rates Medical Imaging UBT worked withflu clinic colleagues so women who came in for a flu shot and were due for a mammogram would be offered an appointment

9. AFFORDABILTY: Common Sense Solutions • Southwood Specialties, Georgia • Gastroenterology department reduces costs by hiring fewer contract specialists and scheduling procedures so that: • doctors perform anesthesia four days a week instead of five • patients requiring anesthesia are seen only on days physicians are available • nurses perform sedation, which does not require a physician

10. SERVICE: Giving Patients the Gift of Sleep Sunrise Inpatient Team, Moanalua Medical Center, Hawaii: To ensure a quieter hospital stay and a better patient experience, this team: • discusses quietness goals during team huddles • has the charge nurse wear a “Quiet” badge • dims the room light starting at 7:00 pm • keeps patients’ doors closed when possible

11. QUALITY: Reaching Out to At-Risk Patients Burke Primary Care, Mid-Atlantic States To increases percentage of patients whose blood pressure is under control, this UBT: • calls hypertensive patients with the message that their doctor is concerned, instead of sending a letter • allows patients to drop in almost any time for free mini-checks • brings a doctor into the mini-check when a patient’s blood pressure reads too high, to discuss treatment options and encourage follow-up within two weeks

12. SERVICE: Finding What Works for Patients Sunnyside Medical Center, Northwest How one Emergency Department speeds up service: • Set up a fast-track area with four patient rooms for patients with low-acuity issues • Standardize criteria for triage • Keep patients in treatment rooms only while being treated; waiting occurs in the fast-track waiting area

13. SERVICE: Spreading Success Regional Infusion Center, Northwest Englewood Medical Office, Colorado UBT members share new approach, give patients the gift of time • Colorado team implemented a faster way of administrating Remicade, used to treat rheumatoid arthritis • Northwest team’s co-leads heard about the practice, pushed for quick approval of the protocol in their region