Rome was not Built in a Day: Creating a System of Support and Structure for Unit-Based Teams to Thrive


Lisa Sperduto; Delmy Deloa; Delilah Jimenez;
Kia Vue, MS; Ryan Darke, MHA, FACHE

In the workshop, “Rome was not built in a day,” participants learned how the Roseville Medical Center built a culture of continuous improvement through performance improvement and Unit-Based Team (UBT) integration, and how Redwood City Women’s Health Team drove frontline improvement. Roseville increased their percentage of high-performing UBTs (Levels 4 and 5) from 9% to 75%, by using 3 foundational interventions: 1) joint (The Permanente Medical Group and Kaiser Foundation Hospitals and Health Plan) senior leadership and frontline labor leader engagement, 2) strategy integration in partnership with the performance-improvement program, and 3) communication via visual boards.

Roseville used existing structures (Local Resource Network [LRN]and Labor Management Partnership [LMP] Steering Committee [LMPSC]) to create support for UBTs. LMPSC leaders “adopted” teams to assist struggling teams, and the LRN provided oversight to hold sponsors and teams accountable. “Super Sponsors,” labor and management high performers, are trained to coach targeted teams, and sponsor forums are held to help build trust among UBTs and to learn from one another across the service area.

Implementation of visual boards allowed teams to huddle daily or weekly without disrupting the work environment. Visual boards facilitated real-time problem solving, brainstorming, visual management, and communication flow.

Associate Improvement Advisor training was required of all Level 5 coleads, as was equipping frontline employees with tools to lead continuous improvement and to mentor other teams; training included SMART goals, Rapid Improvement Model, and UBT Tracker.

Teamwork was key to improvement and to making patient care a priority. The Redwood City Team provided details of how communication within their UBT (including medical assistants and clinicians) drove improvement. Their primary goal was to have patients walk out the office feeling like they were family and knowing they had received exceptional care. The biggest improvement was their use of senior medical assistants to help both staff and patients. Senior medical assistants also helped with problem-solving and brainstorming new ideas. An additional key is how staff-led UBT and staff meetings helped implement ideas and achieve department goals.


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