Laurie Abernathy, SHARE UBT Union Co-Lead. Before the UBT, she says process improvement could often seem like “putting a band-aid on top of a band-aid.” (photo credit: Candace Tauson)
A NOTE FROM THE SHARE CO-SPONSOR
Before establishing a Unit Based Team, the SBO had already been consistently improving. Still, morale among the staff was rocky. Just before we launched the UBT, I attended a staff meeting like none I’d ever seen, one that brought the whole department together . . . except that management stayed out of the meeting so that the staff felt more comfortable to speak freely.
The conversation was led by staff member and SHARE Rep Laurie Abernathy. The staff speculated about how to deal with their many frustrations: turnover had been high, management had been difficult to contact when angry patients needed to be escalated. Their idea-board ideas were stuck in the parking lot, and they found themselves often unable to communicate about essential things. The staff felt adrift and underpowered, detached from other departments in the hospital, and even from their own management structure. But they clearly wanted to do the best job they could, taking care of patients and one another.
At the request of the staff, Laurie brought the concerns and ideas back to me as their SHARE organizer, and to SBO Director, Joy Cournoyer. Joy listened thoughtfully, intent to make improvements. And now that we’re UBT Co-Sponsors together, I’ve gotten to see firsthand how the UBT structure has provided new ways for leadership to support and champion this Team.
Together with Management Co-Leads Michelle Locke and Rebecca Boutilette, Laurie and a half-dozen other SHARE members have been meeting as a team every two weeks. As a result of their UBT, I’ve seen the whole department better enabled to bring their expertise and compassion more consistently to every interaction they have with patients. They have a great story to tell . . .
--Kirk Davis, SHARE Staff Organizer and UBT Co-Sponsor
Michelle Locke & Laurie Abernathy,
SBO UBT Co-Leads
Interviewed by Rafael Rojas
The Unit Based Team: First Impressions
Laurie: I first heard of the UBT when I became a union rep. It was about two years ago when I first heard of the idea, and I immediately thought,” Oh my goodness, my department needs this so bad, we could really flourish from working through this system. We’ve always had ideas, and we’ve usually been able to figure out what the problem is, but we would have a hard time with figuring out how to solve them. We would resort to putting a band-aid on top of a band-aid until some change down the line would just blow all of our band-aids off and we would be forced to start from square one.”
Michelle: So much progress has been made in our department as a result of the UBT. I can honestly say that in my short amount of time here, that I’m unsure that we would have even been put a lot of our goals on the list of what we needed to improve. The UBT has forced us in a good way to hold our feet to the fire. We are making a commitment to the UBT, but also to everyone in the department and it’s a great thing to feel responsible for. We are making changes that will help in the future past the pandemic as well, which is just really exciting.
The First Challenge: Updating the Process Documents
Michelle: When this UBT formed we had a tough time deciding exactly what metrics we would follow to track our progress and improvements, but these have proven to be helpful, and we are still constantly thinking of different and better ways to measure these changes.
Michelle: Our primary, but also biggest obstacle and challenge that the UBT has taken on has been updating our process documents. Our process documents are not only outdated, but they lack information of many processes that happened in our department. Those documents that we did have were scattered throughout a SharePoint site that were not easily accessible. If a representative was looking for information while they were on the phone with the patient, they would be stumbling on the phone just to get them that information. In addition to that, being in the office brought the advantage of being able to lean over and get help from a coworker or from one of the two team-leads that were present on the floor. This is something that simply could not translate to working from home, and it became urgent for us to figure out how to organize this information for the representatives and a patient. We wanted to be sure that we could not only get the patients the information in a timely manner, but to get them the entirety of their information accurately.
In order for us to take on all of these process documents, we as a team have to figure what is the most important document. Where do you start when you take a look and see a hundred or more process documents that need to be updated, where do you even begin? We took a lot of time in meetings and in person, but primarily since we’ve been home, it’s taken a lot of time as a group to get together and brainstorm what is going to be the most beneficial for who’s on the telephone – so let’s first put together our list of process documents, then let’s prioritize them in order of which will have the biggest impact. Then comes the challenge of deciding who will write these process documents? It’s great that we know we need all of these documents, but who has the skills and who has the time to write all of these documents? Working on this from home has been extremely challenging, but we are making significant progress on this end.
UP-ENDED BY THE PANDEMIC
Michelle: Our UBT has been in existence for a little over a year now. When it started, we were a department that was working in an office together, so the dynamics were very different from what they are today. At first, we would meet in a group environment, but after March of last year it shifted to working from home and meeting remotely. This change had a big impact on a lot of people’s lives and really shook up the department. It is not that the UBT was pushed to the side, but we simply had a lot on our plate and certain changes did not allow for the UBT to receive the amount of time that it deserves. The priority was first to make sure that everyone was safe and settled at home as the setting of our work shifted. It was only for a few months that the UBT received less time than we had hoped, but we got right back to it as soon as we were acclimated to working from home.
“Our department went through a significant change in the way that we measured productivity. In a call center environment, you typically take a look at the amount of telephone calls that a representative is taking. Once the shift to working from home happened, the UBT presented the opportunity to change this measuring system that was among other broken parts of the system. The UBT served as a catalyst to implement and make a lot of the changes that we were in the process of doing in a manner that was more manageable for the reps. Instead of management or leadership initiating some of the conversations around issues and concerns, it is the UBT as a whole that presents these topics at our meetings. To have a system of communication that involves all parts of the department makes it feel like a very welcoming space to present some of the issues and concerns that the department has,” says SBO UBT Management Co-Lead Michelle Locke (image from presentation to LMPC)
Laurie: Our department has a large age range, so it can take those who are not as used to relying on so much technology to get their work done forever to simplify the processes and transitions to working from home. For months we just could not get the web-ex meetings to work properly for all of our members and it forced us to slow down and make sure that everyone could acclimate to the change. When we were working on this project of organizing the documents, we also wanted to be sure that we could format and sort them in a way that is accessible to all of our employees. We’re not quite there yet, but that will be one of the challenges that we overcome. People learn differently and the key will be to figure out the best way to train these process documents to a group of people that all have various ways of learning and understanding this information.
Laurie: Our department as a whole had the capacity to figure out where the problem is, what is causing it, and even thinking of how to fix it. The biggest problem was always trying to implement it. We could only take a project so far, but then we’d have to stop and wait for someone to finish.
THE UNIT BASED TEAM: AN IMPROVED IMPROVEMENT SYSTEM
Laurie and Michelle recently presented about their UBT’s challenges and successes to the Labor Management Partnership Council. Our hospital and our union meet monthly to plan together about shared goals and concerns in a group called the Labor Management Partnership Council, or LMPC (see page 6 of the SHARE Contract Agreement for a description of this group).
Laurie: As an alternative to the old improvement system (in which someone would get fed up with something and send an email to management, who would then send an email over to someone else and create a chain that was difficult to track and really emphasize), we now have a chart that organizes and prioritizes our ideas and problems. When something is posted on it, it goes out to everyone, and then everyone has the ability to add their input on how important it is to them or not.
Michelle: Altogether, we have identified and organized 103 different processes prioritized by where it will benefit the representative and where it will benefit the patient. So far, we have completed 20 of them since January.
Laurie: Everyone’s experience in the office is different, but this system really allows us to validate these issues and have them be addressed when they need to be. This has really helped us in our project to update our process documents and the representatives all give good input on where the information is lacking. There is really a lot involved in it when you keep in mind the training that comes with accessing the new documents once they are put together, we are making a lot of progress where a lot of work has to be done, but we are not cutting any corners. As soon as the training is done, we upload the document to a SharePoint site to have it be electronically accessible to everyone. Sometimes, we will even identify to some problems with the documents or programs, and we will go back into the steps to fix it.
WE CARE FOR PATIENTS . . . AND OUR CO-WORKERS
Michelle: We are a very food-driven department with some amazing cooks and menus. We are all here to work, we are not independently wealthy with mortgages to pay and families to provide for. We have to work, and this comes with high goals and expectations. It is important to find some point in the day that is full of humor, and this is something that we tried to implement into the UBT. When you ask yourself if you have goals that you have to make, also ask yourself if you can do it in a fun and enjoyable way. With the inception of the UBT, we could not imagine a better way than to introduce it in a way other than a potluck. It was still a professional and formal way, but it was something that everyone could bring something that they enjoyed. If this team was going to be successful, it had to be introduced that made everyone had faith in us for getting things done and improving what they needed. It also opened the door for a system that excited people and motivated them to be a part of the team. With this in mind, we wanted to be sure that those who joined would work well with each other when solving problems, and it has really worked out. If anyone ever feels burnout after finishing a project, there is room to make a newer team that is ready and excited to take on new challenges.
Laurie: We are essentially a customer service department, so we are always very patient-driven. Our motto is always that the patient comes first, and sometimes we will identify a procedure that doesn’t feel top beneficial to the patient, so we will shift our perspectives and approach accordingly. As a result, we find ourselves working smarter, not harder. Michelle will always help us in reducing the number of steps that we have to take to get the patient their information in the shortest amount of time while working on a very daunting computer program and simultaneously being on the line with someone who is eager to get their information. If we can get them what they need when they need it, the whole process becomes easier for us too.
Michelle: To be a part of this team is truly exciting. It is exciting to see the rest of the team involved and motivated. It is moving to feel the trust that we have in one another to get things done. As a team, it’s a huge motivator to participate because everyone has been so defeated previously in our attempts to make change. It is inspiring to feel that we all want to get things done and make our department the best that it can be.