Kaiser Model Shows the Way to Improving Health Care Delivery

by Mike Hall, Jul 25, 2009

Using a combination of integrated, team-based care and technology, Kaiser Permanente of Southern California developed a Healthy Bones initiative that not only reduced fractures in the most at-risk patients by 37 percent, but lowered the care cost for the same patients by 30 percent.

Similar Kaiser programs have reduced heart disease deaths and treatment costs in Colorado and diabetes complications and costs in Hawaii.

Yesterday, a forum hosted by the National Labor College (NLC) and the Kaiser Permanente Health Care Institute explored how health care delivery and quality can be vastly improved and costs significantly lowered with integrated care and technology and by maximizing the unique labor-management partnership at Kaiser Permanente, where some 96,000 health care workers are unionized.

With the nation in the midst of a debate over how to reform the nation’s broken health care system and how to expand and improve care and reduce costs, the Kaiser model provides a promising blueprint.

One of the cornerstones of Kaiser’s success is the labor-management partnership that allows all caregivers a voice developing and delivering new care initiatives.

In an interview during a break in the presentations, George Halvorson, chairman and CEO of Kaiser Permanente, said:

The labor-management partnership has been very productive. It’s been a huge asset and a lot of this that we are doing with the labor-management partnership would translate to other places.

Halvorson says it would be a mistake to reform health care—whether reform includes expanding coverage, establishing new insurance company rules or financing—without reforming the way health care is delivered

Integrated care ensures that everyone is involved in a patient’s care, from primary physician to specialists, pharmacist, nurse and others, and that new technology allows that information to be shared and analyzed. Speaking at the forum, AFL-CIO President John Sweeney said a health care reform proposal without integrated health care reform “is not optional.” He adds that the team-based care concept is vital.

I think is perhaps our most significant work together-the use of what are called “unit-based” teams to bring doctors, nurses, technicians, pharmacists and other caregivers together on behalf of patients.

The results have included startling improvements in patient outcomes, reductions in medical errors, better preventative care, cost savings and a better, more satisfying work environment for everyone involved.

John August, executive director of the Coalition of Kaiser Permanente Unions, told participants he believes the method by which Kaiser delivers health care can be successful elsewhere, but adds:

You’ve got to have a system where labor and management work together everyday…where workers can feel confident in the team.

He says when changes or new care plans come from a “top-down” management, with a “here’s the plan, implement it” style, it is likely not to have complete worker buy-in and enthusiasm. But with a team-based plan:

It doesn’t take much of a leap of faith to have confidence in it.

Sweeney says the Kaiser Permanente Labor Management Partnership has provided “a framework for what every health care delivery system should do,”

and that’s break down walls and bring caregivers together so they can use new technology and coordinate care 24-hours-a-day.

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