Social Innovator: Louise “Lu” Casa, MSN, CRNP, CTTS on identity, partnership, teamwork

Louse Casa RN 49761
Louise “Lu” Casa, MSN, CRNP, CTTS – 2014

“Wanna see something funny?” That’s what Louise “Lu” Casa said to me when she was teaching a class at the Center for Total Health (@KPTotalHealth). It was the photo below, of Lu in training in 1983.

I interviewed Lu for a bunch of reasons:

  • As part of preparation I was doing to speak with the Kaiser Permanente Labor Management Partnership (@LMPTalk) all hands meeting in December. That presentation was made, and made much better with Lu’s help.
  • To assist my #HHSIgnite team, “HRSA Huddles,” a project of the HHS Idea Lab (@HHSIdeaLab) seeking to improve communication and teamwork in our U.S. Department of Health and Human Services (@HHSGov)
  • To learn about leadership and trailblazing in a profession and environment that sometimes doesn’t know that the world is changing around it – She told me she was an out lesbian throughout her clinical training, which is pretty impressive for its time, so I asked to learn more.

Here’s what I learned:

Lu is currently a Chronic Conditions Nurse Practitioner, for Kaiser Permanente Mid-Atlantic States (@KPMidAtlantic). She’s been with Kaiser Permanente (@KPShare) for 18 years, and is also the shop steward, UFCW Local 400. She supports 18 providers, managing hypertension telephonically and in clinic, directing staff in chronic condition management for 30,000 patients.

On team engagement and communication

It’s important she says, from clinic assistants to the rest of the team, participating in the care and the quality of the care. “Their opinions as member facing staff will help enhance the approach we have with our members.”

How the team lead communicates with the team

There are daily huddles, with Lu as the labor co-lead with her manager who is the other co-lead, for the clinic assistants and nurses. The huddle lasts 10 minutes. People gather outside of the office in the back hall at a set time. They bring up topics, bring up concerns about operations. There is a monthly module meeting with physicians for an hour, where Lu will present Unit Based Team data.

The huddles didn’t exist before 2011. The result with them is that more people are informed regarding operations. The huddles came from the Labor Management Partnership, and they help locally to spread information. Physicians may do individual huddles with their clinical assistants.

What works well? What doesn’t work as well, regarding communication?

What works well, Lu said, is regular recognition of staff. Also, email summaries of each daily huddle (you can see a template of what that summary looks like here). What doesn’t work well are times when information is delayed.

The Labor Management Partnership has created this Huddle Power Users Guide.

Being out in clinical medicine

Lu came out (as a lesbian) in high school, and was out on day 1 in college. When I asked her what it was like to be out in a profession that regularly denied access to people who were LGBTQ, she said,”it wasn’t tough at all, half of my instructors were (LGBTQ). I was lucky that I was strong enough to be able to do that.”

I think this is pretty impressive, considering the data that I have for a time 11 years after this photo was taken, in 1994, of the environment in clinical medicine, where a survey of Directors of FP Residency Programs showed 25 % would rank an applicant lower if they were openly gay or bisexual, and the survey results reported pencilled in comments including “genetic defect,” “aberration,” “psychiatric diagnosis.” This was the profession I entered.

I think I was more successful because of it (being out)

On being in a union

Lu told me prior to being in a union she was a manager – the assistant nurse coordinator at George Washington. When she came to Kaiser Permanente, she says, she was asked to be a shop steward within a year, with the belief that people should perform at their highest ability – “people should know how to perform well, and people also have life situations. Just as I care for my members (patients) I like to care for my (labor) union members.”

I asked what she thought the most important thing for physicians to know about unions. She said they should know that unions are there to help peoples lives be better – to be a voice for people, to support better living better health, just as a person goes into medicine.

What would you tell someone going into nursing today?

Don’t be afraid, be who you are. In order to be fulfilled you have to be yourself.

What would you tell someone going into medical school today?

Lu stresses the need to be good partners – to bring in the voice of everyone on the team, in everything you are working toward. The team has a big hand in making you (a person) successful, she says, and a lot of the parts of the work the team is doing affects physicians and the physician group.

The reason I am more satisfied with my work is because I am part of a union. Doesn’t mean if I make a mistake nothing will happen to me. It means I am part of a successful workforce, offering growth.

Being a clinician, a partner to patients

When going for a masters degree, she said, Lu decided to go the route of Nurse Practitioner. She said she has always wanted to help people.

I love being able to touch my patient and help them make a difference in their life. I used to think I made a difference for them, but they have to make it for themselves.

Nurse Lu 1983 Louise Casa RN
Nurse Lu 1983 Louise Casa RN

Lu and her clinical team have been featured here before, in this video, showing dramatic improvement in blood pressure control in her patient population: Equal Voices = Better care + a commitment to workforce total health | Labor Management Partnership.

I am a member of the Kaiser Permanente Labor Management Partnership, and I agree that everything is better with partnership. Thanks for being ours, Lu 🙂 .

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