Workforce of the Future

Marcella Austin spent her first six years at Kaiser Permanente as a medical assistant. Three years ago, she became a licensed vocational nurse through a partnership between KP, the Ben Hudnall Memorial Trust, Chaffey College and the San Bernardino County Workforce Investment Board that funded a Pathway to LVN project. That gave her the support she needed to advance her career—tuition, books, tutoring and wages. She was one of the first of nearly 50 KP employees to graduate. She was interviewed by LMP Senior Communications Consultant Anjetta McQueen.

Q. What started you on your journey?

A. My father, who is diabetic, had a heart attack when I was in college. My mom and I were the first ones at the ER with him. It was scary, but I remember those nurses and how they took care of him and us. One of the nurses took an orange from her lunch and taught me how to do an insulin injection. I fell in love with nursing. Six months later, I became a medical assistant. I thought that was as close as I would get.

Q. How did you manage school after years of working?

A. I went to school full time and worked in Urgent Care from 5 to 9, getting my 20 hours a week. The Ben Hudnall trust covered the other 20 hours. I never lost a paycheck. It’s not like I could say I didn’t have the funds—the funds were there.

Q. What about the responsibilities at home?

A. I have two kids, a 16-year-old daughter and a son who is 13. I had a husband, mother and mother-in-law all helping me out. I used to be the one who cooked, cleaned and picked up after everyone. All of this helped my kids become more responsible.

Q. College nursing slots are hard to come by. How did Chaffey College help?

A. I have taken one course or another since graduation from high school. I also took time to get married, have children. Chaffey pulled all of my transcripts from everywhere and offered the prerequisite classes I still needed.

Q. Your wages and tuition were covered, but how did you manage all those other costs?

A. We owe a lot of thanks to the county’s Workforce Investment Board. They saw a need for educating people in the community. We didn’t have to worry about transportation, uniforms or supplies during our clinicals. All of that can really add up.

Q. How did the cooperation of your labor management partners help you?

A. Managers and labor leads stayed with us every step of the way. They had meetings with us. They kept asking us how they could help. If there was a barrier, if a schedule needed changing, they would work together to see that it got done. I especially appreciate the help from Susan Rainey, the department administrator for staffing at Ontario; career counselor Michele DeRosa with the Hudnall trust; Margaret Winningham, a senior Human Resources consultant for Fontana/Ontario; and Valerie Robinson, a Local 7600 representative.

Q. What is different about your work now?

A. In the LVN training, you get the basics—biology, anatomy, psychology—but you also learn about nursing care plans, sterile processing, wound care and get hands-on training all while attending school. I can assist RNs in several procedures, do minor surgical assists, order and co-sign documents in KP HealthConnect®.

Q. What is different about you?

A. My confidence has gone through the roof. I was selected to go to the KP Quality Conference, and I was invited to speak in a leadership meeting about my experience. The girls on the unit tease me now, saying they want my autograph.

When Donna Fraser sees something that needs doing, “I like to get it done,” she says. Twenty-one years ago, she joined Kaiser Permanente as a clinical assistant, one of the first in the Mid-Atlantic States region in the urgent care setting. After a few years, Fraser led a couple of her colleagues in approaching their supervisor at the Camp Springs, Md., facility about moving beyond registration and clerical duties to assisting nurses with patients’ health care needs.

“I said, ‘We believe you can utilize us.’ I knew I could do so much more to help out when the nurses were busy.”

She found a training program that ran from 8 a.m. to 2 p.m. five days a week. Meanwhile, she worked 3 p.m. to midnight shifts, mainly on weekends, and completed her courses in about three months. After struggling mostly on her own to pay for certifications in performing EKGs, phlebotomy and other tests and specimen collections, Fraser joined the facility’s fledgling class of urgent care technicians.

Hard work, good support

Today she is the lead RN at the Urgent Care/Clinical Decision units at the Largo Medical Center Hub, one of the newest facilities in the region. Fraser, a member of UFCW Local 400, says she owes much of her success to one of the Labor Management Partnership’s scholarship and wage replacement programs.

“I grew up here,” says Fraser. “It’s a great company if you work hard. You have to show up to win, do the best job.”

Trying to get an education while working full time is not easy, even for someone as motivated as Donna Fraser. That’s why LMP’s Ben Hudnall Memorial Trust was created, to support lifelong learning for union coalition-represented employees.

Wage replacement allowed her to take time off from her regular work schedule to attend classes, continue her employment, and keep up her clinical skills and knowledge. She’s taken advantage of the program twice since her first promotion, becoming an LPN in 2009, an RN in 2011. Fraser became a lead RN in 2013.

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Taking ownership

Jennifer Walker, the Mid-Atlantic States region improvement specialist who works with Fraser’s unit-based team, has seen greater benefit to the training. “Donna has become the person who organizes her group, serves as a support to all and keeps the team motivated,” Walker says. "And she has done this while working a full-time job and raising a family.”

But Fraser credits the Ben Hudnall Memorial Trust program with giving her a sense of ownership and responsibility for her education and her career. “We did the scheduling,” she says. “The big difference was the empowerment our manager gave us. As long as we could find the backfill, we went to our classes.”

The keys, says Fraser, are a supportive supervisor who “believes in the partnership” and a willingness to look to the union as a positive force: “Sometimes when you are an employee, you think you just use unions for when you are in trouble.”

The greatest challenge is helping people see that if they are involved in the process, it will be easier to move up.

“You can always find places within KP that need your expertise,” she says.

With the increasing complexity and pace of change in health care, “soft skills” such as problem solving, collaboration, cultural competence and team leadership are becoming as important as technical skills. That’s why Kaiser Permanente and the unions in the Coalition of Kaiser Permanente Unions, through the Labor Management Partnership and its unit-based teams, engage the workforce in continuous learning, critical thinking and performance improvement.

Recognizing KP’s unique workplace strategy, the Journal of the American Academy of Physician Assistants invited LMP to submit an article for its July 2013 issue, “Building the right skills for the healthcare workforce of the future.” This link will get you to the journal’s website; scroll past the headline to read the full text of the article.

Cutting waste and saving money for Kaiser Permanente members and patients is good. But 350 Environmental Service workers in Southern California are taking that mission a step further by tending to Mother Earth as well.

Kaiser Permanente and two Labor Management Partnership-funded workforce development trusts are among the health care partners nationwide that are training frontline workers and managers in improved recycling, waste disposal, energy conservation and other green practices. The U.S. Department of Labor and the Healthcare Career Advancement Program, a national partnership of unions and hospitals, are leading the effort.

“‘Carbon footprint’ is a phrase that’s thrown around a lot,” says Milford “Leroy” Alaman, EVS operations manager at the Los Angeles Medical Center. “Now our staff is able to understand that when you are talking about conserving energy, water and electricity, you are talking about looking at the resources we have in our facility and holding on to just what we need instead of creating more waste for us and the planet.”

Leading change at work

Along the way, these “green teams” also are reducing operating costs, enhancing employee skills and morale, and improving patient and workplace safety. 

For example, the EVS department is now using environmentally friendly microfiber mops to clean a single patient room. This has the benefit of not spreading infections between rooms and preventing lifting and straining injuries caused by wringing traditional mops and hauling buckets of water.

The department also has started a project that is reducing the cost and trouble of replacing the 500 D-cell batteries used in the hospital restrooms’ automatic towel dispensers. The traditional batteries wore out in a matter of weeks—costing about $3,000 a year to replace and adding some 6,000 batteries a year to local waste or reprocessing streams. Starting in February 2012, workers installed new rechargeable batteries. Overall, EVS' green projects, including the use of rechargeable batteries, are saving an estimated $12,000 a year.

Enhancing skills, raising sights

“I feel better having conversations with anyone…doctors, nurses, I can tell them how to be green,” says EVS attendant Jose Velasco, an SEIU UHW member and a recent graduate of a green certification course offered at West Los Angeles Community College.

The program also was piloted at KP Riverside Medical Center, where the EVS unit-based team is reaching out to others with its newfound expertise. Now an EVS member is embedded with the Operating Room UBT—with others to follow—to help tackle waste and hygiene problems there.

The SEIU UHW-West & Joint Employer Education Fund and the Ben Hudnall Memorial Trust have helped underwrite the cost of the training for Kaiser Permanente’s LMP-represented workers. Eventually, frontline workers may be able to use their certifications for higher pay and promotions as medical center “green leads,” a program that would be negotiated between KP and the unions.

But the training already is making a difference to workers as well as to KP and the community. “They have more tools, more knowledge, so they are able to catch things,” says Angel Pacheco, management co-lead of the EVS UBT at Riverside. “We talked about saving the environment for future generations.”

Three years ago, when Joann Horton learned her job might be eliminated when HealthConnect™ came online, her first response was fear.

A medical clerk at the Hayward Medical Center in Northern California, Horton needed the income, but she also loved her job. “I was terrified,” she says.

Joyce Lee, an imaging transcriptionist at the Fontana Medical Center in Southern California, found herself in the same boat last year. With KP shifting to a new voice-to-text technology for transcribing radiology results, Lee’s skills were becoming obsolete.

“All of us were figuring out how we were going to do the transition,” she says.

Both of these “changing workplace” stories could have ended badly, especially in today’s shaky economy.

But now, Horton and Lee are fans of the job counseling and retraining provided to partnership union employees through the Employment and Income Security Agreement that allowed them to stay with KP.

Successful retraining 

The two women received one-on-one guidance from career counselors who helped them identify and train for in-demand positions.

Horton, who is now the department secretary for Home Health in Hayward, says career counselor Martha Edwards “gave me what I needed to build my skills up, but she also gave me a lot of emotional support.” Edwards works for the Ben Hudnall Memorial Trust, established under the 2005 National Agreement to provide career counseling and job training to members in 12 of the unions that are part of the Labor Management Partnership.

Lee, who now works as a phlebotomist at the Fontana Medical Center in Southern California, also received services through the Ben Hudnall trust. She says counselor Michele DeRosa “has a gift for networking; for figuring out all the pieces of the puzzle, for being the encourager.”

Ongoing outreach

The partnership’s career counseling benefits have benefited thousands of employees in a short amount of time. From its inception in 2007 through March 2011, roughly 10,000 employees had seen career counselors through the Ben Hudnall Trust, with many more attending workshops or promotional events.

The SEIU UHW-West & Joint Employer Education Fund offers similar services to SEIU-represented employees in the Northern California, Southern California, Colorado and Northwest regions. Since 2006, almost 16,000 KP employees have enrolled in training through the program and 6,885 have received counseling and referral services. 

Those who have used the programs’ services are enthusiastic proponents; however, ongoing outreach is required, Edwards says, especially since the concept of career counseling is new to many employees. 

“I think there’s a lot of mystery around the words ‘career counselor,’ ” she says, “and perhaps some intimidation and confusion.”

Obstacles to career counseling include a fear of being seen as vulnerable or needy, difficulty finding the time for training while working and concern that some managers might not appreciate an employee who is seeking to advance from their current position, Edwards says.

It’s an important part of the counselor’s work to help employees get over these hurdles so the program works best for their needs, she says.

Many employees first learn of the services when facing a major challenge, like Horton and Lee.

However, the programs are designed to offer help in many situations, from employees seeking to change careers to those wanting to gain skills in their field; from those struggling with a manger or co-worker to those struggling with work-family balance.

All services are confidential.

“Our goal is to have something for everyone,” says Lucy Runkel, director of the SEIU UHW fund. “We reach many employees, but we always want more.”

Managers are educational partners

Data from the programs show most employees learn of career counseling through word of mouth. Information also is available at events and online.

Both programs have started boosting educational outreach to managers, whom they view as key allies in spreading the word about the services.

“With a manager, we get more bang for our buck, because they can educate all of their staff,” says Runkel. 

Both Kaiser Permanente and its union-represented employees stand to gain, she says. “We think people who are better trained, happier, and have greater longevity on the job are going to provide better care than someone who is new, or unhappy or poorly trained.”

Career counselor Edwards put it this way: “It helps with Kaiser’s ‘best place to work’; seeing employees vital, motivated, moving and growing is a plus for the whole team.”