Frontline Workers

In 1997, the Labor Management Partnership turned strife between Kaiser Permanente and its unions into strength.

That strength is coming to the forefront again today. Decades of working in partnership are helping the organization respond to the COVID-19 pandemic, move forward together and provide a model for the health care industry.

With interest-based problem solving, a Free to Speak culture and performance improvement through unit-based teams, the Partnership has built a foundation that’s given leaders, managers and union members tools and relationships to collaboratively address this crisis.

Acting fast

Some of the response took place at the highest levels. Over a weekend, Kaiser Permanente and union leaders reached an agreement to temporarily enhance benefits for physicians and frontline employees.

“I’ve never negotiated anything as fast,” says Dennis Dabney, senior vice president of National Labor Relations and the Office of Labor Management Partnership.

Throughout the crisis, union leaders joined twice-weekly calls with top Kaiser Permanente leaders and played a central role with command centers and surge planning.

The key to making faster decisions was directly involving labor in operations meetings, says Hal Ruddick, executive director for the Alliance of Health Care Unions.

Having a voice

Partnership laid the groundwork for a nimble response in other ways, too. When COVID-19 hit, most vision appointments were canceled.

In Northern California, IFPTE/ESC Local 20 negotiated with management to have optometrists work in different roles. More than 120 optometrists volunteered to staff the COVID-19 test results call-in line.

“We showed our willingness to do alternative work — work that would be meaningful and keep our union members safe,” says optometrist John Corpus, a member of the local union’s optometry unit board.

Having a voice on the job equipped members to negotiate that deal, which included training, laptops and greater flexibility to work remotely.

“If our teams remain safe, are listened to and feel respected in the changes, they can live with the changes during this time,” Corpus says.

Improving workflows

At Beaverton Medical Office in Oregon, after COVID-19 testing began, managers saw that patients often needed multiple services. A new workflow was required — and the Nurse Treatment Room team’s registered nurses and medical assistants rose to the challenge.

“Everyone began sharing ideas and brainstorming possible solutions,” says nurse manager Cyndy Gillis. “The team formulated a plan that respected scope of practice, safety for the staff and patients, and a streamlined workflow that continues to adjust to new challenges.”

“It was the epitome of collaboration,” says team member Kellie Butchino, a certified medical assistant and SEIU Local 49 member.

Fighting together

One of the most vexing problems during the pandemic has been getting caregivers the personal protective equipment they need to safely care for patients. Working in partnership has helped.

“It’s not perfect,” says UNAC/UHCP member Andrew Calderon, a physician assistant at South Bay Medical Center in Southern California.

“But labor and management were there updating staff regularly and fighting to get us the materials we needed.

“We are able to provide the best care for our members because of partnership.”

Looking forward

Such collaboration across the enterprise will help Kaiser Permanente navigate the future — and inspire others, too.

In May, LMP leaders shared their pandemic experiences during a Labor and Employment Relations Association webinar, drawing praise from members of a 4-year-old labor- management partnership in Massachusetts.

“We are trying to proceed on the premise that there is no business case for adversarial labor relations,” says Bart Metzger, chief human resources officer for UMass Memorial Health Care. Partnership is “the only way we can push organizations such as ours forward.”

Partnership is an effective strategy for labor and management, Ruddick says.

“It’s harder, but it’s worth it because the results that you get are better.”

After government stay-at-home orders derailed their plans for a patient support group, members of Kaiser Permanente’s Marlow Heights Behavioral Health team in Maryland set up a video chat for vulnerable individuals sheltering in place.

“With the COVID-19 pandemic, we had to be open and receptive to connecting with our members in a different way,” says Dawn Anderson, a psychotherapist with UFCW Local 400 and union co-lead for the Level 4 unit-based team. “This way we’re still supporting patients with serious health issues.”

Propelled by the global pandemic, Behavioral Health teams across the Mid-Atlantic States are using partnership principles and tools to transform how and where patients seek care — resulting in changes likely to outlast the crisis.

Connecting with patients

Therapists are working from home and counseling patients via telephone and video. Unit-based team members are meeting virtually, too, using collaborative digital tools to identify challenges and solutions.

They’re also using such tried-and-true performance improvement tools as the Rapid Improvement Model to reveal the best ways to connect with patients by telephone and video.

“Sometimes I will connect with patients on video, then after 5 minutes something will cause a disruption and I’ll have to ask if we can connect via telephone,” says Anderson. “We are still adapting to telehealth technology.”

Adapting quickly

The rapid-fire changes haven’t been easy for team members, who are conducting assessments with patients by phone instead of in person because of social distancing requirements.

“We’ve done things in this pandemic season that we normally would not have done,” says Reuben Steele, Behavioral Health operations manager and management co-lead. “That has caused some initial anxiety but, ultimately, the team has been able to adapt and adjust quickly.”

Being heard

Team members agree having a voice in decisions about ways to deliver care is helping them cope with change. A key feature of the Labor Management Partnership is involving frontline workers and union leaders in decision making.

“The LMP is a great way to think outside of the box and figure out what we can do to meet people’s needs,” says Lindsey McDaniel, a psychotherapist, UFCW Local 400 member and labor co-lead for the Silver Spring Behavioral Health team, a Level 4 UBT in Maryland.

Anderson agrees.

“We’re able to ‘check egos at the door’ and come forth with ideas and suggestions. That’s what I love about the UBT setting,” she says. “Our UBT consultant and manager support us and are open to feedback on team projects and goals. This is the forum where I feel my colleagues and I are being heard.”

Even during a pandemic, it’s important to keep learning.

When Kaiser Permanente storekeeper Vincent Woodard heard about skills days in May at Oakland Medical Center, he signed up.

“You’ve got to keep up with the times,” says Woodard, an SEIU-UHW member who orders and delivers supplies for doctors and nurses. “I’m always wanting to learn more. The more I know, the more I can teach and share.”

Kaiser Permanente encourages lifelong learning. With COVID-19 reshaping health care from the emergence of new roles to increased virtual care, the 2 Labor Management Partnership-supported education trusts are tailoring trainings to help employees adapt by building career resilience and digital skills.

Partnership Supports Upskilling

Northern California’s Workforce Planning and Development Committee was planning skills days when COVID-19 hit. The committee wanted to proceed. The administration agreed. In 2 weeks, labor and management organized skills days with the SEIU UHW-West & Joint Employer Education Fund.

“It’s a trying time with workflows changing to adapt to COVID-19,” says committee labor co-chair Sonya Allen-Smith, an SEIU-UHW contract specialist. “You have to stay skilled up because the work world is constantly changing.”

More than 80 employees participated in 2 Oakland sessions. Housekeepers, medical assistants and radiology techs met in a large conference room, wearing masks and keeping social distance, learning in person and virtually about communication, leadership and emotional intelligence.

Woodard, a 7-year Kaiser Permanente employee and longtime youth basketball coach, related to lessons about teamwork, bringing positive energy and managing frustrations.

“I’m definitely going to use this,” Woodard says. “You’re not always going to get your way. You’ve got to know when to walk away. Hold yourself accountable.”

Northern California is looking to expand skills days. Other regions also are exploring virtual skills days.

“This training is good for labor and management,” says Janis Cruz, support services administrator for the East Bay. “It helps develop soft skills to navigate uncertainty and ignite interest in continued learning.”

Building career resilience

To help adjust to changes, Kaiser Permanente and the education trusts offer online critical skills courses in collaboration, consumer focus, digital fluency and performance improvement.

In May, the Ben Hudnall Memorial Trust launched the Career Resilience Quest, an online course that explores the characteristics of resilience — the ability to adjust to workplace change as it happens.

“We’re experiencing drastic change,” says Ben Hudnall career counseling project manager David Rosenberg. “Developing resilience in general, and career resilience specifically, really helps to respond constructively.

“Career resilience characteristics are like muscles. We need to exercise those muscles, so they’re strong.”

Pharmacy assistant Sergio Romero, a UFCW Local 324 member in Southern California, knows the power of resilience. A few years ago, his mother and roommate died months apart.

He reflected on his career, worked with Ben Hudnall career counselor Jan Cummings, completed a certification program and then began the resilience course.

“With this pandemic, there’s a lot of hopelessness,” Romero says. “The resilience quest boosted me back up. It kept me going.”