UNAC/UHCP

The training and education resources negotiated by Kaiser Permanente and the Partnership unions are helping employees advance their careers. These opportunities are making KP’s promise of a diverse and inclusive workplace come to life. Learn more from employees, managers and leaders who shared their stories during the first virtual Workforce Development Week.

Addie Darby, UFCW Local 1996, quality control, Health Information Management, Georgia

With the help of the Ben Hudnall Memorial Trust and encouragement of manager Sophia Wilson, Darby has earned an associate degree in business management, a bachelor's in health administration, and a master's in health technology and education. She’s not stopping there. Darby is enrolled in a doctorate program and plans to graduate this year (2021).

Sadao Nakachi, UNAC/UHCP, emergency room nurse, Southern California

After leveraging workforce development opportunities to become an RN and earn a bachelor’s degree in nursing, Nakachi went on to get a master’s in business for veterans. He holds numerous professional certifications and connects fellow nurses to educational opportunities. “I always try to find courses that’ll overall maximize my potential at KP,” he says. Follow him on Instagram @NurseScholar.

Crystal Muir, OPEIU Local 2, clinical assistant, Mid-Atlantic States

Muir is using tuition reimbursement to pursue her bachelor’s degree in nursing. She’s also used the Ben Hudnall Memorial Trust’s Individual Stipend Program to attend school once a week, which she says, “I've been fortunate to do with trying to balance school, work and life being a mom.” She aims to graduate in 2022.

Sophia Wilson, supervisor, Health Information Management, Georgia

“I encourage all my staff to pursue education to stay marketable and relevant,” Wilson says. “I tell managers, ‘Please do not be so rigid as to make it harder for your employees to soar.’ If you put the resources into your staff, it can be nothing but a win-win.”

Philidah Seda, director, Specialty Care, Georgia

Not only does Seda encourage her staff to use workforce development resources, but she herself is studying for her doctoral degree. “The health care environment is getting more and more complex,” she says. “For us to prepare the workforce of the future, we have to invest in their learning.”

Eula Smith, SEIU-UHW, medical assistant, Northern California

Ask Smith why she wanted to work in health care, and she will bluntly tell you she didn’t. She started at KP as a shuttle bus driver. When that department was outsourced, Smith was offered the opportunity to train as a medical assistant with the help of the SEIU UHW-West & Joint Employer Education Fund. She has overcome her initial reluctance to deal with patients, saying “I love it now.”

Ingris Solares, SEIU Local 105, medical lab technician, Colorado

Solares began her career at KP as a phlebotomist before getting trained in her current field in an apprenticeship program with the help of SEIU Local 105 and the SEIU UHW-West & Joint Employer Education Fund. She intends to get more education to become a clinical lab scientist. “I knew I wanted more because I'm the first generation here in the United States,” she says. “My parents came from Guatemala, so I always felt like I needed to make the trip here worth it.”

Michael Brown, senior vice president, HR Consulting, National Functions

Before embarking on a career path that would bring him to KP as an HR leader, Brown went to law school. His father was frank with him: As a Black man, he needed an advanced degree to position himself for the same opportunities that others had.

“Before I even started working, I knew that education was going to be the equalizer.” That’s why he encourages KP employees to use workforce development programs and cultivate learning agility by trying different shifts, joining different departments and seeking informal leadership roles.

Kerrin Watkins, manager, Dental Office, Northwest

It's hard to lose top performers, but amazing to see them grow. “Invest in your employees and let them know you want to see them succeed,” Watkins says. “This will benefit you in the long run, because you will have employees that will feel more valued. If you take care of your employees, your employees will take care of your business.”

As physician assistant Larry Rick, PA-C, made his rounds of the South Bay Medical Center one recent morning, staff stood at the hospital’s main entrance and screened members, patients, and employees for signs of cold- and flu-like symptoms. Like Kaiser Permanente facilities enterprise-wide, the Southern California hospital adopted the new procedure to protect patients and staff from COVID-19, the respiratory illness caused by the novel coronavirus.

A well-established approach is also helping: Frontline workers here say years of working collaboratively with managers as part of the Labor Management Partnership has better prepared them to fight the pandemic. The Partnership has saved money, improved care, and led to better service – and now will literally be saving more lives because frontline workers, managers, and physicians are working together.

An opportunity to speak up

“Partnership is a fantastic tool,” says Rick, a member of UNAC/UHCP, who has 34 years of experience fighting infectious diseases including H1N1, HIV, and sexually transmitted diseases to prevent the spread of HIV. “Every Kaiser Permanente senior leader has been responsive to our requests and has heard us. We’re working together and everybody is leaning in” to treat more patients now, while preparing for an expected surge. In response to unit-based team members’ concerns, for example, tape was placed in 6-foot intervals on pharmacy floors to help members and patients maintain social distancing while standing in line.

“We’re able to speak up as labor and help figure out the solution,” says Alejandra Navarro, a registered nurse in Maternal Child Health and a member of UNAC/UHCP.

Working in partnership together has also built trust between management and labor. That’s been key to maintaining open lines of communication now and helping counter misconceptions spread by social media, say frontline workers.

Education and support

“They’re educating us and giving us a lot of support,” said Lizz Burnett, a licensed vocational nurse in Geriatrics and a member of SEIU-UHW. “If I can help educate someone and they can tell their family, then maybe we can stop this.”

Tynikko Snyder, a registered nurse in Family Medicine at the Gardena Medical Offices, has 2 children with asthma and her mother suffers from chronic obstructive pulmonary disease. She is worried about the impact of her work on her family. “I am afraid, but I know that I need to step up to the plate and do what needs to be done,” says Snyder, who is a member of UNAC/UHCP. Rick says that can-do spirit is needed to combat the spread of the disease: “If we all do our jobs, we will save lives.”

Beep! Beep! Beep! The electronic sound of Cary Brown’s alarm clock wakes him at 5 a.m.

The Kaiser Permanente member rises to shower and make breakfast, careful not to disturb his sleeping wife, Elissa, who is recovering at home after surgery on a broken leg at the Woodland Hills Medical Center in Southern California.

On top of completing household chores, the retired Hollywood TV director spends his day making sure Elissa is comfortable and pain-free.

The experience has taken a toll on him.

“The hours of staying awake and the repetitive nature of it—and not having any life at all outside of home—is very difficult,” says Brown, who worked on the hit TV series Doogie Howser, M.D.

Now he’s part of an ambitious effort by the Southern California region to enhance support for caregivers, who play a vital role helping to heal and comfort patients outside the hospital. By reducing caregivers’ social isolation, integrating them into the hospital care team and addressing their health needs, regional leaders hope to improve patient safety and quality in the home.

‘Human-centered design’

Under the initiative, frontline workers, physicians and managers are partnering with KP members and their families to design the ideal in-home care experience for patients and caregivers. Participants are using a creative approach to problem solving known as human-centered design, which starts with the people you’re designing for and ends with solutions that are customized to their needs.

“It’s a way to engage the folks who are most affected from day one,” said Dr. Nirav Shah, senior vice president and chief operating officer for Clinical Operations in Southern California. “No program that I could ever design will be as good as one that had the people who are most affected design it with us. It’s about empathy and understanding.”

Human-centered design is also an ideal tool for unit-based teams to use on performance improvement projects. It delivers on the fundamental concept of the Value Compass—to put the member and patient at the center of decision making—and both frontline workers and Labor Management Partnership leaders, from management and the Coalition of Kaiser Permanente Unions, have been supporting the caregiver project.

Reducing the overwhelm factor

At a meeting in Pasadena, the participants—patients and caregivers, KP employees and physicians—gathered in small groups to share personal tales and draw storyboards to help identify barriers, come up with potential solutions and provide insights to regional Home Health leaders.

Shawna Wallace, a senior physical therapist for Home Health and member of UNAC/UHCP, said the experience was eye-opening.

“I’ve gone into homes where caregivers really care about their loved ones, and they are extremely overwhelmed,” she said. “This is a great opportunity for us to see where we can make better programs for our caregivers and members in these scenarios.”

Brown is hopeful that the approach will give caregivers—and their loved ones—the emotional and physical support they need to thrive.

“If you take care of the family as a unit,” Brown says, “you make it possible for each individual in the family to be better.”

Su-Xian Hu and Runeet Bhasin make partnership look easy. The telemetry team co-leads at Downey Medical Center in Southern California share a relaxed rapport that belies the time, planning and occasional friction that are part of running a busy inpatient unit. 

Together for more than a year, the pair attribute the success of their budding relationship to communication and a commitment to partnership principles—especially consensus decision making. Those core values came in handy recently when a disagreement arose about the best way to educate patients about medications. 

Nurses preferred a less overwhelming one-page sheet, but managers wanted to switch to a detailed three-page form that had been adopted by other units in the hospital. 

“It was a major issue,” says Bhasin, RN, a staff nurse and member of UNAC/UHCP who is the team’s labor co-lead. “We had to come up with a solution to fulfill management’s needs and labor’s needs.”

At the time of the disagreement, UBT members turned to consensus decision making to determine next steps they all could support. A subsequent test of change resulted in a short-term fix: Nurses used the short form with patients, while the longer handout was provided as a resource guide in patient rooms.

New to partnership

Managing in partnership was a new experience for Hu when she joined the team in April 2016 as assistant clinical director and became a co-lead. She previously had overseen a Kaiser Permanente inpatient nursing unit that was not part of the Labor Management Partnership. Bhasin, a co-lead with two years of experience, served as mentor and coach.

“Runeet was wonderful with helping to bring me onboard,” says Hu, who is also an RN. 

Both say LMP training has given them a shared understanding of their roles as co-leads, the purpose of UBTs and how to use consensus decision making. A business literacy class both took proved especially fruitful: With the information they brought back, the team tackled an affordability project that reduced overtime costs by more than $95,000 last year. 

“The UBT classes,” says Bhasin, “made me realize the real meaning of partnership, the collaboration of labor and management to work toward the same goal to provide high-quality care and to have a great work environment.”

The pair’s approach seems to be working. Their 75-member UBT is at Level 4 on the five-part Path to Performance, and it has earned accolades for outstanding patient care and gains in workplace safety and affordability. 

“We want what is best for patients and for staff,” says Hu. “We might have differences, but we always come together with open and professional communication, sitting down together to solve those issues.”

Management and union representatives in Southern California were at odds when they gathered in March 2015 to settle a UNAC/UHCP grievance over the working conditions of registered nurses in Home Health, Hospice and Palliative Care. 

Because of the dispute’s complexity and scope, involving nurses regionwide, it was moved from the grievance process into issue resolution.

“When they started, it was the Mason-Dixon Line. It was management on one side and labor on the other side,” recalls Marcia Meredith, who works as a neutral facilitator in Southern California. She gets called on when “sticky and contentious” issues come up involving the Labor Management Partnership, which is celebrating its 20th anniversary this year. “It was pretty tense.”

Months later, managers and union representatives were working side by side, forging consensus on key issues. 

Key to their success was the issue resolution (IR) process spelled out as part of the partnership between the Coalition of Kaiser Permanente Unions and Kaiser Permanente. It incorporates interest-based problem solving (IBPS) and consensus decision making (CDM) to provide a framework for settling disagreements collaboratively—providing a modern-day take on Henry J. Kaiser's line, “Problems are only opportunities in work clothes.” 

Bringing order to chaos

They also benefited from the fact that Southern California—after watching people struggle for months and sometimes years without resolving their problems—recently had clarified how the process was to be used and had added a clear path for escalating issues.  

“Issue resolution helps you focus on what the problem is and the possible solutions,” says Meredith.

The nurses and managers eventually agreed to make changes to assignment workflows, improve communication and enhance training opportunities for frontline workers. “They came up with good things that they’re still using,” says Meredith. 

Crafting Southern California's appeals process took months of hard work. Key stakeholders included regional LMP Council members, coalition union leaders and Human Resources administrators.

Before escalation changes took effect on Jan. 1, 2015, the issue resolution process had tended to spin out of control. 

‘It was like the Wild West’

“It was like the Wild West. Everybody did their own thing,” recalls Ilda Luna, an SEIU-UHW service representative for Glendale Medical Offices in Southern California. 

Alex Espinoza, the Coalition of Kaiser Permanente Union’s national coordinator for Southern California, agrees.

“People would email whomever they thought would resolve the issue,” he says, citing examples of individuals who leapfrogged layers of union and management intervention to appeal directly to leaders at the national level.

During national bargaining in 2015, Southern California representatives shared the region’s appeals process, and the subgroup working on the issue recommended a similar process be created in every region.

The approach calls for resolving issues at the lowest possible level. For stubborn disagreements, there is now a standardized process for escalation the aggrieved parties can turn to, with 30-day deadlines for resolution at every step of the way.

In Southern California, for issues that can’t be resolved at the facility level, a nine-member regional SWAT team made up of management and union representatives serves as a court of last resort before the matter heads to national leaders. 

But since the process was adopted two years ago and local LMP Councils and union leaders were educated about how to use it, no issue has been referred to the regional team. 

That’s good news, says Maryanne Malzone Miller, senior director of Human Resources in Southern California and a SWAT team member. 

“I like to believe we’re pushing it to the level where it should be resolved,” Miller says. 

“It’s a success,” agrees Espinoza, also a SWAT team member. “Folks are engaged and are talking to each other.”