20th anniversary

Twenty years ago this fall, Kaiser Permanente and the Coalition of Kaiser Permanente Unions formed the innovative Labor Management Partnership—a new way of working that now includes more than 150,000 managers, physicians and union-represented workers across Kaiser Permanente.

To commemorate this event, California Governor Jerry Brown has issued a proclamation congratulating Kaiser Permanente and the Coalition of Kaiser Permanente Unions for 20 years of successful partnership and collaboration.

“This model has resulted in improved patient outcomes, workplace innovations, process efficiencies, and measurable service and quality enhancements while creating a safer, healthier work environment with opportunities for health care workers to improve their skills and advance their careers,” said Governor Brown, “I commend all of the organizers and participants in this process for making the Golden State a better place to live and raise our families.”

The Labor Management Partnership is proof that labor unions aren’t just about making things better for workers, but improving outcomes for everyone. In just the first six months of 2017, partnership teams launched nearly 10,000 self-directed projects to improve Kaiser Permanente’s quality, service, and affordability. Departments with strong employee engagement report:

• 60 percent fewer patient falls with injuries
• 38 percent fewer workplace injuries
• 21 percent fewer lost work days
• 13 percent improvement in patients’ overall hospital satisfaction

In 2016, the partnership also helped Kaiser Permanente to keep costs down, with teams working together to save more than $48 million, on top of $35 million saved in 2015. 

More than 74 percent of Kaiser Permanente’s workforce is unionized. By contrast, 6.4 percent of private-sector workers nationwide belong to a union, according to the Bureau of Labor Statistics. Union representation is supported by a growing number of Americans, an August 2017 Gallup poll suggests. Sixty-one percent of adults surveyed say they approve of labor unions, the highest percentage since the 65 percent approval recorded in 2003.

Working together, Kaiser Permanente and the Coalition of Kaiser Permanente Unions will continue to improve health care for members and the community overall. Together we thank our workers, managers and physicians for their dedication, and appreciate Governor Brown’s recognition of their accomplishments.

“You have two ears and one mouth for a reason,” television’s Judge Judy frequently says, quoting an ancient Greek philosopher. “You should listen twice as much as you talk.” Successful co-leads realize that making a partnership work requires listening and learning from one another. 

Caroline Masikonde, RN, had been a management co-lead with the urgent care team at Largo Medical Center in the Mid-Atlantic States, an experience that helped her understand the importance of valuing her partner’s input. But when she accepted a new role as clinical operations manager in Northern Virginia Audiology in January 2016, she didn’t have any experience in audiology. So she’s relied heavily on her new labor co-lead, Lynn M. Reese, Au.D., a UFCW Local 400 member. Masikonde has learned why audiology UBT members escort patients outside (so they can try out new hearing aids in different conditions)—and her willingness to listen helped the co-leads bond quickly. 

“Lynn is very experienced,” says Masikonde. “I lean on her even now.” 

Reese, on the other hand, was new to the unit-based team structure, since the audiology UBT had just formed. That’s where Masikonde’s expertise came in. “We fit together pretty well,” says Reese. “Caroline is very open to listening and learning new things.”

Reese, too, expanded her knowledge, growing into an appreciation that she and Masikonde have equal say on what’s now a Level 4 UBT. “Everyone contributes,” says Reese. The ability to speak up led to Reese and the rest of the team requesting and receiving approval for an additional booth to test patients’ hearing. 

Relationship tested

Their new relationship was tested when a member—after waiting more than 12 weeks for a refund on a hearing aid that had cost more than $1,000—alerted them, loudly and angrily, to the problem. 

Instead of pointing fingers, UBT members figured out the issue: The refund request had to be processed through a department in Southern California, but the team had no way to follow up once the request was submitted. 

“This lady forced us to look at this and do better for our members,” Masikonde says. “It prompted us to come up with a better workflow,” and now the team has names and contact information for the people who work on the refunds.

“Even though it was a bad situation, she made us want to improve,” Reese says. 

Because the co-leads already were accustomed to relying on and listening to each other, they were able to quickly and calmly handle this tense situation with the unhappy member.

“We really learned our lesson,” Masikonde says. “Recently, we did a refund on a Monday—and by Friday, the member had the check. Lynn and I know our parts and do our dance.”

They finish each other’s sentences; they call each other “Mrs.”; they praise in public and correct in private.

Antronette Moore-Mohead and Joanna Harris are a model couple. They’d make a marriage counselor proud. 

They’ve been together for three years, but they’re not married (to each other, that is)—they’re the unit-based team co-leads in the National Claims department, based in Oakland. Since co-leads frequently move on to new positions, Moore-Mohead and Harris are a long-term couple in the world of UBTs. 

“We are all for the team,” says Harris, a national claims processor and OPEIU Local 29 steward, the UBT’s labor co-lead. “Praising workers’ effort or accomplishments helps keep morale up and folks engaged in their work.” 

“Being transparent is key to succeeding as a team,” adds Moore-Mohead, the department’s processing supervisor and the management co-lead. “Also, honest, clear, concise communication is a must. So is having fun.”

'Let's talk it out'

They share stories and photos of their families, they tease each other about maybe not needing that sugary snack, and they can tell when the other is “in rare form.” Even on days when stress is high, the two know when to give each other space or when to say, “Let’s talk it out.”

“We are free to bounce ideas off of each other, without fear of being shot down,” Harris says.

The positive vibe and mutual respect between the co-leads is apparent, but they are clear that they don’t mix outside of work time to alleviate any appearance of favoritism. 

“I love that Antronette is passionate about her work. She operates from the perspective of ‘there is no Big Me, little you,’” explains Harris. 

The department they lead is responsible for collecting fees and processing claims from services performed outside of Kaiser Permanente facilities. Last year, the high-functioning Level 4 team of 39 claims processors and examiners, who are represented by OPEIU Local 29, saved more than $6 million by negotiating better rates for services rendered outside of the network. 

“It’s important to pay it forward,” says Moore-Mohead. “We want to make sure we are growing our team and others have opportunities to learn.”

Forty percent of U.S. marriages end in divorce after an average of eight years. Most business partnerships fail to meet expectations. And most campaigns end when they achieve their goals or the world moves on.

But the Labor Management Partnership between Kaiser Permanente and the Coalition of Kaiser Permanente Unions has beaten the odds: October 2017 marks the 20th anniversary of the partnership’s founding, making it by far the largest, longest-running and most sweeping such partnership in the country.

We’ve accomplished a lot together. And in a world of change, sustaining a healthy long-term relationship is an achievement in itself. A key to our success has been the willingess to honestly reflect on our successes, failures, and opportunities to improve. 

By working in partnership, says Kaiser Permanente Chairman and CEO Bernard Tyson, “We have tapped into the potential of smart people all over the organization coming here every single day trying to figure out, ‘How do I improve quality, how do I improve service, how do I improve affordability?’ That’s an incredible competitive advantage for the organization.”

Marking a milestone

This fall Kaiser Permanente and the union coalition will be celebrating those achievements with special events and employee outreach. It won’t be all cake and balloons, however. LMP regional councils, unit-based team sponsors and co-leads, and others will host reflection sessions where workers, managers and physicians can share their experiences, pain points and suggestions for the future of partnership. Participants will consider three questions:

• What is different since we created partnership? (Or, what do you see as the top accomplishments of partnership?)
• What are the greatest challenges it faces today?
• How might we address those challenges, to strengthen partnership now and in the future?

Getting results

Partnership is not easy, and the parties don’t always agree on things. So what’s kept it going?

“It’s nice if we can all get along,” says Tyson. “But most important, we’re here to get results.” Here are some of the results achieved in partnership:

• Performance improvement: More than 50,000 team-led improvement projects since 2007, with measurable gains in quality, service, the work environment—and cost savings exceeding $48 million in 2016.
• Best place to work: Industry-leading wages and benefits, a voice in decision making, and an Employment and Income Security Agreement providing retraining and redeployment for displaced workers.
• Joint marketing: Strategic engagement brought strong gains in KP membership, union coalition membership, and more than $108 million in revenue for Kaiser Permanente in 2016.
• Job training and career advancement: More than 300,000 professional, academic and skill-enhancement courses taken by 104,000 coalition-represented employees since 2007.
• Systems collaboration: Joint implemention of multiple complex programs and systems, including KP HealthConnect, Claims Connect, ICD-10 and call center reorganization.

Lessons for success

All of the above have garnered attention from business, union and academic leaders over the years.

“The Labor Management Partnership is a shining example of how you bring labor and management together to produce results,” said Liz Shuler, secretary-treasurer of the AFL-CIO. “What I love about this model is the notion that, no matter where you work in the system, you have a place at the table and your voice is heard.”

Working in partnership also holds lessons that apply outside of work—including lessons that might have saved some of those failed marriages.

“If you are going to be a good partner and have a successful relationship, with a partner, kids, friends,” says a facilitator from 2015 national bargaining, “you have to have your partner’s needs in mind as well as your own.”

To learn more about LMP anniversary activities, visit the 20th Anniversary How-to Guide.