COVID-19

Union leaders crunched the numbers, and they didn’t like what they saw.

At the beginning of February, less than 50% of SEIU-UHW members at Kaiser Permanente were vaccinated against COVID-19. It was even worse for employees in the Emergency Department at Downey Medical Center in Southern California, where Gabriel Montoya works as an emergency medical technician. There, only 40% of his fellow union members got the shot.

Montoya and his fellow union members — working with physicians and managers — wanted to raise those rates, so they pulled together labor-doctor huddles. And by mid-April, 64% were vaccinated. 

“We did it in partnership,” says Montoya. “The labor partners led the huddles and introduced the doctors. I can’t imagine that happening in a nonunion hospital or even a non-Partnership hospital.”

Going live

SEIU-UHW members set up a phone bank to call — in Spanish and English — members who worked in housekeeping, food service and central supply departments, where vaccination rates were lowest. The union also hosted a Facebook live event where Black and Latino KP doctors answered questions.

Those proved so popular that they wondered, why not do this live at the facilities?

Angela Glasper loved the idea. The chief shop steward at Antioch Medical Center in Northern California got frustrated when she talked to fellow union members who were conflicted about getting vaccinated.

“I listened, but I couldn’t address their concerns,” says Glasper, who works in optical sales and needed someone with the clinical expertise to answer their questions. “Wouldn’t you rather hear it from a doctor than me?” she asks, with a hearty guffaw. “People would say to the doctors, ‘Labor has been telling us about it, but you answered our questions.’”

One of the most popular doctors at the huddles in Antioch was Jeffrey Ghassemi, MD, an anesthesiologist. He shared his harrowing stories about working on the COVID units and was, in Glasper’s words, “patient and gentle.” With a newfound confidence, employees signed up for vaccine appointments during huddles.

Building trust

Pediatrician Carol Ishimatsu, MD, who volunteered to talk at a huddle in Downey, has given children shots to prevent measles, mumps and chickenpox for more than 2 decades.

“Vaccines are our most important intervention,” says Dr. Ishimatsu.

To build trust, Dr. Ishimatsu emphasized her shared experience with SEIU-UHW members as warriors on the front line.

“I told the employees: I do the same thing you do after work,” she says, describing her ritual of removing her clothes in the garage and putting them directly in the washing machine before entering the house. “We are in different professions, doing the same thing.”

Joel Valenciano, an Environmental Services manager at Downey, helped organize huddles at outlying clinics.

“I encouraged the staff to be honest, relate their fears and doubts, anything holding them back,” he says. “And they really opened up.”

The trust and open communication cultivated by working in partnership were key to building vaccine confidence.

“Working in partnership has intensified during the pandemic,” says Valenciano, “because people realize we need to work together.”

Dr. Ishimatsu agrees. She was involved with the Labor Management Partnership when it started more than 20 years ago. “At the time, I wasn’t sure it would evolve,” she recalls. “It treats us like one big family, instead of segments. The thing that keeps one person safe, keeps everyone safe.”

After learning more than a year ago that patients were having trouble getting doctors’ appointments, members of the Keizer Station Family Medicine team in Oregon began exploring ways to improve service and access. Their solution? Offer more video visits.

“What we didn’t realize at the time is that this work would put us in a unique position to be ready for the pandemic, which wasn’t on anyone’s radar in fall 2019,” says Ruthie Berrell, medical office director and management co-lead for the Family Medicine/Nurse Treatment Center unit-based team. 

Collaboration by the team’s frontline workers, managers and physicians has served as a partnership model for UBTs in the Northwest Region. It’s also earned the department applause for improving service and access at a critical time in health care, as teams across the enterprise adapt to the rise of virtual care. 

“It wasn’t always easy,” says Molly Maddox, RN, the team’s labor co-lead and OFNHP member. “This took a lot of working out the kinks and working together.” 

Overcoming resistance to change 

One of the team’s earliest challenges involved staff resistance to virtual care. Worried that patients would perceive virtual visits as a “takeaway,” some staff members pushed back. 

“The culture of how we delivered care was in the medical office, and people had different levels of acceptance across the spectrum,” says Caroline King-Widdall, MD, team co-lead and physician in charge. 

So, team members educated their peers on the benefits of virtual care and developed scripting to help them feel at ease offering video appointments to patients.

“People are more comfortable now taking the lead and scheduling appointments,” Berrell says. Others feared that older patients were less tech savvy and would have difficulty accessing their virtual visits. In response, team members posted informational fliers in exam rooms and emailed instructions to patients before their appointments. 

Building team engagement

Key to the team’s success was engaging everyone, including physicians. Medical assistants and nurses partnered with providers to review physician schedules and flag appointments they could convert to virtual visits. 

Also, UBT members participated in weekly huddles “where we brainstormed new tests of change and talked about what worked and what didn’t work,” says Maddox. The team’s efforts paid off. 

Patient satisfaction scores for ease of scheduling appointments jumped from 53% to 85% between August 2019 and December 2020. And because members access video visits through kp.org, website registration among the department’s patients increased by nearly 10% during the past year. 

The hard work has not gone unnoticed. This past fall, the team received the region’s UBT Excellence Recognition Award for improving service and access. 

Maddox attributes the team’s success to strong relationships rooted in partnership. “We know that we would not have had this success if our team didn’t work together.” 

This past year has been filled with pain and loss, from COVID-19 to the killing of George Floyd. These crises have been immense and intense.

But thanks to the tireless efforts of our entire workforce, we at Kaiser Permanente have responded to meet the moment of today’s historic challenges.

This issue looks at how our Labor Management Partnership has addressed systemic racism amid the pandemic, advancing equity in care and in the workplace.

Kaiser Permanente and the Partnership unions believe in equity and inclusion for all, and are committed to delivering affordable, high-quality care and service. As we move along on our journey to equity for all, we’re highlighting examples of this work across our Partnership.

Our cover story focuses on unit-based teams working to minimize health care disparities for the most vulnerable among us, from improving maternal-child health to treating diabetes and high blood pressure. You’ll also find resources to foster workforce and health equity.

Read about teams cultivating an inclusive workplace. See how physicians play a key role in partnership, and how our education and training resources are expanding opportunities for employees to advance their careers.

Try our puzzles and games to explore elements of equity. View our SuperScrubs comic for a thought-provoking take on the topic. And don’t miss our back cover for an inspirational quote from our chairman and CEO, Greg A. Adams.

Let’s build on these examples and commit to actions we can take to advance equity and partnership. Kaiser Permanente, and the members and communities we serve, will be better for it. 

Welcome to e-Hank! The national Labor Management Partnership communications team is pleased to serve you in this new format, and we’re grateful to those of you who’ve reached out and said you miss the print editions of Hank. But until the crisis of the COVID-19 pandemic subsides, an electronic communication seems best.

This issue looks at how our Partnership — which now includes 2 union federations, with separate National Agreements — helped Kaiser Permanente meet the extraordinary challenges that a worldwide pandemic brought to our doors. We’ve never been tested like this before. And how we’ve responded in the last several months provides a look at how we will respond and grow and adapt to future challenges. The dialogue and collaboration that have been taking place during the pandemic are a model for the future.

In this e-edition of Hank, we’re also introducing 2 concepts we think will help strengthen the culture of partnership throughout the enterprise.

The first is a renewed focus on The Basics — tips, tools and stories that will help you understand the core philosophy of the Labor Management Partnership and what it means to work in partnership. New to the Partnership? These materials will help show why Kaiser Permanente and the Partnership unions that belong to the Alliance of Health Care Unions or the Coalition of Kaiser Permanente Unions are committed to it as an operating strategy. Been around for a while? Dive in and refresh your knowledge of the principles and processes that make our Partnership a success.

The second is a new focus on Joy in Work, a concept pioneered by the Institute of Healthcare Improvement. By Joy in Work, we don’t mean smiley faces or i’s that are dotted with hearts. We hope our Joy in Work stories and tools will help you connect with your deeper, personal motivations for working in the  demanding health care field. The stats show that people who feel this sort of connection — this fundamental Joy in Work — are less likely to suffer from depression and burnout.

Lastly, don’t miss the back cover, which provides a quick refresh on a core principle that helps our Labor Management Partnership thrive: Free to Speak. It’s a reminder that your voice matters. Thank you for reading this and for all your hard work. Together, there is strength in partnership.

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.”

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.”

COVID-19 is testing partnership as never before.

Management and labor have had to work together quickly to retool the delivery system to support rapidly changing needs. Employees’ and physicians’ skills and talents are needed in new ways and in new places — so leaders from Kaiser Permanente and unions created labor pools to get KP employees to where they were needed.  

It’s one of dozens of innovations made to provide top-quality care at a time when every day is bringing new challenges. The swift work was possible in part because of the foundation provided by the relationships and values of the Labor Management Partnership.

In Southern California's Riverside service area, “It’s all-hands on deck,” says Jiji Abraham, area chief financial officer. “Even physicians are in the labor pool.”