About LMP

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.

When the leaders of Kaiser Permanente and the Coalition of Kaiser Permanente Unions shook hands on their Labor Management Partnership 20 years ago, they weren’t sure where it would take them. Today, it is the largest, longest-running partnership of its kind. It is also the most studied by university researchers.

A new book published by the Labor and Employment Relations Association (LERA) and Cornell University Press shows that the partnership remains a model for workplace innovation. “The Evolving Healthcare Landscape: How Employees, Organizations, and Institutions are Adapting and Innovating” devotes three chapters to LMP’s history, accomplishments and challenges.

Lessons for others

Adrienne Eaton and Rebecca Givan, professors at Rutgers University, and Peter Lazes, a director and researcher at The City University of New York, studied six health care partnerships, including LMP. They were struck by:

“…the extent to which unions have been proactive in driving [all] these efforts....Another development in health care partnerships has been a significant deepening of the role of labor relations staff in operational matters.

“It is [also] important to note that the cases described here have influenced one another because the key stakeholders have directly learned from each other....[For example,] union and management stakeholders in Los Angeles [Department of Health Services and SEIU Local 721] as well as union leaders from the University of Vermont Medical Center have looked to Kaiser for answers.”

Another chapter, by Jody Gittell of Brandeis University and KP Northwest staff members Joan Resnick, Sarah Lax and Eliana Temkin, reports on regional efforts to promote collaboration across work teams. KP was selected for the study in part for what the authors call its “record of leadership and innovation [including] in patient care delivery, health information systems and labor-management relations.” Several strategies, including “living room huddles”—an informal, building-wide get-together—and job shadowing across departments led to higher employee engagement and patient satisfaction scores.

An inside look

The chapter “Leading Change Together” by Jim Pruitt, vice president of labor relations for the Permanente Federation, and Paul Cohen, LMP senior business consultant, explains the conditions that gave rise to the partnership, the need to implement it consistently across the organization and the way it achieves results:

“By bringing together diverse points of view and providing a framework for joint problem solving, the Labor Management Partnership has helped Kaiser Permanente tackle difficult issues....The partnership formed because conditions demanded change. It has endured because it has achieved measurable results. And it continues to flex and grow because we follow a few key principles and practices [including] self-directed work teams, interest-based problem solving and honest conversations.”

All of which explains why outside experts continue to take an interest in the joint efforts of KP and the union coalition. Pruitt and Cohen quote Thomas Kochan, a professor at MIT's Sloan School of Management, who put it this way in a 2013 study:

“Kaiser Permanente is now one of the nation’s leaders in the use of frontline teams to improve health care delivery....The Labor Management Partnership continues to serve…as a model for health care delivery and improvement.”

The Labor Management Partnership operates in seven of Kaiser Permanente's eight operating regions across the United States. These regions serve the needs of their respective KP members and patients, guided by a common set of partnership principles and practices. Learn more about each.

Colorado

Serves 541,000 members in 34 medical offices. Of its 256 unit-based teams, 188 (73 percent) were rated high performing as of June 2021.

Georgia

Serves 316,000 members in 29 medical offices. Of its 108 unit-based teams, 94 (87 percent) were rated high performing as of June 2021.

Hawaii

Serves 258,000 members throughout the islands, in 24 medical offices and one hospital. Of its 60 unit-based teams, 54 (90 percent) were rated high performing as of June 2021.

Mid-Atlantic States

Serves 787,000 members in Maryland, Virginia and the District of Columbia in 39 medical offices. Of its 277 unit-based teams, 213 (77 percent) were rated high performing as of June 2021.

Northern California

Serves 4.5 million members in 249 medical offices and 35 hospitals. Of its 1,347 unit-based teams, 1,006 (75 percent) were rated high performing as of June 2021.

• LMP NCAL [KP intranet]

Northwest

Serves 633,000 members in Oregon and Southwest Washington, in 59 medical and dental offices and three hospitals. Of its 407 unit-based teams, 280 (69 percent) were rated high performing as of June 2021.

• LMP Northwest [KP intranet]

Southern California

Serves 4.7 million members in 257 medical offices and 19 hospitals. Of its 1,115 unit-based teams, 789 (71 percent) were rated high performing as of June 2021.

Washington

Serves more than 688,000 members in the Puget Sound area and east to Spokane with 48 medical facilities and one hospital. The Washington region became part of Kaiser Permanente  in 2017. The region's LMP council held its first meeting in Q2-2019.

• KP Washington LMP [KP intranet]

National Functions

These departments (Finance, Health Plan Administration and IT) serve KP members, patients and staff across the program. Of 81 unit-based teams, 50 (62 percent) were rated high performing as of June 2021.

Independent studies into the Labor Management Partnership. 

How Labor-Management Partnerships Improve Patient Care, Cost Control, and Labor Relations [opens PDF]

A 2012 Cornell School of Industrial and Labor Relations study of labor partnerships at 3 health care systems, including Kaiser Permanente.

Building a Collaborative Enterprise

This 2011 Harvard Business Review article shows how Kaiser Permanente, our Labor Management Partnership and other leading organizations are redefining way companies do business.

Study of High-Performing Teams

Researchers from Rutgers University, Johns Hopkins and Kaiser Permanente identified 5 key enablers of unit-based team performance and development (2011). 

Negotiating in Partnership: A Case Study

This report traces the landmark 2005 labor negotiations and the resulting contract (2006).

The Kaiser Permanente Labor Management Partnership: 2002-2004

This MIT report analyzes LMP’s evolution from 2002 to 2004 and identifies issues and challenges that emerged in those years (2005).

The Kaiser Permanente Labor Management Partnership: The First Five Years

MIT researchers trace the early evolution of the Labor Management Partnership from its inception in 1997 to June 2002 and identify critical issues facing the parties (2003).

Take advantage of everything LMP Communications has to offer and more!

Hank

The flagship publication of the Labor Management Partnership, Hank (named in honor of Henry J.) brings forward the diverse perspectives of frontline workers, managers and physicians across Kaiser Permanente. It features:

• Stories about unit-based teams that have taken a collaborative approach to achieve measurable performance improvement.
• Stories about individuals who, by working in partnership, have undergone a personal shift that has changed their level of engagement at work.
• Examples of effective practices that a team or individual can apply.
• Tools that make working in partnership easier: Practical tips and techniques for improving performance and solving problems in a team environment.

Each quarterly issue also has a comic on a partnership theme, puzzles and games, a poster and more.

LMP Insider

Our twice-monthly e-bulletin links you to useful tips, tools, team-tested practices and videos on LMPartnership.org. Subscribe today! (Scroll to the bottom of this page and enter your email address in the box.)

Oldie but Goodie

A checklist from the Labor Management Partnership’s early days, with seven principles and 37 related behaviors describing what working in partnership looks like.