LMP Concepts

As we celebrate the 20th anniversary of the Labor Management Partnership, Hank would like to call out the tens of thousands of individuals who have made partnership a success: the frontline workers, managers and physicians who have believed in our ideals and taken the time to build the positive working relationships that are the backbone of this groundbreaking endeavor.

Visit Humans of Partnership to read their stories—and look through their eyes into our past, our present and our future. 

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.”

Workforce Planning and Development

Key accomplishments

• Program enrollments in Kaiser Permanente’s two education trusts grew from about 3,000 in 2007 to nearly 62,000 in 2016. 
• Tuition reimbursement course applications nearly tripled, from less than 20,000 in 2008 to more than 57,000 in 2016, largely benefiting members of unions in the Coalition of Kaiser Permanente Unions.
• Critical skills training launched in June 2017 with a Digital Fluency pilot program for more than 2,000 employees.

Going forward

• A top priority will be addressing the impact of economic, social and technological changes on care delivery and future KP staffing models. (Learn more at kpworkforce.org.)

Workplace Safety

Key accomplishments

• Since program inception in 2001, KP’s injury rate has been reduced by 69 percent.
• Injuries associated with patient handling and/or mobilization have decreased by 32 percent since 2011.
• The program-wide workplace safety strategy was strengthened in 2016, based on the National Safety Council’s model.

Going forward

• The strengthened safety strategy will be implemented, with the goal of closing the gap between KP’s injury rate and the Bureau of Labor Statistics adjusted injury rate for health care.

Total Health

Key accomplishments

• More than 76,000 employees have taken the Total Health Assessment (THA) since 2014.
• Ninety percent of eligible employees completed their recommended health screenings in 2014 and 2015, earning a $40 million payout under the Total Health Incentive Plan.
• More than 3,000 UBT health and safety champions helped teams across the organization conduct 1,756 wellness projects in 2016—a 45 percent increase from 2015.

Going forward

• New awareness campaigns, including one focusing on prediabetes education, will inform and empower employees to take charge of their own health and wellness.

Joint Marketing and Growth

Key accomplishments

• Helped secure more than $108 million in revenue for Kaiser Permanente in 2016.
• Supported the 20-year growth in the number of employees represented by a union in the Coalition of Kaiser Permanente Unions, from 57,000 to 116,000, and in Kaiser Foundation Health Plan membership, from 7.4 million members to 11.8 million. 
• Since 2012, mobilized 51 union ambassadors who attended more than 300 community events and engaged more than 70,000 KP members and potential members—many of them unionized—increasing community knowledge and understanding of KP.

Going forward

• Through the expansion of health plan membership, support job security and the continued growth of the coalition.

Attendance 

Key accomplishments

• Enhanced time-off benefits to provide incentives for appropriate use of sick leave.
• Developed the Time-Off Request Tracking System to provide greater flexibility and responsiveness in managing planned time off.
• Achieved 21 percent fewer lost workdays in high-performing UBTs. 

Going forward 

• Attendance data, systems and results will continue to be assessed and improved.

Where were you 20 years ago? The three of us were each on a different path—paths that crossed in unexpected ways, and changed the way we do our jobs.

Our Labor Management Partnership often is described as a journey, for good reason. It is ever changing. It can be difficult. And you never know where it’s going to take you next. But it also has a few rules of the road that help us find our way:

Understand and respect one another’s needs and interests. Listen openly and assume the best intentions of your counterparts. Ask questions, especially, “Why?” Create an environment where people feel safe speaking up.

Over the years, that approach has gotten positive outcomes for Kaiser Permanente, our unions, our workforce and, most important of all, our members and patients.

That doesn’t mean our partnership is perfect; it isn’t. Or that we always agree; we don’t. But we’ve tried the traditional ways of working, and the trip is much better on the high road that Kaiser Permanente and the Coalition of Kaiser Permanente Unions have chosen.

Thank you for your hard work and dedication. We invite you to join colleagues in your unit, department or region this fall to celebrate your accomplishments, reflect on our challenges, and commit to creating an even better future.

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.