Total Health and Workplace Safety

Finding ways to help Kaiser Permanente employees enjoy long, healthy, productive lives is the mission of the Total Health and Workplace Safety subgroup.

The subgroup, one of three in national bargaining this year, will expand upon the achievements of the 2012 National Agreement. It will also address how Kaiser Permanente and the Coalition of Kaiser Permanente Unions can partner to improve the total health of the communities we serve.

Delivering exceptional care and service and supporting a healthier, injury-free workforce go hand in hand. “We can’t provide quality, affordable care to our members and communities unless we first provide a safe and respectful environment that promotes the collective health of our workforce,” says Kathy Gerwig, Kaiser Permanente’s vice president of employee safety, health and wellness and the management co-lead for the subgroup.

Personal and collective health

In 2012, negotiators established the groundbreaking Total Health Incentive Plan. The wellness program encourages employees to assess their own health and aim for collective improvement in measures like cholesterol and body mass index. In addition, healthy employees can serve as role models for Kaiser Permanente patients.

This year, the parties will suggest ways to create a healthier, safer work environment by improving employee access to services such as wellness coaching and better understanding trends in workplace violence and prevention. Another goal is to encourage employees to eat healthily, exercise at breaks and prevent workplace violence and intimidation.  

Expanding wellness to communities

In a first for national bargaining, the subgroup will also suggest ways to bring a holistic approach to wellness into communities Kaiser Permanente serves, especially those with limited access to healthy food, affordable health services and places to exercise.

“Our union members tend to live in communities that have high needs around health or issues around violence,” says Meg Niemi, the president of SEIU Local 49 and also a union co-lead for the subgroup. “So our members have an interest in their communities being healthier and safer further upstream, before they need critical care.”

The other two subgroups tasked with crafting recommendations are Work of the Future and Operational and Service Excellence in Partnership. (For more on Work of the Future, watch this slideshow and read this article.) Negotiators are developing a tentative agreement that will become the National Agreement after it is approved by Kaiser Permanente leadership and ratified by union locals this summer.

Visit bargaining2015.org for more information, videos and slideshows, and to sign up for bargaining updates.

Kaiser Permanente and the Coalition of Kaiser Permanente Unions have reached a formal agreement that ensures the safety and compensation of KP employees involved in caring for patients with the Ebola virus.

The agreement, reached December 15, 2014, clarifies questions coalition unions had about the engagement and protection of their members who may encounter or care for a patient with Ebola. It codifies standards outlined by the Centers for Disease Control around protective protocols and equipment. It also outlines training and support provided to employees, including for employees who may be unable to work during an isolation period for a possible Ebola exposure.

Safeguarding workers and patients

“As health care workers, we’re used to putting our patients first,” said Ken Deitz, president of United Nurses Associations of California (UNAC). “Because Ebola is an infectious disease, to maintain patient safety we also had to ensure our own safety.”

The parties came to agreement quickly and with little disagreement, with conversations focused on clarifying the practices KP facilities already are doing as outlined by Centers for Disease Control guidelines.

Union and KP leaders say it reflects their desire to work together—and to continue to focus on educating, protecting and preparing employees who may come in contact with Ebola patients.

“By working together, we have ensured that employees are prepared to care for patients with Ebola while keeping themselves and their colleagues protected from infection,” said Kathy Gerwig, vice president of Employee Safety, Health and Wellness for KP.

Education, training and protection

Specific provisions of the agreement include:

• All employees with the potential to interact with, treat, or do cleaning or waste handling for suspected Ebola patients will receive paid time for education and training in such areas as Ebola signs and symptoms; care and treatment; proper donning and doffing of personal protective equipment; proper cleaning of treatment rooms or areas; and proper disposal of the patient’s body fluids and wastes.
• Employees in key treatment or intake areas will receive sufficient personal protective equipment supplies.
• Ebola treatment teams would be staffed by volunteers. If there are not enough volunteers, local KP and union leaders would identify team members.
• If a coalition union-represented employee cannot work, or receives care as a result of work-related exposure to Ebola, the employee will receive paid time off, and all medical costs will be covered through workers’ compensation.

Read the agreement.

Do you doubt you can lead changes that make Kaiser Permanente a better—and safer—place to give and get care?

A small group of nurses at the San Diego Medical Center showed that leading change is, in fact, part of their job.

Brittni Demers, RN, and three of her colleagues spearheaded a successful effort to reduce needlestick injuries, and now their expertise is being tapped throughout Kaiser Permanente to bring the voice of frontline workers to safety initiatives.

Demers, a member of UNAC/UHCP, is on KP’s National Sharps Safety Committee. It is one of the many sourcing and standards teams that advises KP on everything the organization buys—and it is the only one with union representation. As such, it gives the caregivers who actually use needles, scalpels and other sharps a way to influence purchasing decisions. It also impacts workplace safety and tools workers use every day.

From July to December 2013, a huge remodeling project at the hospital shut down two medical-surgical units, leaving several nurses temporarily without anywhere to work. Demers and RNs Jessica Heffern, Leanne Vitacco and Lucas Pepin got together to tackle a problem that had been concerning them: needle and sharps injuries. By July 2014, the team’s project had led to an astounding 76 percent decrease in needlestick injuries in inpatient nursing units. There were similar improvements for all sharps injuries throughout the San Diego service area.

Here’s what the team did:

Peer-to-peer training

Only two years out of nursing school, Demers quickly saw that “real life” didn’t always comport with what she had learned in her classes. “You go to school, you learn correct techniques, then you go into a hospital and it’s different,” she says. “People like doing things their way.” The team devised a quick refresher for nurses, by nurses, that emphasized what the evidence and research said about safe needle handling. The nurses traveled from unit to unit in the hospital, and to some outlying clinics, to make their case. “When you emphasize safety—our own and the patients’—and provide the supplies, then people will do it,” she says.

“The peer-to-peer approach was effective because the team understood the nurses’ day-to-day concerns,” says Mark Trask, the director of environmental health and safety in San Diego. “There is empathy and understanding, which allows for more dialogue.” In addition, because the trainers were registered nurses, they could spell other nurses for the 10-minute refresher. More than 700 nurses, physicians and lab techs took the training.

Standardize supplies

While demonstrating safe needles to other units, the team members often would hear, “Oh, we don’t have that one.” So they got to work standardizing the needles throughout the medical center. “We went through every single medication room,” says Demers. “They became supply chain experts,” says Trask. By adjusting the types and amounts of equipment, they also reduced waste and saved money.

Share expertise

These nurses now participate in incident investigations when there is a needlestick injury, which is an important part of the region’s workplace safety program. Plans are in the works to spread the training to primary care departments in the ambulatory setting.

Identify resources

Demers’ participation on the National Sharps Safety Committee extended her reach system-wide. The committee field tests safety sharps in every KP region to identify products that most effectively prevent injuries. Based on user feedback, the committee selects the highest-rated safety sharps as KP’s national standard.

Why did the four frontline nurses step up? For Demers, the answer is easy: “You have to be focused on safety when you have a needle in your hand.”