The nearly 100,000 members of the Coalition of Kaiser Permanente Unions and Kaiser Permanente reached agreement Monday, July 23, on a three-year national contract. The pact covers workers in 28 unions at hundreds of Kaiser Permanente health care facilities in nine states.
Employees and Kaiser formed a unique Labor Management Partnership (LMP) in 1997 as a way to transform the relationship between workers and managers. The partnership daily involves workers, managers and physicians in a joint decision-making and problem-solving process based on common interests. Workers covered by the partnership include registered nurses, pharmacists, maintenance and service workers, technicians of many kinds, psychologists, lab scientists and many others.
We spoke with John August, executive director of the Coalition of Kaiser Permanente Unions, about the landmark agreement and how the partnership contributed to the successful settlement of a contract that benefits workers, managers and patients.
Q: When members tentatively approved the agreement on May 11, you described it as providing union members with the tools to improve care and efficiency—rather than chop care or benefits. Further, you said: “Improvement, delivered by workers at the front line, is the key to extending quality care to every person in our country. Health care simply costs too much, and as union workers we are absolutely committed to addressing cost and access—as well as care and quality.”
Can you elaborate?
August: There are many reasons why health care in our nation is unaffordable. It is true that there is too much profit; drugs and medical equipment are too expensive; and there is no regulation of the industry to make it accountable to provide safe and effective care at an affordable price.
However, no matter what kind of system we have, it is in the delivery of care that costs the most! Waste and inefficiency; redundancies; errors; inability to track improvement, not just of individuals but across whole populations, are the drivers of why our system is unaffordable.
Kaiser Permanente has the right model for the nation. Pre-payment; fully integrated electronic medical records; a program based on prevention; and our labor-management partnership…all together provide the leadership needed to reduce costs and thereby increase access to the millions who need care.
Our new National Agreement sets forth powerful goals and support systems so that our front-line workers, managers and physicians can continue their collaborative efforts across the entire 9 million members we serve. Our unit-based teams are constantly improving their capability through the transformative learning inherent in the language of our unique collective bargaining agreement.
We will resist attempts by management to “chop” workers, wages or benefits because this approach does not fix anything for the long haul. Rather, we are committed to systemic improvement: quality/cost=value…that is our formula and it is in the DNA of the Coalition and KP; we cannot let that change.
Q: How do patients benefit from this new pact?
August: Over the last five years, Kaiser Permanente has achieved number 1 or number 2 in key quality measures among all competition in the regions in which they operate. Sixteen of Kaiser Permanente hospitals are rated among the top 56 in the nation!
Kaiser Permanente members/patients are direct beneficiaries of the systemic improvement work of the front line.
Our new agreement strengthens and raises the bar even higher. We have agreed that by 2016, 85 percent of all front-line teams will be “high-performing.” A high performing team is measured against a consistently applied Path to Performance (part of our collective bargaining agreement) set of criteria, which requires training, sponsorship and demonstrable and sustainable improvement in strategic goals of improvement in clinical quality, patient safety, customer service, efficiency and affordability.
No organization in the industry can even aspire to this kind of achievement…we are doing it!
Q: What is the most important contract improvement for workers?
August: In these very difficult economic times, the workers see that maintaining all of their best-in-class benefits is a great achievement. All workers will receive across-the-board wage increases that will ensure that they can maintain their standards of living. I have no doubt that these two achievements will stand out most for the workers.
It is fitting, too. Our mantra of “reduce cost through improvement” means that we must create more and more value to protect and enhance our standards of living as well as create the resources for KP to continue to develop the technology and capital investment necessary to innovate in this knowledge-based, high-tech industry. If we did not increase wages and benefits we would be contradicting our strategy: IMPROVEMENT!
Q: How did having a partnership between Kaiser unions and Kaiser Permanente facilitate this agreement?
August: Over the 15 years of the LMP, the parties have learned that interest-based bargaining and interest-based problem solving are very effective. The 400 people involved in bargaining participated in true problem solving…and this is the culture that is deeply developing throughout the unions and KP. We are here for our patients, our communities and our nation. We have a responsibility to solve the seemingly intractable issues we face in health care and to do so while keeping the bar high on economic improvements for all employees.
Q: What can others learn from your innovative partnership with Kaiser?
August: Everyone wants to solve real problems. That is why workers join unions…to have their experience be valued in terms of the products and services they create and the lives they lead with their families.
Our economy is in tatters.
From the shop floor, to the operating room and everywhere in between, I think we want to share our experience with others and let them take from our experience that which is relevant for them.
In today’s world, innovation is the key to beating the competition…efficiency alone cannot do it.
Our bargaining and our LMP are helping everyone, mangers, doctors and union members look at each other as owners of the outcomes of the work. In so doing, we keep our standards high by creating the best experience for the patients who need the services of KP.
We have made a commitment to being business partners at every level. It is a journey…there is not playbook.
We have much to learn…and I believe much to share.