Teaming Up for Better Patient Care
When Kaiser Permanente experienced financial problems, it looked for and found allies: its employees and the unions that represent them.
HARBOR CITY, CALIFORNIA
In his 23 years as an employee of Kaiser Harbor City, Fred Tinamisan, RN, has seen good and bad sides of Kaiser Permanente, the Oakland-based health maintenance organization. Now he’s seeing a very good side, one that is bringing thousands of AFSCME nurses a 31 percent pay increase over the next five years — and full participation in Kaiser’s efforts to provide better patient care.
Five years ago, the HMO was in dire financial difficulties and demanding take-aways in negotiations. “Salaries for the most senior people were cut sharply,” says Tinamisan, who was on the bargaining team. He understood why management needed to reduce costs, but the cuts obviously angered the 6,000 nurses and physicians’ assistants represented by United Nurses Associations of California (UNAC)/National Union of Hospital and Health Care Employees, an AFSCME affiliate.
IF AT FIRST... AFSCME had proposed a labor/management partnership during the ‘95 negotiations, but Kaiser rejected it. So AFSCME led the way in convincing other affected unions to come together to push a partnership with Kaiser. That initiative led to a labor/management committee and, after a couple of years of union prodding, to the country’s first national labor/management alliance in health care. The HMO listened to workers’ concerns and set up systems to address them. With work groups, they investigated systemic problems and brought in trainers to help create a spirit of teamwork.
If the 2000 contract is any indication, the spirit lives, and the partnership has succeeded.
WINNING RESULTS. Tinamisan, who is president of the local at Kaiser Harbor City, found bargaining very different in 2000. “It was interest-based, not adversarial,” he says. Both union and management had to consider the overall health of the organization. “You couldn’t demand something unreasonable.” And both sides prepared thoroughly for the talks.
The process began last April with cooperation at each step. Bargaining task groups were established to explore and research seven issue areas: wages, benefits, health and safety, work/life balance, performance and workforce development, quality and service, and work-life management.
This preparatory effort gave the national negotiating committee information for developing the overall national contract. Once that was approved, management and the individual unions “customized” their own agreements.
TAKE A BOW. The union’s negotiators are justly proud of the five-year agreement. In addition to the 31 percent increase, UNAC members will also receive equity adjustments of .75 percent the first year and 1.75 the second.
That’s not all. The contract provides for exemplary job security, employer neutrality toward future organizing efforts and joint staffing decisions for one of Kaiser’s hospitals. In addition, management agreed to drop its very unpopular “Earned Time Off” provision, which had resulted in workers being charged with abusing leave when they tried to get time off. The new system provides holidays, life-balancing days, vacation and sick days.
Tinamisan, a charge nurse in the hospital’s recovery room, is most pleased with the revised disciplinary process. “It creates a very positive way of handling mistakes — a way of making things better,” he says. Instead of scape-goating nurses when an error occurs, the new process will probe for faults in the system that let it happen. “People won’t have to hide their mistakes. Patient safety will improve.”
The partnership doesn’t end with the contract. New committees have been formed to bring workers and management together to find new ways of getting things done.
These new procedures seem sure to make Kaiser Permanente a better place to work — and a better place to be a patient.
