Emily Wu
Medical Social Worker
Kaiser San Francisco

by Ed Herzog

Dec. 2001

Labor management relations at Kaiser changed dramatically in 1997. Faced with a health care industry that was undergoing rapid change, and the explosive growth of the for-profit health care industry, SEIU and Kaiser decided it was a time to enter into a new way of doing business. A coalition of AFL-CIO unions, including SEIU and Local 535, and Kaiser Permanente agreed to enter into a labor partnership. They united around the common purpose of learning to work together in order to deliver the highest quality health care possible.

“In the beginning there wasn’t a whole lot of trust,” recalls San Francisco medical social worker Emily Wu. “We would sit across the table from each other and think, okay, what do you want, what’s your hidden agenda? We wondered, how can we talk openly with the same people we’ve been battling for years?”

Labor and management representatives went through months of training on team-building, shared decision-making, and communication skills. They used a federal mediator. Both sides agreed upon common goals: improving the quality of health care for all Kaiser Permanente patients, making Kaiser a better place to work, providing employees with the maximum possible employment and income security, and involving employees and their unions in decisions. Out of months of discussions were born five- and ten-year plans which included creating the position of labor liaison.

Wu is Local 535’s first labor liaison. Part shop steward and part educator, labor liaisons involve workers in the decision-making process, teach communication skills, and educate union members about the partnership’s business plan.

“No longer is the budget a big secret,” says Wu, “Having a voice in how money is spent requires information. We need to be educated to make informed decisions, so we meet in groups and ask questions like: How are we going to spend our department’s resources and what are the potential consequences of these decisions?

“Kaiser used to issue mandates and expect front line people to fall in line. We had no input whatsoever. The partnership is a different world. It’s about getting people to the table. The labor liaison brings the tools and information to workers so they can make the best decisions for themselves and their patients.”

Issue Resolution

One of the important tenets of the partnership is finding new ways of mediating conflicts. Called issue resolution, employees are involved in creating mutually approved solutions to workplace problems. A panel of representatives from both management and labor hears cases. If the solution arrived at is not acceptable, workers have the right to proceed to a grievance. “It’s a different way to resolve problems where workers are part of the solution,” adds Wu.
Though the partnership is in its early stages, Wu sees improvements. “We have managers like our internal medicine manager, who embraces the partnership and involves her staff. They have meetings together to look at the budget and discuss jointly how to run the clinic. Improved work life and patient care aren’t going to come to fruition until we provide a foundation, which is what we’re trying to do now.”

Cooperative Skills

Wu teaches two partnership orientations a month for both front line employees and managers. “Instead of an adversarial approach to labor relations, people learn cooperative skills,” says Wu, “and are educated about the business end of Kaiser. We look at how we get our money, how premiums are determined, and how the budget breaks down in different departments. We’re such a huge organization, it’s difficult to understand how the organization runs as a whole. For people to see the big picture, it’s really eye opening.”

According to Wu the partnership has been a success so far. “Kaiser has opened new hospitals in Roseville and in Los Angeles. Both are using the partnership approach, and both hospitals report improved employee-management relations. People are happier because they have input into the day-to-day operations of the hospitals. When people feel valued, are involved in the decisions that affect their work lives, and are pulling in the same direction, you get higher employee morale and a better product.”

“I like to be proud of where I work. I was trained at Kaiser and did my graduate school internship here. At the time, Kaiser was a cool place to work. The pay scale was good and people wanted to work here. But over the years, as managed care became more competitive, Kaiser changed. I didn’t like working at this new Kaiser.

“With the partnership, Kaiser has returned to its roots: giving the highest quality patient care. That’s why we’re in social work. Taking pride where you work and giving back to the community is part of that. You can’t sit around and hope things improve. You have to get involved and make changes. I tell that to everybody I talk to. It takes only one dedicated person and you can make a difference.”