Peter Lazes is the founder and director of Programs for Economic Transitions, Strategic Planning Programs for Unions, and the Healthcare Transformation Project at Cornell University’s School of Industrial and Labor Relations. These institutes provide labor unions and management with consultation, training and research to implement strategic worker participation programs and new work systems. He earned his Ph.D in clinical and industrial psychology. Here are his reflections on Kaiser Permanente’s Labor Management Partnership.

Q: How do partnerships such as Kaiser Permanente’s Labor Management Partnership affect the performance of organizations, specifically health care organizations, both financially and in terms of the safety and quality of patient care?

A: When done well, a process of redesign and engagement of frontline staff has a direct impact on the quality of care and on controlling costs. When partnerships are nested in the operations—not merely labor relations strategies—they work. When it’s done right, it has a direct impact on quality of care, patient satisfaction, and reducing costs and staff turnover.

We have to ask, where does it rest, in operations or in HR? When partnerships are effective, it’s because of strong leadership from both unions and management. There has to be committed leadership, as well as sufficient resources to support the teams. 

Q: Does the current economic crisis create special challenges and/or opportunities for partnerships? What should unions and management do in response?

A: Companies’ attempts to control costs and deal with wrenching change are a real opportunity for labor management partnerships. The question is: Does the company engage the unions, or keep them on sidelines? That’s a choice the company has to make. For example, in the 1980s at Xerox, they had significant cost problems. The company decided there was no way to keep the work in the states so they began plans to outsource some work to maquiladoras in Mexico. In response to these economic problems and decision to go offshore, the union and management at Xerox decided to establish a study-action team to reduce costs and freed people up full time to work on these problems. In four months this team, along with ideas and suggestions from other employees, ended up identifying needed costs savings to save 180 jobs.

UBTs are 'a major breakthrough. Impressive results are starting to emerge.'

Peter Lazes 

The current global economic crisis is an opportunity for partnerships. Goals have to be set in a fair manner. It’s a terrible environment, but it gives partnerships an opportunity to be real partnerships. The workforce—nurses, LVNs, pharmacists—know what’s going on and what can be done to solve many of the quality and cost problems. If we unleash them in an effective way to use their knowledge to find solutions, it can offset costs and avoid unnecessary layoffs.

Q: What do you say to people who might say, "Partnerships are a 'luxury' that companies can't afford right now"?

A: A partnership is not something that can be turned on and off. If you go back to a management-only process, then you’ve created a disconnect.

Q:  What are your thoughts on unit-based teams as a tool to improve performance and quality?

A: It’s an important strategy. It’s at the unit level where the work gets done. It’s a major breakthrough, and impressive results are starting to emerge. This is where you are going to see significant changes to help improve the quality of care and efficiencies. 

Q: Do you see differences between unions that are in partnerships and those that aren't?

A: Unions in this country are in crisis. Unions that are in the Partnership are attempting to deal with improving patient care, but they also have a goal of benefiting the union and helping it to grow by improving communication with members and giving members a real voice in patient care. Unions that engage in partnerships are expanding their toolkit beyond collective bargaining and contract administration. The outcome of this work is a broader engagement of workers in how their work gets done and provides them an opportunity to contribute to decisions that affect their work.

If the unions can deliver this, that is a very big thing. Such activities end up increasing membership and gaining more members who now want to be stewards and organizers. Members get excited about having a greater voice in decisions that affect their work. Partnerships therefore have the potential to be an effective union-building process as well.  Non-union workers will see these successes, and they might want to have a union to gain a greater voice in decisions that affect their work. These activities directly lead to opportunities for growth and stronger rank and file involvement in patient care and union activities.

Q: What should unions be doing to build their members’ capacity to participate more effectively in their companies?

A: It is important for unions to help members understand the changing health care environment and how their union is expanding its role to help provide members a greater voice in decisions that affect their work. Unions can be helpful by providing their members critical information about the health care industry, how it’s funded, how hospitals are evaluated and accredited. Unions play an important role to ensure members get needed skills such as problem solving, team meeting and workflow analysis, so they can effectively contribute to problem solving and work redesign process.

Union leaders need to be visible and actively support the development of partnership—which includes extensive mentoring and coaching of staff, so they can be effective in various partnership activities, as well helping to remove barriers so their members can have access to critical information and have a direct impact on improving patient care.