Staff overtime soared. Patient satisfaction scores plunged. Large numbers of contract nurses filled shifts each day to keep up with patient care.

By the end of 2022, staffing challenges at the Kaiser Permanente Downey Medical Center in Southern California called for drastic action.

Today, those struggles have eased, thanks to more staff nurses and a workplace innovation that tracks staffing data. Stakeholders from the executive suite to the front lines credit one thing for the turnaround: partnership.

“We worked closely with labor unions, made agreements, and stuck to them,” says Mitch Winnik, senior vice president and area manager for Downey. “The results have been amazing.”

“Patient care is getting better because labor and management are working together,” adds Paul Ciriacks, a registered nurse at Downey and UNAC/UHCP member.

How the change happened

The solution started with a simple step: setting up monthly meetings between hospital and union leaders to discuss staffing.

At these meetings, they quickly agreed on 2 main goals:

• Hire more nurses to reduce overtime and rely less on contract workers. A key tactic was attracting hundreds of applicants through day-long hiring events organized by management and labor.
• Follow existing staffing agreements to ensure frontline workers have a say in decisions. Make sure they arrive on time, take breaks, and avoid unnecessary overtime.

The results

Success by the numbers:

• Six hiring events helped bring in about 1,000 new nurses.
• Contract nurses dropped from 270 at the end of 2022 to just 20 in 2024.
• Patient satisfaction scores at the hospital hit an all-time high — rising 35% in 2 years in the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey.

Building trust through transparency

Supporting Downey’s success is a new staffing dashboard that covers all job classifications. It allows managers to share real-time data about staff vacancies, hiring progress and overtime usage with frontline workers.

Downey and Panorama City Medical Center are piloting the dashboard. By 2026, the staffing dashboard will be available to all Kaiser Permanente hospitals in Southern California.

Managers access the dashboard — containing sensitive personnel data — using a password. Entering a unit-based team’s name and ID number initiates an automated process that pulls recruitment and payroll data from HRconnect.

The result is an up-to-the-minute glimpse of the team’s staffing situation — and a comparison to the previous month to highlight personnel trends.

Charlene Young, a nurse manager, used the dashboard to explain a recent rise in overtime. It showed that 2 open positions were in the process of being filled. "That should help with the situation," she told her team in Downey’s medical-surgical-telemetry unit.

Andre Welch, a nurse assistant and SEIU-UHW member, says seeing the data makes him feel more confident. “For me, it always helps when they show me the hard numbers.”

With a little inspiration from Goldilocks, Kaiser Permanente pharmacies strive to get their medication supplies just right.

They aim to avoid overstocking costly drugs that might go unused, while also ensuring they don't understock and leave KP members without necessary medications.

The goal to find the right inventory balance may sound as elusive as a fairy tale. However, a Southern California unit-based team project shows how KP pharmacies come close by maximizing supplies and reducing waste.

The 24-hour pharmacy at Kaiser Permanente Woodland Hills Medical Center in Southern California leads the project. The pharmacy fills prescription orders with unused supplies from KP pharmacies across the market. It also ships its unused supplies to KP pharmacies that need them.

The collaborative effort follows common practice across the organization, where pharmacies routinely track inventories to reduce waste. This ensures members receive the medications they need. It also saves Kaiser Permanente millions of dollars each year, contributing to our mission of delivering high-quality, affordable health care.

“Say we have a medication that costs $10,000,” says Nogie Demirjian, outpatient pharmacy operations manager at Woodland Hills. “When we aren’t using it but the pharmacy in West LA has a patient that needs it, we will ship it over there. This way they don’t have to spend money to buy it, and we won’t be sitting on it until it expires and has to be thrown away.”

Supplies reviewed weekly

Weekly inventory reports show how unused medicines at one KP pharmacy may be in demand at another.

The process begins every Monday. Veronica Hoover, an inventory control assistant and UFCW 770 member, reviews all medications in Woodland Hills that have not been dispensed in at least 120 days.

Hoover checks to see if Woodland Hills' excess supplies are needed at a KP pharmacy in Southern California. When there’s a match, she calls the second pharmacy and arranges to send the medicine there.

Hoover says she recently sent a bottle of chemotherapy drugs to another KP pharmacy. The medicine costs $20,000 per bottle.

“If we don’t use that, that’s a pretty big hit,” Hoover says.

Sensible practice, substantial savings

The effort is part of an affordability initiative led by Kaiser Permanente and the Alliance of Health Care Unions.

In 2023 and 2024, they saved nearly $230 million through affordability initiatives. Of this, $43.7 million came from Southern California unit-based team projects, including the Woodland Hills project.

Patty Rivas, a UFCW Local 770 member and pharmacy assistant in Woodland Hills, is impressed by her team's efficiency.

“Once we started adding up the numbers,” she says, “we were amazed to see how much we were saving.”

Frontline workers see technology as important to their work. But they vary widely in their views on how easy it is to use tech at work.

What can help workers feel more at ease with tech? Unit-based teams.

"Of surveyed employees, 82% saw the importance of technology enabling work in their unit. At the same time, 52% saw this as difficult to do. Those involved in UBTs were more positive on the importance of technology and saw lower difficulty in implementing new technology," says Spencer Lewis, a Brandeis University doctoral student.

Lewis analyzed results of the most recent survey commissioned by Kaiser Permanente and the Alliance of Health Care Unions. The survey asked workers how they perceive technology, the Labor Management Partnership, and UBTs.

Here are 4 key findings:

1. The greater an employee's UBT involvement, the more effective they perceived workplace tech to be.

2. Frontline workers interested but not yet involved in UBTs were among the most optimistic about tech's importance, effectiveness, and ease of implementation.

3. Employees without LMP training are more pessimistic about tech.

4. Employees uninvolved and uninterested in UBTs are the most pessimistic about tech's importance, effectiveness, and ability to be implemented.

Learn more about UBTs.

Related: Teams Tackle Technology One Byte at a Time