“Everyone must put on their leadership hat. It doesn’t relate to title or overall responsibility —  it’s what you control and influence from where you stand,” said Ronald Copeland, MD, senior vice president and chief equity, inclusion and diversity officer, at the National Equity, Inclusion, and Diversity Virtual Conference Series in October.

The Labor Management Partnership is designed to foster leaders at every level, to encourage everyone to use their voice and add their ideas to solving the challenges at hand. As our nation and our organization seek new ways to advance equity and diversity — including equity in health care — doing the right thing has never been more important.

“Action matters more than passion, and impact matters more than intent,” Dr. Copeland said. “It’s great to say, ‘I want everybody to achieve equity and inclusion,’ but we have to do the actions that make that occur.”

See equity in action in this issue of Hank with inspiring actions taken by 4 unit-based teams from across the organization. Together, their commitment to achieving equitable outcomes in maternal-child health, and in treating diabetes and high blood pressure, is reshaping what culturally sensitive care looks like for thousands of our members and patients.

This past year has been filled with pain and loss, from COVID-19 to the killing of George Floyd. These crises have been immense and intense.

But thanks to the tireless efforts of our entire workforce, we at Kaiser Permanente have responded to meet the moment of today’s historic challenges.

This issue looks at how our Labor Management Partnership has addressed systemic racism amid the pandemic, advancing equity in care and in the workplace.

Kaiser Permanente and the Partnership unions believe in equity and inclusion for all, and are committed to delivering affordable, high-quality care and service. As we move along on our journey to equity for all, we’re highlighting examples of this work across our Partnership.

Our cover story focuses on unit-based teams working to minimize health care disparities for the most vulnerable among us, from improving maternal-child health to treating diabetes and high blood pressure. You’ll also find resources to foster workforce and health equity.

Read about teams cultivating an inclusive workplace. See how physicians play a key role in partnership, and how our education and training resources are expanding opportunities for employees to advance their careers.

Try our puzzles and games to explore elements of equity. View our SuperScrubs comic for a thought-provoking take on the topic. And don’t miss our back cover for an inspirational quote from our chairman and CEO, Greg A. Adams.

Let’s build on these examples and commit to actions we can take to advance equity and partnership. Kaiser Permanente, and the members and communities we serve, will be better for it. 

Joy in work might seem like an idea that’s superficial or unattainable — especially in a pandemic. But in times like these, it’s more important than ever.

Joy in work is about being connected with what you do and why you do it. It’s the feeling of success and fulfillment that comes from doing work that matters. It connects us with colleagues and patients through a sense of shared purpose.

Joy in work is practical and science-based, according to the Institute for Healthcare Improvement, which has taken the lead in researching the subject. Joy in work produces tangible results: Studies link it to reduced turnover, higher productivity, and improved patient experience, outcomes and safety.

It doesn’t turn every workday into a breeze. There still will be fatigue, long hours and tough days.

But cultivating joy in work creates the deep engagement that helps keep stress from turning into burnout — which was a serious issue in U.S. health care even before COVID-19 arrived on the scene.

For everyone’s benefit, let’s nurture it at Kaiser Permanente.

What brings you joy in work? Use the stories, tips and tools on these pages to explore that question — on your own and with your team. Work together to create joy in work.

What does it mean to work in partnership?

It’s a joint commitment to collaborate, enshrined in the Labor Management Partnership’s national agreements.

It’s employees, managers, physicians and dentists building on common interests to make decisions and solve problems.

It’s Kaiser Permanente and the Partnership unions finding creative, mutually beneficial solutions that result in improved care, service and affordability.

There's never been a better time than right now to shine a fresh spotlight on the basics — the team-tested tools and practices fundamental to a strong partnership, such as the Rapid Improvement Model, consensus decision making and interest-based problem solving.

Whether you’re new to partnership or well-versed in its ways, use these performance improvement tools to identify issues, test changes, solve problems, make decisions, deliver better care and service, and enhance your work life.

LMP tools are designed to help you work together when things are going well — and bridge differences when the going gets tough. This approach addresses the needs of union members and helps the organization improve performance — which ultimately benefits Kaiser Permanente’s patients, members and communities.

Welcome to e-Hank! The national Labor Management Partnership communications team is pleased to serve you in this new format, and we’re grateful to those of you who’ve reached out and said you miss the print editions of Hank. But until the crisis of the COVID-19 pandemic subsides, an electronic communication seems best.

This issue looks at how our Partnership — which now includes 2 union federations, with separate National Agreements — helped Kaiser Permanente meet the extraordinary challenges that a worldwide pandemic brought to our doors. We’ve never been tested like this before. And how we’ve responded in the last several months provides a look at how we will respond and grow and adapt to future challenges. The dialogue and collaboration that have been taking place during the pandemic are a model for the future.

In this e-edition of Hank, we’re also introducing 2 concepts we think will help strengthen the culture of partnership throughout the enterprise.

The first is a renewed focus on The Basics — tips, tools and stories that will help you understand the core philosophy of the Labor Management Partnership and what it means to work in partnership. New to the Partnership? These materials will help show why Kaiser Permanente and the Partnership unions that belong to the Alliance of Health Care Unions or the Coalition of Kaiser Permanente Unions are committed to it as an operating strategy. Been around for a while? Dive in and refresh your knowledge of the principles and processes that make our Partnership a success.

The second is a new focus on Joy in Work, a concept pioneered by the Institute of Healthcare Improvement. By Joy in Work, we don’t mean smiley faces or i’s that are dotted with hearts. We hope our Joy in Work stories and tools will help you connect with your deeper, personal motivations for working in the  demanding health care field. The stats show that people who feel this sort of connection — this fundamental Joy in Work — are less likely to suffer from depression and burnout.

Lastly, don’t miss the back cover, which provides a quick refresh on a core principle that helps our Labor Management Partnership thrive: Free to Speak. It’s a reminder that your voice matters. Thank you for reading this and for all your hard work. Together, there is strength in partnership.

In 1997, the Labor Management Partnership turned strife between Kaiser Permanente and its unions into strength.

That strength is coming to the forefront again today. Decades of working in partnership are helping the organization respond to the COVID-19 pandemic, move forward together and provide a model for the health care industry.

With interest-based problem solving, a Free to Speak culture and performance improvement through unit-based teams, the Partnership has built a foundation that’s given leaders, managers and union members tools and relationships to collaboratively address this crisis.

Acting fast

Some of the response took place at the highest levels. Over a weekend, Kaiser Permanente and union leaders reached an agreement to temporarily enhance benefits for physicians and frontline employees.

“I’ve never negotiated anything as fast,” says Dennis Dabney, senior vice president of National Labor Relations and the Office of Labor Management Partnership.

Throughout the crisis, union leaders joined twice-weekly calls with top Kaiser Permanente leaders and played a central role with command centers and surge planning.

The key to making faster decisions was directly involving labor in operations meetings, says Hal Ruddick, executive director for the Alliance of Health Care Unions.

Having a voice

Partnership laid the groundwork for a nimble response in other ways, too. When COVID-19 hit, most vision appointments were canceled.

In Northern California, IFPTE/ESC Local 20 negotiated with management to have optometrists work in different roles. More than 120 optometrists volunteered to staff the COVID-19 test results call-in line.

“We showed our willingness to do alternative work — work that would be meaningful and keep our union members safe,” says optometrist John Corpus, a member of the local union’s optometry unit board.

Having a voice on the job equipped members to negotiate that deal, which included training, laptops and greater flexibility to work remotely.

“If our teams remain safe, are listened to and feel respected in the changes, they can live with the changes during this time,” Corpus says.

Improving workflows

At Beaverton Medical Office in Oregon, after COVID-19 testing began, managers saw that patients often needed multiple services. A new workflow was required — and the Nurse Treatment Room team’s registered nurses and medical assistants rose to the challenge.

“Everyone began sharing ideas and brainstorming possible solutions,” says nurse manager Cyndy Gillis. “The team formulated a plan that respected scope of practice, safety for the staff and patients, and a streamlined workflow that continues to adjust to new challenges.”

“It was the epitome of collaboration,” says team member Kellie Butchino, a certified medical assistant and SEIU Local 49 member.

Fighting together

One of the most vexing problems during the pandemic has been getting caregivers the personal protective equipment they need to safely care for patients. Working in partnership has helped.

“It’s not perfect,” says UNAC/UHCP member Andrew Calderon, a physician assistant at South Bay Medical Center in Southern California.

“But labor and management were there updating staff regularly and fighting to get us the materials we needed.

“We are able to provide the best care for our members because of partnership.”

Looking forward

Such collaboration across the enterprise will help Kaiser Permanente navigate the future — and inspire others, too.

In May, LMP leaders shared their pandemic experiences during a Labor and Employment Relations Association webinar, drawing praise from members of a 4-year-old labor- management partnership in Massachusetts.

“We are trying to proceed on the premise that there is no business case for adversarial labor relations,” says Bart Metzger, chief human resources officer for UMass Memorial Health Care. Partnership is “the only way we can push organizations such as ours forward.”

Partnership is an effective strategy for labor and management, Ruddick says.

“It’s harder, but it’s worth it because the results that you get are better.”

After government stay-at-home orders derailed their plans for a patient support group, members of Kaiser Permanente’s Marlow Heights Behavioral Health team in Maryland set up a video chat for vulnerable individuals sheltering in place.

“With the COVID-19 pandemic, we had to be open and receptive to connecting with our members in a different way,” says Dawn Anderson, a psychotherapist with UFCW Local 400 and union co-lead for the Level 4 unit-based team. “This way we’re still supporting patients with serious health issues.”

Propelled by the global pandemic, Behavioral Health teams across the Mid-Atlantic States are using partnership principles and tools to transform how and where patients seek care — resulting in changes likely to outlast the crisis.

Connecting with patients

Therapists are working from home and counseling patients via telephone and video. Unit-based team members are meeting virtually, too, using collaborative digital tools to identify challenges and solutions.

They’re also using such tried-and-true performance improvement tools as the Rapid Improvement Model to reveal the best ways to connect with patients by telephone and video.

“Sometimes I will connect with patients on video, then after 5 minutes something will cause a disruption and I’ll have to ask if we can connect via telephone,” says Anderson. “We are still adapting to telehealth technology.”

Adapting quickly

The rapid-fire changes haven’t been easy for team members, who are conducting assessments with patients by phone instead of in person because of social distancing requirements.

“We’ve done things in this pandemic season that we normally would not have done,” says Reuben Steele, Behavioral Health operations manager and management co-lead. “That has caused some initial anxiety but, ultimately, the team has been able to adapt and adjust quickly.”

Being heard

Team members agree having a voice in decisions about ways to deliver care is helping them cope with change. A key feature of the Labor Management Partnership is involving frontline workers and union leaders in decision making.

“The LMP is a great way to think outside of the box and figure out what we can do to meet people’s needs,” says Lindsey McDaniel, a psychotherapist, UFCW Local 400 member and labor co-lead for the Silver Spring Behavioral Health team, a Level 4 UBT in Maryland.

Anderson agrees.

“We’re able to ‘check egos at the door’ and come forth with ideas and suggestions. That’s what I love about the UBT setting,” she says. “Our UBT consultant and manager support us and are open to feedback on team projects and goals. This is the forum where I feel my colleagues and I are being heard.”

Even during a pandemic, it’s important to keep learning.

When Kaiser Permanente storekeeper Vincent Woodard heard about skills days in May at Oakland Medical Center, he signed up.

“You’ve got to keep up with the times,” says Woodard, an SEIU-UHW member who orders and delivers supplies for doctors and nurses. “I’m always wanting to learn more. The more I know, the more I can teach and share.”

Kaiser Permanente encourages lifelong learning. With COVID-19 reshaping health care from the emergence of new roles to increased virtual care, the 2 Labor Management Partnership-supported education trusts are tailoring trainings to help employees adapt by building career resilience and digital skills.

Partnership Supports Upskilling

Northern California’s Workforce Planning and Development Committee was planning skills days when COVID-19 hit. The committee wanted to proceed. The administration agreed. In 2 weeks, labor and management organized skills days with the SEIU UHW-West & Joint Employer Education Fund.

“It’s a trying time with workflows changing to adapt to COVID-19,” says committee labor co-chair Sonya Allen-Smith, an SEIU-UHW contract specialist. “You have to stay skilled up because the work world is constantly changing.”

More than 80 employees participated in 2 Oakland sessions. Housekeepers, medical assistants and radiology techs met in a large conference room, wearing masks and keeping social distance, learning in person and virtually about communication, leadership and emotional intelligence.

Woodard, a 7-year Kaiser Permanente employee and longtime youth basketball coach, related to lessons about teamwork, bringing positive energy and managing frustrations.

“I’m definitely going to use this,” Woodard says. “You’re not always going to get your way. You’ve got to know when to walk away. Hold yourself accountable.”

Northern California is looking to expand skills days. Other regions also are exploring virtual skills days.

“This training is good for labor and management,” says Janis Cruz, support services administrator for the East Bay. “It helps develop soft skills to navigate uncertainty and ignite interest in continued learning.”

Building career resilience

To help adjust to changes, Kaiser Permanente and the education trusts offer online critical skills courses in collaboration, consumer focus, digital fluency and performance improvement.

In May, the Ben Hudnall Memorial Trust launched the Career Resilience Quest, an online course that explores the characteristics of resilience — the ability to adjust to workplace change as it happens.

“We’re experiencing drastic change,” says Ben Hudnall career counseling project manager David Rosenberg. “Developing resilience in general, and career resilience specifically, really helps to respond constructively.

“Career resilience characteristics are like muscles. We need to exercise those muscles, so they’re strong.”

Pharmacy assistant Sergio Romero, a UFCW Local 324 member in Southern California, knows the power of resilience. A few years ago, his mother and roommate died months apart.

He reflected on his career, worked with Ben Hudnall career counselor Jan Cummings, completed a certification program and then began the resilience course.

“With this pandemic, there’s a lot of hopelessness,” Romero says. “The resilience quest boosted me back up. It kept me going.”