Staffing shortages – worsened by pandemic-related burnout and an aging workforce – are among the health care industry's most pressing challenges.

But Kaiser Permanente has an edge over the competition: the Labor Management Partnership, which provides leaders, managers, and union members with the tools, support, and long-lasting relationships to respond to challenges creatively.

The Partnership – an operational strategy shared by Kaiser Permanente and 2 union federations – is helping the organization address staffing challenges on several fronts.

Recent progress includes work with the Coalition of Kaiser Permanente Unions to implement a joint staffing process and accelerate hiring to fill thousands of vacancies through 2024; and a venture with the Alliance of Health Care Unions to design a training program to overcome a shortage of wound-care nurses.

Now, management and labor are boosting another central staffing effort: all-day hiring events that can attract hundreds of job candidates. Often, applicants come away with a job offer in hand.

 "The Partnership is essential to our success," says Abbot Kohler, senior director, Pipeline and Operational Excellence for the Northwest Region, where Partnership union members participate in planning and conducting hiring events. "By bringing labor into the mix, our applicants get a more complete view of the many advantages of working for KP."

'Tailor-made for partnership'

Staffing challenges remain for Kaiser Permanente and the health care industry at large. While KP has taken aggressive action to hire and fill vacancies – and things are starting to improve – staffing continues to be a top priority for management and labor. The hiring events, supported by KP and the Partnership unions, are a step in the right direction.

The events focus on addressing hard-to-fill vacancies for 2 or 3 open positions based on a facility or service area's greatest need. KP works with the Indeed job listings website to advertise events, connect with candidates and schedule interviews.

Enterprisewide, at least 30 hiring events took place in 2023, drawing more than 5,000 applicants and helping KP hire more than 1,200 new employees in 5 regions. Alliance and Coalition union members are actively involved in these hiring efforts. In the Northwest Region, they participated in 9 events that resulted in 149 new hires last year.

"The staffing issue is tailor-made for partnership," says Joshua Holt, RN, a board member with the Oregon Federation of Nurses and Health Professionals. "Involving labor in the hiring process helps to identify new members of the team who will provide the high standard of care that this organization requires."

Event organizers say a central draw for candidates are the unions and their commitment to the Partnership, which empowers frontline workers to collaborate with managers and physicians in decisions to improve care, service, and quality of work life.

"They see it as being able to have a voice and not getting in trouble for speaking your mind," says Olivia Devers, a certified nursing assistant at Kaiser Permanente Sunnyside Medical Center near Portland and a senior labor partner with SEIU Local 49. She served on panels interviewing certified nursing assistant candidates at 2 events last year.

More hiring events in 2024

Partnership union members have been pivotal in driving attendance. A social media campaign led by UNAC/UHCP nurses at South Bay Medical Center in Southern California proved effective in promoting an event last May focused on filling select positions, including tele-health nurses.

Nearly 300 job candidates turned out, with interview panels meeting with applicants late into the day.

"Nurses know other nurses. We've worked together in the past, or we're friends from nursing school," says Cathy Tu, RN, a contract specialist with UNAC/UHCP who promoted the event on Instagram. "When we put out the word, we hit that target audience."

As hiring events continue in 2024, the involvement of frontline union members will remain paramount to their success.

The Coalition, for instance, has committed to taking part in at least 10 hiring events in 6 regions as part of its 2023 national agreement with Kaiser Permanente.

"Anytime you've got a diverse team with different perspectives coming together with a single goal in mind, you come out with a great result," says Shannon Surber, executive director for staffing systems and strategy in the Northwest Region.

If one word inspires dread in the Optical Lab Surface department, it is “swirl.”

The Northwest team helps make eyeglasses for Kaiser Permanente members. Their work is sometimes complicated by swirls – circular scratches on the lenses that can occur during the production process.

In 2022, the team - based at Kaiser Permanente Sunnyside Medical Center outside Portland - grappled with a mysterious increase of swirls.

“Normally, we will get about one swirl per day that we can’t polish out,” says Rodney Edwards, department supervisor and the team’s management co-lead. “But suddenly we were seeing 12 or 13 per day. We knew we were dealing with something very strange.”

When extra polishing can't remove a swirl, the team must fashion a new set of lenses. This raises costs and slows production, delaying delivery of eyeglasses to KP members.

By conducting a painstaking review of its processes, the team uncovered the cause of the swirl surge and improved care and service.  

When everyone participates in performance improvement, the better the results and the stronger the work environment. Collaborating on performance improvement also advances a culture at KP in which continuous learning and improvement come naturally.

From technicians to sleuths

Finding the source of the swirls was not easy. The Level 4 team prepares about 700 eyeglass lenses each day.

“It’s tough for us to troubleshoot these things," says Dustin Rushing, an optical lab technician and OFNHP Local 5017 member, who is the team's labor co-lead. "We’re operating at such a high volume we can’t really stop the presses."

To identify the problem, the team performed multiple tests of change.

Team members analyzed vats of liquid lens polish. They improvised new polish filtration devices. They scrutinized surfacing procedures and the calibrations of each piece of machinery. The tests and tweaks occurred while the team tried to keep up with high demand for eyeglasses.

Weeks of testing uncovered the problem: wear and tear on machinery was leaving metal shavings in liquid used to polish new lenses. The solution? Modifying worker procedures and intensifying maintenance and replacement of machine parts.

As a result, the team saw a 94% reduction in swirls during the first 4 months of 2023. That success continues. The team reduced monthly costs to replace damaged lenses, from $525 to $31, for a projected annual savings of $6,000.

While the cost savings may seem small, it illustrates the impact of unit-based teams. Enterprisewide, more than 3,600 teams contribute to KP’s national leadership in measures of affordability, quality, service, and care.

The project earned the optical lab team a UBT Excellence Award from regional leaders.

“The biggest reason for this project’s success was the openness and communication between us all,” Edwards says. “That really opened up some doors for us as a team.”