Though total union membership in the United States held steady last year and membership of public sector employees declined, unions saw major growth in private sector industries like construction, food service — and healthcare.
"Labor unions continue to increase their influence in the healthcare industry," James Trivisonno, president of IRI Consultants, wrote in a recent report. He also sees two major movements happening in big labor that will likely have an impact on hospitals and health systems. Here, he explains the movements and shares what hospitals can — and should — do to prepare for their impact.
National Labor Relations Board activities
The NLRB has been very active of late, according to Mr. Trivisonno. For instance, in February, the NLRB announced proposed changes to representation case election rules. Essentially, it would reduce the timeframe from 42 days to 10 to 21 days between when a petition is filed and when an election is held, Mr. Trivisonno explains. This would limit the campaign period, during which the employer can communicate with staff about the implications and consequences of unionization.
"It's easier to unionize with a quicker election," he says, so the key for hospital leaders is to be prepared for a campaign prior to even a petition being filed. Mr. Trivisonno shares the following six components hospital leaders should follow to prepare for a possible 10-day campaign.
1. Have a written plan for the compressed timeline.
2. Educate the staff. Everyone from the board of directors down to managers should know enough about labor unions to have a conversation about unionization, Mr. Trivisonno says. It is especially helpful for managers to have an "elevator speech" about the organization's position on unionization memorized and ready.
"It's really important that from the day an employee starts, at orientation, that they understand your position," he says. "[Hospitals likely] have a rational position and [managers] shouldn't be afraid to talk about it."
3. Perform a vulnerability assessment. Hospital leaders should assess their organization's level of vulnerability on an ongoing basis, especially given the changes many organizations are currently undergoing.
4. Communicate regularly. First, leaders need to understand what channels of communication people use, including electronic and social media channels, which Mr. Trivisonno says healthcare employers have been "reluctant to embrace." Then, leaders should pan to communicate openly and honestly not only about unions, but also about any changes happening within the organization.
5. Provide leadership development opportunities. Teaching managers how to better perform in their role can "pay big dividends," even beyond union avoidance, Mr. Trivisonno says. "It boils down to good management. If you treat employees well and pay them well," they're less likely to seek representation from a union, he explains.
6. Keep employees engaged. "If you involve employees in decisions that affect their jobs and people see their managers and supervisors as advocates, unions will have a difficult time," Mr. Trivisonno says.
Unions applying pressure through corporate campaigns
There is a growing trend in which healthcare unions are using corporate, or public relations, campaigns to put pressure on hospital and health system officials. "I think it's a shrewd move on behalf of unions," Mr. Trivisonno says.
For example, the SEIU-United Healthcare Workers West in California started a campaign to put two propositions on an upcoming ballot that would limit hospital executive pay and make it so hospitals could not charge more than 25 percent of actual costs. The two sides ended up coming to an agreement so the ballot initiatives would not be filed.
Mr. Trivisonno gives the following advice to hospital leaders to prepare for union corporate campaigns:
• Look at the organization objectively. "Examine the points of vulnerability from a union's perspective," he says. Some sensitive areas to keep an eye on include charity care, billing practices and executive compensation.
• Be prepared. In today's lightening-fast news cycle, reporters want responses back sometimes in minutes instead of hours. "If you don't get something back within half an hour, [the story] is likely on the internet already" without the hospital's or health system's point of view, Mr. Trivisonno says. For that reason, being prepared is of upmost importance.