Chapter 14Managing with Organized Labor

Address the relationship of organized labor and management in healthcare

Distinguish the different phases of the labor relations process

Describe the evolving role of unions in the healthcare workforce

Examine legislative and judicial rulings that affect management of organized labor in healthcare settings

Review emerging healthcare labor trends Consider the potential impact of the Internet on

the labor management relationship

Learning Objectives

Labor relation process occurs when management and the union JOINTLY determine and administer the rules of the workplace.

This is especially important for health care because labor costs account for 70% - 80% of expenditures.

Just because a union has won the right to represent the employees does not mean management must accept all of the terms.

Introduction

Ranges of Labor Management Relationship in Healthcare:

◦Positive

◦Neutral

◦Negative

Introduction

Union membership is declining Public vs. Private Sector Healthcare workforce

Overview of Unionization

National Labor Relations Act Outlines the labor relations process and is legally binding

Key Participants◦ Management◦ Union Officials◦ The Government◦ Arbitrators

The Labor Relations Process

Recognition Phase◦ This is Unions attempt to be recognized as

representing the employees Often Management will attempt to prevent the Unions

from being able to recognize the employees Many of these tactics can be considered unfair labor

practices.

3 Reasons Employees want to Form and Union:◦ Wages◦ Benefits◦ Perception about the workplace

The Labor Relations Process(cont.)

Warning Indicators for potential Union Organizing◦ Increased Turnover◦ Increased Employee Generated Incidents◦ Increased Grievances◦ Decreased Communication◦ Increase in informational requests (IE: policy and

procedures)◦ Increase in employees meeting off-site◦ Increase in Grapevine activity◦ Increase in Absenteeism and Tardiness

The Labor Relations Process(cont.)

Process◦ Union will solicit signed authorizations

◦ When at least 30% of the employees have agreed to be represented then the Union can ask the company to voluntarily recognize them

The company rarely agrees to this (less than 2%) When refused the Union is now allowed to seek NLRB

assistance to petition other employees

The Labor Relations Process(cont.)

Bargaining Units◦ The NLRB determines who can be represented by

a Union These “groups” are called Bargaining Units The NLRB doe not all managers or supervisors to be

part of a Bargaining Unit

The Labor Relations Process(cont.)

Elections◦ The Union is permitted to conduct pre-election

campaign◦ Management may not make threats regarding the

outcome of the election◦ Management is allowed to conduct their own

meeting with employees to tell them what changes will occur if a Union with the election

To win the Union needs a simple majority

The Labor Relations Process(cont.)

The process of negotiating is called “Collective Bargaining”

The NLRA requires negotiation to occur in Good Faith

Types of Bargaining: ◦ Concessionary◦ Integrative◦ Distributive

Negotiation Phase

Agreements of the negotiation must be applied and enforced

Management may discipline employees and must base all procedures on due process◦ Arbitrators will usually side with Management is progressive

discipline was used

Grievance Procedures This is a useful tool to manage the terms of the agreement

Arbitration◦ Unresolved issues are sent to arbitration◦ Arbitration is typically limited the terms of the agreement and

the application of those terms.

Administration Phase

Important Cases◦ NLRB v. Kentucky River Community Care, Inc.

◦ NLRB Ruling: Oakwood Heritage Hospital, Taylor, Michigan

Important Legislation ◦ The Taft-Hartley Act◦ 1974 Healthcare Amendments to the Taft-Hartley

Act

A Review of Legislative and Judicial Rulings

Unions Physicians House Staff (Medical Residents, Interns and

Fellows) and Medical Students Nurses The Impact of the Internet

Developments in Organized Healthcare Workers

Create a policy on Unionization Must have policies and procedures that

ensure a proper fit of personnel with specific jobs

Provide necessary training for implementing policy and procedures

Implement consistent disciplinary actions Each phase of the labor relations process in

interrelated.

Management Guidelines