Chapter 14 Managing with Organized Labor Learning Objectives

Chapter 14 Managing with Organized Labor

Learning Objectives � 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

Introduction � 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

Overview of Unionization � Union membership is declining � Public vs. Private Sector � Healthcare workforce

The Labor Relations Process � National � Outlines the labor relations process and is legally binding � Key ◦ ◦ Labor Relations Act Participants Management Union Officials The Government Arbitrators

The Labor Relations Process(cont. ) � 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

Negotiation Phase � The process of negotiating is called “Collective Bargaining” � The NLRA requires negotiation to occur in Good Faith � Types of Bargaining: ◦ Concessionary ◦ Integrative ◦ Distributive

Administration 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.

A Review of Legislative and Judicial Rulings � 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

Developments in Organized Healthcare Workers � Unions � Physicians � House Staff (Medical Residents, Interns and Fellows) and Medical Students � Nurses � The Impact of the Internet

Management Guidelines � 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.