In the May 2008 hardcopy and online editions of Health Leaders, I’m quoted in Corey Christman’s article “From Collaboration Comes Motivation–Motivating your unionized work force to achieve a top level of performance must be a joint effort between labor and management.” The full article is below. Thanks Corey!

Department Focus: Human Resources–From Collaboration Comes Motivation

Motivating your unionized work force to achieve a top level of performance must be a joint effort between labor and management.

Motivating unionized frontline staff can be like pushing the proverbial boulder up a mountain for hospital leadership. But it doesn’t have to be that way if executives and union representatives both put their shoulders to the stone.

At the University of Miami Hospital, local union representatives and hospital leaders are taking a collaborative approach to motivating union members with a joint training program designed to unify the entire work force and improve both quality of care and patient satisfaction.

Hospital leadership traditionally had communicated performance expectations to various groups of staff members individually—with questionable results, says Errol Douglas, human resources director at the 312-staffed-bed hospital. “Now we’re going to approach it very differently. We’re going to do joint training with the union shop stewards and the department directors,” Douglas says. “That’s never happened here before. So we’re going to be in the room together, airing a common message: It’s a new day. Let’s work together.”

The union leadership and the hospital’s CEO will collaborate to decide which processes will motivate performance throughout the hospital—not just union or nonunion workers specifically. The overarching goal is to create best practices across all areas of the hospital while increasing employee satisfaction. The union representative and hospital management will then work together to help staff meet the standards.

The road to this partnership wasn’t always smooth, says Douglas, who arrived at Miami a few years ago when tensions between the hospital and union were running high. Through daily meetings with the union agent, Douglas learned about employee issues and the background of the relationship between the hospital and the union.

Douglas eventually reassured the union representative of his philosophy of transparency. “They have the right to confront and address issues because they represent some of our employees. This is a peer with whom I have to deal, so this peer has unlimited access to me,” says Douglas. “Many times they are the eyes and ears to some issues that we do need to fix.”

In any situation where unionized employees are asked to change the nature of their work, hospital leaders should involve the union ahead of time, says Charles Krugel, a labor, employment law and human resources attorney based in Chicago. Otherwise you’ll spend time, effort and—most important—money initiating a program that will get caught in the union’s grievance and resolution process and go to waste. “As management, you don’t want egg on your face,” says Krugel.

By being open about why a motivation program needs to happen—and by reaching out to the union for involvement and input—employee buy-in is easier to secure, says Krugel. But hospital leaders should enter a project with time for changes to be made and provide a detailed explanation of their plans to increase performance, he adds. This will assure the union that the hospital is serious about the endeavor.

Many hospitals in New York have also found that collaboration between union and management yields the best results. In 2007, a partnership between the 1199 SEIU United Healthcare Workers East and 28 hospitals resulted in a campaign to educate and motivate frontline workers to take a bigger part in infection prevention through better hand hygiene, flu shots for employees, and environmental improvements. The program, created by the union and hospital management, was funded through a grant from the New York State Department of Health.

“We educate our members about improving quality because it’s personal,” says Maria Castaneda, secretary-treasurer for SEIU’s New York chapter. Many of the employees live in the cities and communities of the hospitals, and the union motivates employees to improve by reinforcing the fact that the initiative is for them and those they care about.

It’s on this daily level and through engaging the frontline staff more deeply in patient care that an organization will see returns on improved performance, says Krugel. “If you do something that helps employees be involved in something larger than themselves, you’re going to get more buy-in, and they will feel happier and perform better.”

—Corey Christman