Friday, October 30, 2015

Five-Tidbit Frightday: October 30, 2015

Happy Halloween! And, too, happy Respiratory Care Week!


Halloween candy is bad for you. Vegetables, on the other hand, are good for you. Beyond these generally accepted facts, there’s a lot of conflicting dietary information out there. This week, the World Health Organization released a report saying definitively that processed meats cause cancer, and that, probably, red meat does, too. Related reports argue that you don’t need to give up those meats altogether. Fortunately, when you’re trying to figure out how to make sense of the varying and contradictory information, the Harvard School of Public Health offers this guide to deciphering media stories about diet.


You know those stories about random, unsuspecting trick-or-treaters being poisoned (or worse) by tainted Halloween goodies? They’re all urban legends, every single one. Or so contends Dr. Joel Best, the world's leading expert on Halloween hostility, in this podcast.  


Need ideas for getting creative to make your kids visible to car traffic? Also, if you plan to offer candies that are free of allergens and cross-contamination, don’t forget to review this year’s list of allergen-friendly candies, especially if you’re participating in the Teal-Pumpkin Project.


This irreverent video guide to trading Halloween candy sums up the Halloween barter system pretty nicely.


And, finally, after you’ve applied the “Mom and Dad Tax” to the kids’ candy stash, and they’re tucked away in bed, you can consult this infographic for pairing candy and wine. (There are still a few studies that hold to the idea that the resveratrol in wine might be good for you, after all.)

See you here next Friday! Hope you have a great weekend.

Thursday, October 29, 2015

Recognizing Respiratory Therapists

Did you know that over one hundred SHARE members work as certified Respiratory Therapists? They are specialists in lungs and hearts and emergency care. They often manage life support for patients in the ED and ICU. They keep countless airways clear, and for that, we're very thankful.
This year, October 25-31 marks National Respiratory Care Week, an annual event that recognizes the respiratory care profession and promotes awareness of lung health issues and practices. Hats off to our own Respiratory Therapists!
SHARE Respiratory Therapists on the Memorial Campus

SHARE Respiratory Therapists on the University Campus

Friday, October 23, 2015

Five-Tidbit Friday: October 23, 2015

. . .  during the coming week
  • University Campus – October 27 (Tuesday)
  • Worcester Business Center – October 28 (Wednesday)
  • Memorial Campus – October 29 (Thursday)

Do you have out-of-towners coming for a visit? Check out Massachusetts InstaFoliage for streaming foliage footage.


SHARE members, like many hospital employees, tend to be savvier about healthcare than most people. Still, if you’re considering changing health care plans this year, and would like to make sure you’re covering your bases before arriving at the benefits fair with your specific questions, here’s some useful online advice.
In this article, Consumer Reports directs people to begin by focusing on three big questions:
  • What does the plan cover?
  • How much does the plan cost? (for SHARE members, the plan costs are roughly the same, with the exception of the PPO plan, which costs more.)
  • Which doctors and hospitals are in the plan?
Nerdwallet provides a sensible and more detailed process for evaluating options.


Among other things, American Unions can rightly claim credit for the weekend and the eight-hour workday. This piece in Forbes magazine makes an argument that we should push for more. (Or less, depending on how you look at it.)


October is Medical Ultrasound Awareness Month. SHARE is happy to recognize our Ultrasound Technologists.

See you here next Friday! Hope you have a great weekend.

Thursday, October 22, 2015

2016 Contract Negotiations: Where We’ve Been, One Big Problem, and the Year Ahead

When UMass and then Memorial employees voted to form the SHARE union, the main goal was participation. People wanted a say in decisions that affect them at work.

With a merger, and with healthcare changing rapidly all around us since, there have been many decisions being made that affect SHARE members. As a new union and in the 18 years since those votes, we’ve checked off most of “the biggies” from our list:
  •  SHARE members wanted to make raises predictable, with raises every year, and a salary system that was fair, transparent, and moved people up to grade max over time.
  • SHARE members wanted to hold onto the benefits they had, in spite of the merger, especially:
    • Health insurance, keeping the 85%/15% premium split the state workers had had.
    • A defined benefit pension.
  • SHARE members wanted to land safely in new jobs when there were layoffs, especially in the highly uncertain times of the early merger. And we wanted to feel that seniority was valued equally no matter which campus you came from. 
  • SHARE members from Memorial and UMass wanted to have the same policies across campuses, without going to the lowest-common-denominators among those policies. And we wanted to continually improve on these policies.
We all know that there’s plenty more we can do to improve even further on those goals. Still, our achievements have been significant and hard-won. Congratulations to all of us for sticking together when our union has faced hard times and hard negotiations.

Changing How it Feels to Come to Work

While we have steadily, persistently ticked the goals off our list, there’s one important nut that we haven’t cracked: We really want to change how it feels to come to work every day.
  • We want to save lives and improve patient health to the best of our ability.
  • We want patients’ experience -- from making an appointment to paying the bill – to go smoothly and give the patients what they need.
  • We want to have fun at work
  • We want to be able brag to our neighbors that we work at UMass Memorial, to have the respect of our peers and leaders, and to leave work consistently with our heads held high.
SHARE wants to focus on that problem -- how to re-imagine and improve our entire work culture -- in our next contract negotiations.

Many forces combine to cause our work to be stressful and frustrating:
  • Constant change, and financial pressure that leads to “doing more with less”
  • Work systems that are complicated and wasteful rather than clear and efficient
  • An old culture of “command and control,” and a “shame and blame” approach to problems that make positive teamwork tough to establish
Changing how it feels to come to work is not a simple goal. We have lots to figure out, and we may need to try several approaches before we figure out what works. 

We Need Your Ideas!

We hope that all SHARE members will take part in this conversation as we prepare to tackle this difficult set of problems. We are starting with a survey for all SHARE members to get your thoughts, questions, concerns, and ideas.

We will negotiate about raises and benefits too – so there will be a lot going on in this coming year. We will set up lunch-time SHARE information meetings across the hospital’s campuses in the new year. You can also contact your SHARE reps and organizers through the SHARE office any time.

And of course, we will post updates here on this blog. Stay tuned…

2016 SHARE Member Negotiations Survey

We need to hear your opinions! Your thoughts, your ideas, your experiences! Please take the 2016 SHARE Negotiations Survey:

This survey kicks off our thinking about the upcoming contract negotiations. In the past, our contract surveys have been very useful -- giving us concrete information to use in negotiations, and figuring out what areas need the most work. This survey focuses on your day-to-day work experience -- what works well and what needs to be improved. We are trying to figure out how to improve how it feels to come to work every day. For more about where we've come from as a union, and our next challenges, click here.

Our current contract expires on September 30, 2016.  We will start negotiations with UMass Memorial sometime in the spring. After we collect SHARE members' responses to the survey in the next few weeks, we will use the results to help set the priorities for negotiations. There will be plenty of time to talk about those priorities at lunch-time information meetings in the new year.

The survey takes about 10 minutes. Please fill it out, and encourage your co-workers to do the same!

Friday, October 16, 2015

Report from ThedaCare

As we prepare for SHARE’s contract negotations with UMass Memorial in 2016, we want to know what other hospitals are doing. We are looking for good ideas that could:

  • Make SHARE members’ work easier, 
  • Increase SHARE members’ “say” at work, and 
  • Improve how it feels to come to work every day.

I visited the ThedaCare hospitals in Wisconsin last week and it was quite inspiring. They believe in two main ideas:

  • Continuous Improvement: They say, “Improving the work is the work.”
  • Respect for People in everything they do.

[For another SHARE perspective on ThedaCare, see this previous blog post]

Their Friday morning "Team Report Out and Celebration" made a big impression on me. Every week, a few teams of front-line staff spend 3 or 4 full days to work on improving some process in their department. At the end of that week, in front of a couple of hundred people, the teams report on what they did. 

Last Friday there were 3 teams reporting out:

  • A PCA (ER Tech), a Respiratory Therapist, and an RN from the ED spent the week re-designing several patient rooms for higher acuity patients. By stocking more supplies in the room, staff now have to leave the room an average of twice per patient, instead of the average of 9 times they were going in and out to get supplies before the re-design. Clearly this is good for the staff and the patient. They improved respect for people, both staff and patients, further by setting up the room so that staff don’t have their back to the patient when looking at the computer, and by improving the room’s ergonomics to decrease staff injuries. 
I really like that front-line staff do the improvement work because they know their work best, and that they have time away from their regular duties for it.
  • RNs from the maternity units on two campuses worked together for the week to figure out why their number of CLABSIs (central line associated blood stream infections) were increasing. They figured out better processes (or “standard work” as they call it), and trained each other. They emphasized "respect for people" in respecting different levels of experience among the staff – with no blame – and giving people the tools and training they need to do their jobs. 
I love it: fix a bad process, don't shame and blame an employee.
  • The Root Cause Analysis (RCA) team re-designed their process to make it faster. These process improvement coaches (like the CITC coaches at UMass Memorial) are on-call for an adverse event. We heard the story of a patient having an assisted fall off an OR table. Right after it happened, a staff person was posted on either side of all OR tables to make sure it couldn’t happen again until they figured out what went wrong. The RCA team would arrive immediately to talk to people about what happened before everyone forgot. Then the RCA team leads a root cause analysis to change how the work is done to make sure that a fall like that can’t happen again.
They see a problem is an opportunity for improvement -- that's a positive outlook that I'd love to see more of at UMass Memorial.

Dr. Dickson leads trips to ThedaCare as an example of the direction he wants our hospitals to go. I agree – they have some very good ideas and it was impressive to see those ideas in action. 

As we collect experiences from other hospitals and other unions who are working to transform healthcare, I’m especially interested in the question: How do we there from here? More on that question to come...

Looking Back: An Earlier Trip to ThedaCare

“Three jumbo jets,” my co-worker, SHARE staff-organizer Will Erickson, said to me, just about a year ago. “That's how many people we kill every day in this country, despite having the supposed best healthcare system in the world.” It’s a rough quote of something that he had heard during his own trip to check out Thedacare. Now that SHARE staff-organizer Janet Wilder is just back from her visit to Appleton, I'm reminded of this conversation. I think it provides some useful context for Janet's more recent report. Here are some of Will's impressions:

KD: What is ThedaCare?

WE: ThedaCare is a mid-sized hospital system in northern Wisconsin. It's got about 5500 employees. So, it's half the size of our place, but spread out. The real reason Thedacare is interesting is because it went from being, you know, a decent hospital, and it became one of the first hospitals in the country -- in the early aughts, under the leadership of this guy John Toussaint -- to try to figure out why factories make so many fewer errors than hospitals . . . despite the fact that hospital staff are so extraordinarily well-trained.

KD: Factories?

WE: I think John Toussaint is an interesting guy. When he became CEO, he figured, you don't get to be CEO forever, so you need to pick one thing that you can work on. Basically he was to bring Lean into the hospital. He did it because he was so horrified by the degree of death and disability that our healthcare system creates. You know healthcare is the third leading cause of death in the country? You’ve got heart disease, then cancer, and then being a patient. Only so many of these are like “oopsie” medication errors. They’re system errors, times when the field of medicine knew what would have saved a person, but that thing didn’t get done.

KD: So ThedaCare’s reputation grew out of an idea that hospitals should stop allowing unnecessary deaths?

WE: Basically, yes. That's what he Toussaint kept saying over and over while we were there: three jumbo jets.  That's how many people we kill every day in this country, despite having the supposed best healthcare system in the world. That defect rate would not be tolerated in any other industry. So Toussaint figured, you don't get to work on everything--so my thing, the thing that I was gonna do--was figure out how to eliminate those kinds of errors. And we're gonna do that through our processes.

KD: Taking care of patients is different from making snowblowers. Why did they think that factory production methods would be appropriate in a hospital?

WE: Toussaint basically said, I went to my friend Don Berwick asked, ‘What other hospitals are doing this?’ And he said, ‘you could be the first one.’ So Toussaint spent some number of months touring around, looking at factories, trying to figure why their defect rates are so low. He got criticized for that. His response to that was, if only we treated patients as well as the guys down the road treat their lawnmowers, we would be saving a hundred thousand people every year in this country.

The long and short of it is that ThedaCare now, ten years later, is the safest, the cheapest, lowest-mortality hospital in the country. They are now able to see to treat twice as many patients.

KD: Don’t employees there worry they could put themselves out of a job if they’re too efficient?

Thedacare really really believes in -- they evangelize about -- their no layoff philosophy. They have a commonsensical view that the people are gonna be wary of of improving themselves out of a job, or their friends out of job.

KD: So how did they do what they did?

WE: They did all of that by focusing on three things. They're always trying to improve quality, lower cost, and engage staff. This is where John Toussaint really started to catch my attention. He said something like, You know, it's easy to work on one of those things. You can go through and make a particular system cheaper by slashing and burning, but your quality will go down, and your staff is going to be angry. Or you could, I suppose, go around and hand ice cream cones out to the staff to make them happier to work there. Maybe that would work for a little while. But the magical thing about healthcare is that as you improve quality, you lower cost. But you can't really improve quality without without engaging staff.

Your people are the same as our people. They’ve gotten into the profession for the right reasons, to come to work every day, wanting to do an awesome job, deliver great care. Shame on all of us hospital leaders for perpetuating the systems that prevent them from being able to do that, to live out their vocation. People come to work wanting to doing awesome job. They want to work in harmony with their team and their institution. They want to have meaningful work.

KD: That sounds like stuff that SHARE has been saying all along, explaining to hospital leaders that if they want to improve systems, that has to be done by the people who know the work best, the people who do it every day.  We’ve seen a lot of dud ideas from previous leaders of our hospital. They hire outside consultants, contract trainers who preach trendy customer service techniques, and fall in love with successful hospitals elsewhere, little of which has improved the work-life of SHARE members. What made you interested to go all the way to Wisconsin to check out ThedaCare firsthand?

WE: Partly, I went because I was accepting an invitation from Eric Dickson. He’s very interested in the model of healthcare that ThedaCare provides. I went with a few different VP’s and Directors from UMass Memorial. We were all scoping the place out. Going there, I knew that ThedaCare has front-line employees at the center of the decision-making, and I’m looking for any excuse to make that happen in our hospital.

Five-Tidbit Friday: October 16, 2015


During the period that SHARE and the hospital were negotiating the current contract, new-hires to SHARE positions were mistakenly credited with one year less credit than they should have been. After a too-long period working have the error corrected, those SHARE employees are finally getting their pay righted. Each one will receive a small raise to correct the miscalculation, plus all of the retro back to January 1, 2012.


Did you know that yesterday was Global Handwashing Day, “an opportunity to design, test, and replicate creative ways to encourage people to wash their hands with soap and water at critical times?” Did you know that one trillion germs can live in one gram of poop?


Today is National Mammography Day, and we’d like to appreciate SHARE members in the Mammography departments at UMass Memorial. You can learn more about breast cancer, and about how to create your own early detection program, through the National Breast Cancer Foundation.


One running theme on this blog has been about the concept of happiness: how we can make work more enjoyable, strategies for reducing stress, etc. In the interest of addressing the subject more thoroughly, here’s William Davies cautioning an audience to be wary of what he calls “the happiness agenda.”


SHARE members with student-loan debt are not alone in their uphill efforts to pay off schooling costs. If you’re currently considering further education, it can be hard to make sense of all of your options, but it will be worth your while to minimize the problem of debt by making informed borrowing decisions from the outset, including from your college’s advisors (or, for a free online alternative, check out

One of the most frustrating realities of the situation is that many debt-relief funds go unspent because those who need them don’t know how to find them. Many graduates don’t realize, for example, that some jobs could make them more likely to qualify for federal loan forgiveness than others, particularly community service jobs such as those in hospitals and schools.  Until college is free, we’ll keep reporting out information about education funds for SHARE members.

See you here next Friday! Don't forget to wash your hands. Hope you have a great weekend. 

Friday, October 9, 2015

Five-Tidbit Friday: October 9, 2015

FREE CLASSES Did you know you could take free online courses, many of them for credit, from other leading universities such as MIT, Harvard, BU, Columbia, Berkeley, and Berklee at

WATCH THIS In this video, Margaret Heffernan makes a compelling case for getting rid of the pecking order, ditching “the superchicken model,” and helping one another at work.

JANET SAYS HI This weekend, SHARE organizer Janet Wilder joins UMass Memorial system leaders in Appleton, Wisconsin to look under the hood at Thedacare, a hospital network that claims “employees [of Thedacare] created a hospital department from the ground up – not only changing how rooms were designed, but also how care is delivered at the bedside. Janet will have a full report when she gets back.

WORKPLACE DEMOCRACY Earlier this week, Senator Bernie Sanders introduced The Workplace Democracy Act, an amendment to the National Labor Relations Act designed to undo “Right-to-Work” laws and other barriers to unions. Meanwhile, the White House hosted the Summit on Worker Voice.


See you here next Friday! Hope you have a great weekend.

Do You Know Your Department's Severe Weather Policy?

If you’ve worked at UMass Memorial through a snowy Winter, you probably know that, along with sloppy weather, there comes some confusion. We encourage you to plan ahead, and know what to do when travel conditions get tough.

Weather is coming
Now is a good time to remind your manager that they should cover your severe weather plan in a meeting with all of the staff in a staff meeting. If there is no plan, or it needs updating, we encourage SHARE members to be involved in figuring out what works for their department. See the Severe Weather Policy on page 103 of the SHARE Contract, which includes the following guidelines:

In order for employees to know what their responsibilities are in the case of severe weather, departments are encouraged to develop plans for their areas within the framework of the hospital plan. . . . Employees are encouraged to participate in the development of the plan for their department. Department severe weather plans could include: what staffing level is required in the case of severe weather (such as full staffing, skeletal staffing, or no staffing necessary); how employees will find out if they are required to be at work that day, who to call and how to reach them; and whether there is a difference in their department between the plan for severe weather and the plan for a declared state of emergency. Department managers should review the severe weather plan for their department with all employees annually before winter weather begins.

If you would like help developing or revising the policy for your department, please contact the SHARE office.

Friday, October 2, 2015

Five-Tidbit Friday: October 2, 2015

This is the seventh installment of Five Tidbit Friday, and this week we’ve got news items ranging from near to far and back again.

  • CANCER WALK Congratulations to participants of this year’s cancer walk! The roughly thirteen thousand participants this year have raised nearly $400,000 for cancer research and care. 20150927_093855.jpg

  • OTHER UNIONS, OTHER HOSPITALS The Kaiser Permanente Union Coalition has recently ratified a new contract agreement. The coalition represents over 100,000 healthcare employees, primarily in states along the west coast. This group of unions coordinates the largest Labor Management Partnership in the country. SHARE has been watching Kaiser Permanente closely, and in particular their “Unit-Based Teams” approach, which is designed to put employees directly in charge of important work-design decisions. Among other things, the new KP agreement includes:
    • Increased funds for employee training programs and for members’ tuition reimbursement,  
    • Increased training and accountability for frontline managers, and
    • New tools and support to increase the effectiveness of the Unit Based Teams
You can find even more highlights from the Kaiser Permanante agreement online, and read more about the effectiveness of the Labor Management Partnership in this report out of MIT.

  • INNOVATIONS in HEALTHCARE The Legal Services Corporation recently announced that Community Legal Aid in Worcester, Massachusetts will receive a 24-month $209,524 Pro Bono Innovation Fund grant to develop a partnership with UMass Memorial Medical Center. The model will address legal needs that can negatively impact the health of low-income and minority communities and interfere with healthcare providers’ ability to improve the health of these patients.

  • FREE SPEECH at WORK In national news, an NLRB complaint against Quicken Loans could redefine the rules of free speech in the workplace, reports the Detroit Free Press. The case is likely to have implications for social media. The ruling is expected to uphold current standards, including that "employees have a ... right to discuss wages, hours, and other terms and conditions of employment with fellow employees, as well as with non-employees, such as union representatives." Meanwhile, the US Department of Labor has continued its emphasis on employee rights with a Worker Voice Summit, which will underscore the value of worker organizing and collective bargaining, as a new #starttheconvo initiative invites frontline voices from around the country into that conversation.

  • happymoose.jpegMOOSE! SHARE members are now using ICD-10 coding guidelines in our hospital. The new codes allow for far greater precision, including for those patients receiving care as a result of “Burn due to water-skis on fire, initial encounter (V91.07XA),” or even less-likely conditions. At the time of this publication, our research team has not yet uncovered a code for “Incident with urban moose in Worcester County,” although we hear that a moose has been recently seen on our local streets. Drive safe.

See you here next Friday. Hope you have a great weekend.