An analysis of hospital union election activity: 1985-1987--by hospital ownership, size, and system, and employee organization and bargaining-unit size

During the three-year period 1985-1987, there were 238 elections in nongovernmental, short-term hospitals to determine whether or not unions would represent the employees. Unions had a success rate of 47.1 percent, similar to that of earlier years. This study reports these election results by hospital and election characteristics. For hospitals, the analysis includes elections by census region, ownership, bed size, and multi-institutional characteristics. For elections, the analysis includes the nature and type of election, employee organization, and employee bargaining-unit-size characteristics. This study concludes that the number of union elections decline as hospital bed size increases, and the union success rate is curvilinear and higher in both small and very large hospitals; union success declines as bargaining-unit size increases. Investor-owned and nonprofit, religious hospitals that are members of multi-institutional systems have lower union success rates than nonsystem hospitals do in their ownership category. However, unions are much more successful in multi-union and decertification elections compared with single-unit elections and initial recognition elections.     

The impact of union elections on human resources management practices in hospitals

The purpose of this article is to explore top management's perceptions of how various human resources management (HRM) practices changed in hospitals (n = 101) after union elections. Significant increases in many HRM practices that are believed to lead to competitive advantage through human resources were reported in firms in which unions lost elections but not in firms where unions were certified.     

Union certification elections in nursing care facilities

This empirical study examines 387 union certification elections conducted by the National Labor Relations Board in nursing care facilities (North American Industry Classification System 623) from January 1999 to December 2001. Unions won 60% of the elections. Service Employees International Union was involved in 42% of the elections. Bargaining unit size significantly impacted union victory. Unions had a better probability of winning elections in the northeast and midwest than in the south. Unlike other industries, American Federation of Labor-Congress of Industrial Organizations affiliated unions did not suffer a big labor image in nursing care facilities. Implications for union organizers and administrators of nursing care facilities are discussed.     

A profile of hospital union election activity, 1985--1994 NLRB rulemaking and results in right-to-work states

The authors present union election results in non-governmental, short-term hospitals for the 10-year period 1985--1994. The authors include profiles for the periods before (1985--1989) and after (1990--1994) the National Labor Relations Board (NLRB) rulemaking. When comparing the period data, they found that the impact of rulemaking was a reduction in mean bargaining unit size, an increase in the absolute number of elections in hospitals, and an increase in the percentage of union wins. Their examination of hospital union election results in right-to-work (RTW) versus non-RTW states revealed that unions did not aggressively try to organize workers in non-RTW states and, when they did, they were not very successful. When the authors examined only initial recognition elections during the periods before and after rulemaking, as well as the whole 10 years, regression analysis identified three variables significantly related to union wins: the 1989 NLRB rule change, bargaining unit size, and employee participation rates.     

Calendar of Meetings

The authors present union election results in non-governmental, short-term hospitals for the 10-year period 1985-1994. The authors include profiles for the periods before (1985-1989) and after (1990-1994) the National Labor Relations Board (NLRB) rulemaking. When comparing the period data, they found that the impact of rulemaking was a reduction in mean bargaining unit size, an increase in the absolute number of elections in hospitals, and an increase in the percentage of union wins. Their examination of hospital union election results in right-to-work (RTW) versus non-RTW states revealed that unions did not aggressively try to organize workers in non-RTW states and, when they did, they were not very successful. When the authors examined only initial recognition elections during the periods before and after rulemaking, as well as the whole 10 years, regression analysis identified three variables significantly related to union wins: the 1989 NLRB rule change, bargaining unit size, and employee participation rates.     

新医改背景下加强公立医院工会工作的做法与成效

新医改背景下,赋予医院工会新的任务和要求。文章从加强民主管理、关爱职工、文化建设等方面,对工会利用自己的工作优势创新性开展工作进行了阐述,对工会工作服从和服务于医院发展大局作了有益探索,对公立医院工会工作有一定借鉴意义。     

Bargaining unit rules having little effect on hospital union activity

The number of hospital union elections rose only slightly between 1990 and 1991, suggesting that the National Labor Relations Board's new hospital bargaining unit rules haven't had much impact on hospital organizing efforts. NLRB data appear to contradict the dire predictions of many hospitals and labor attorneys who said expanded bargaining unit categories would lead to unbridled union organizing efforts.     

Special report. The new hospital labor picture: More unions? More strikes? More problems for security directors?

A recent U.S. Supreme Court decision upholding National Labor Relations Board (NLRB) rules for hospital bargaining units appears to be fueling union efforts to organize hospitals nationwide. As unions gain more footholds in hospitals, the prospects for strikes and labor unrest increase. This expected surge in organizing may place hospital security departments in critical situations, whether they're the specific target of unions or not. This report reviews the implications of the new bargaining unit rules as they affect hospital security operations.     

Labor relations: an update

Preventive labor relations training for managers and supervisors is vital today. Management must take the necessary steps to prepare its leadership to face the reality of hospitals being a prime organization target in the 1990s. The U.S. Supreme Court ruling will undoubtedly result in increased union activity as was experienced following the enactment of the 1974 healthcare amendments. Because of the rapid changes taking place within the healthcare industry and these new bargaining unit rules, hospitals will be targeted by unions. Management must be prepared in order to remain union free. Employee opinion surveys and preventive labor relations training for managers and supervisors are positive steps to be considered for a union-free workplace.     

Hospitals and union elections

This study examines union certification elections in hospitals from October 1994 to September 1997. Results indicate that union win rates were significantly higher in single-union elections and larger bargaining units. On the other hand, union win rates were significantly lower in church-related hospitals and hospitals that belonged to a health care system or had higher payroll costs. Unions also appeared to win elections at a higher rate in this period than in the past.     

Union elections and the NLRB. The healthcare industry continues to challenge bargaining unit determinations

In the healthcare industry today, unions and management must cope with a confused, contradictory, and often changeable body of law and National Labor Relations Board (NLRB) policy when unions attempt to establish themselves at a particular institution. More than 15 years ago, Congress amended the National Labor Relations Act to grant labor unions the right to organize employees of not-for-profit hospitals and other healthcare organizations. An election to form a union cannot be held, however, until the NLRB determines which employee classifications constitute an "appropriate" collective bargaining unit. Since 1974, labor and management have fought over this basic question before Congress, the NLRB, and the federal courts. One paragraph of congressional instruction to the NLRB, which stipulates that the board prevent "proliferation of bargaining units in the health care industry," has over the years been construed in widely varying ways by the board and the courts. Management has argued that two units should be the maximum number allowed as appropriate whereas unions have argued for more. Last April the NLRB established a rule allowing for as many as eight bargaining units at a particular institution, but three months later a federal district court issued a permanent injunction against the rule. The board has appealed the injunction, and as both sides await a ruling, dozens of pending hospital union election cases have mounted up. Nor does a decision by a court of appeals promise to resolve the issue.     

Political coalitions for mutual advantage: the case of the Tobacco Institute's Labor Management Committee

In 1984, the tobacco workers' union and the Tobacco Institute, which represents US tobacco companies, formed a labor management committee (LMC). The institute relied on LMC unions to resist smoke-free worksite rules.In a review of the internal tobacco industry documents now publicly available, we found that the LMC succeeded for 2 primary reasons. First, the LMC furthered members' interests, allowing them to overcome institutional barriers to policy success. Second, the LMC used an "institutions, ideas, and interests" strategy to encourage non-LMC unions to oppose smoke-free worksite rules.While public health advocates missed an opportunity to partner with unions on the issue of smoke-free worksites during the era studied, they can use a similar strategy to form coalitions with unions.     

Hospital union election activity, 1974-85.

This study, using National Labor Relations Board data and American Hospital Association data, reports on the status of union election activity in the hospital industry for a 65-month period, January 1980-May 1985, and contrasts it with earlier data for a similar 65-month time period (1974-79). Together these data provide a comprehensive overview of union election activity in non-Federal, nongovernment hospitals since the passage of the 1974 Nonprofit Hospital Amendments to the Taft-Hartley Act. The study analyzes union, election, hospital, and environmental characteristics. Comparisons over the two time periods show that, while union victory rates in hospital elections have remained constant, the total number of elections has declined dramatically in the hospital industry.     

A look at the central issues surrounding joint consultation

Over the past 30 years the value of staff consultative committees has been challenged by unions and managers alike. Authors argue that the revival of interest in staff consultative committees will be accelerated if elections to staff-sides are carried out on a union rather than professional group basis.     

Unions and hospitals: some unresolved issues

This article investigates the impact of unions on the wages of hospital workers. Our OLS findings agree with previous OLS studies--unions increase registered nurses' (RNs) wages by five percent and by about eight to ten percent for other hospital workers. By contrast, we find (after correcting for selectivity bias in hospital unionization status) a direct union effect of about twenty percent on RN wages and in excess of thirty percent on wages of other hospital workers. While the results based on selectivity bias adjustments make us uneasy, we do not reject them out-of-hand. We also find indirect union effects (up to five percent) by other unionized occupations within a hospital and up to ten percent by other unionized hospitals in the local labor market. Prospective reimbursement programs have a negative impact on the wages of hospital workers but are only significant for non-unionized occupations. Our three empirical tests of monopsony all reject the view that monopsony is a factor in hospital wage-setting. Even considering the large union effects (based on selectivity bias adjustment), we conclude that unions have been a minor contributor to hospital cost inflation.     

Decertification elections in health care: some recent evidence

This article examines union decertification elections conducted by the National Labor Relations Board between January 1999 and February 2002 in hospitals and nursing and residential care facilities. Employees petitioned 92% of all decertification elections. Service Employees International Union was involved in nearly 43% of all decertification elections and won 57%. Forty-three percent of all decertification elections involved bargaining units with 50 employees or less. Unions lost 66% of decertification elections in departments, but won 75% in bargaining units consisting of both professional and clerical employees. The union win rate in non-right-to-work states was 52% compared with 37% in right-to-work states.     

Physicians find power in unions

A growing number of physicians are using organized labor to gain economic leverage. Hospital downsizing and autocratic managed-care plans have prompted more doctors to join the ranks of other professionals who carry union cards. While not a sweeping trend, interest in unions is growing--even among private-practice physicians who can't bargain collectively because of antitrust laws.     

Physician unionization in the United States: fad or phenomenon?

This article explores the current trends and issues surrounding physician unionization in the United States, using data from secondary sources and nine interviews with leaders of organizations at the forefront of physician unionizing efforts. Several key points are supported by these data and prior unionization research. First, unions should become a viable organizing alternative for the almost 50% of doctors who are salaried employees because of fewer legal barriers to collective representation, the involvement of national labor unions with resources to spend on organizing, more physicians belonging to demographic groups less hostile to organized labor. and work-related pressures faced by physician-employee under managed care. A second key point is that unions will find it difficult to represent self-employed physicians because of the influence of organized medicine and legal barriers to gaining collective bargaining rights for this group. This discussion is intended to raise awareness of the physician union issue among health care policy-makers and researchers.     

Nurses and the new NLRB rules. Implications for healthcare management

The inclusion of nurses as an allowable bargaining unit is one of the most significant aspects of the U.S. Supreme Court's decision to uphold the National Labor Relations Board's new collective bargaining unit rules. For a number of reasons, the decision makes it more likely that nurses at a given hospital will vote to form a union. Union nurses receive, on average, 6 percent higher salaries than do their nonunion counterparts. In addition, being able to organize into a smaller unit gives nurses a much stronger bargaining position. Finally, because of the new collective bargaining unit rules, labor leaders now find hospitals an attractive place to attempt to establish unions. In responding to the possibility that nurses might unionize, hospital managers should acknowledge that nurses often have legitimate grievances concerning pay and working conditions. They should also be aware that changes in the healthcare system during the 1980s often led managers and administrators to neglect focusing on nurses' satisfaction in favor of an emphasis on the bottom line. In the future, if managers can offer nurses the same rewards a union organizer offers and at the same time establish a cooperative, employee-oriented hospital atmosphere, nurses will benefit from the Supreme Court Ruling, whether or not they ultimately join a union.     

Smoke-free airlines and the role of organized labor: a case study

Labor unions play an important role in debates about smoke-free worksites. We investigated the role of flight attendants and their unions in creating smoke-free air travel. We used case study methodology to search tobacco industry documents and labor union periodicals and to interview key informants (i.e., people identified as having first-hand information and experience in the campaign to make airlines smoke free). We then compared findings across these data sources. Tobacco industry strategies against the establishment of smoke-free worksites failed in the case of airlines, largely because of the efforts of flight attendants and their unions. Other factors contributed to the failure but likely would have been insufficient to derail industry efforts without strong stands by the flight attendants. This case illustrates the potential for successful partnerships between unions and tobacco control policy advocates when developing smoke-free worksite policies.