1. Michigan Primary Care Consortium (MPCC) Board of Directors Working Together: Pursuing Collaborative Initiatives Dr. Marick F. Masters Director, Labor@Wayne Professor of Business and Adjunct Professor of Political Science Wayne State University 255 Walter P. Reuther Library 5401 Cass Avenue Detroit, MI 48202 TEL: (313) 577-5358 E-mail: marickm@wayne.edu July 22, 2011 1

2. Healthcare Delivery and Organization Healthcare Workforce Labor-Management Relations in Healthcare Fraser Center Contexts 2

3. Healthcare Industry Contexts Economic/Budget – Stagnation – Chronic Budget Deficits – Healthcare Inflation Demographic – Growing Population – Aging Population – Obese Population – Increasing Indigent Population Legal-Political – Patient Protection and Affordable Care Act – Medicare/Medicaid Reform – ACOs Technological – Diagnostic and procedure equipment – EMR – CDSS 3

4. Healthcare Industry 14.3 million employees 595,800 establishments 17.3% of GDP, 2010 19.3% of GDP, 2019 Federal and state governments projected to soon fund the majority of healthcare 4

5. Healthcare Delivery and Organization Consolidation Diversification Profit Centers New Delivery Model Accountable Care Organization 5

6. Healthcare Workforce Personnel Shortage (2020) – 200,000 physicians – 1 million nurses Personnel Distribution (underserved) – Rural – Inner City Skill Mix – Leaders – Manager – Technology Usage – Shifting Roles Changing Employment Relationship 6

7. Healthcare Workforce Needs Increase skill set (communication, collaboration) Increase adaptability Increase effective deployment Increase cross-functional coordination 7

8. Labor-Management Relations Significant union presence Growing unionization opportunities Workplace conflict and tension 8

9. 9 YearTotalHospitalsRegistered Nurses Licensed Nurses Physicians 200013.9%13.8%19.9%--5.8% 200512.5%13.7%16.6%11.3%6.4% 201011.9%14.3%18.7%10.2%5.0% Union Membership (%) in Healthcare

10. The Nurses’ Union National Nurses Union – Michigan Nurses Association – California Nurses Association – Minnesota Nurses Association – DC Nurses Association – Iowa Nurses Association – Massachusetts Nurses Association – Florida Nurses Association – Hawaii Nurses Association Service Employees International Union Nurses Alliance American Nurses Association United Steelworkers American Federation of Teachers International Brotherhood of Teamsters United Auto Workers Office Professional Employees International Union American Federation of State, County, and Municipal Employees 10

11. The Bargaining and Union Structure Splintered Varied Destabilizing 11

12. Key Labor-Management Issues Staffing – Ratio – Role/Usage – Deployment/Scheduling – Training Health Information Technology – Routization – Deskilling – Surveillance Workplace Health and Safety – Accident – Exposure – Bullying – Disruptive Behavior – Violence 12

13. Douglas A. Fraser Center for Workplace Issues Wayne State University College of Liberal Arts and Sciences Mission: Subsidize, encourage and enable teaching and research in various areas of workplace issues; Increase public understanding of workplace issues Delivery:Conferences Workshops Subsidized Research Working Paper Series 13

14. Fraser Center Healthcare Industry Academic Panel Dr. Bengt Arnetz, School of Medicine, WSU Dr. Judith Arnetz, School of Medicine, WSU Dr. Michael Diamond, School of Medicine, WSU Dr. Joseph Fortuna, CEO, PRISM Dr. Julia Gluesing, College of Engineering, WSU Dr. Allen Goodman, Economics, CLAS, WSU Dr. Peter Hammer, School of Law, WSU Dr. Janet Hankin, Sociology, CLAS, WSU Dr. Peter Litchenberg, Institute of Gerontology, WSU Dr. Leslie Monplaisir, College of Engineering, WSU Dr. Kenneth Riopelle, College of Engineering, WSU Dr. Andrea Sankar, Anthropology, CLAS, WSU 14

15. Fraser Center Plan: 2011-2012 Two Conferences – Working Together: Improving the Healthcare Workplace – Healthcare Organization and Workforce of the Future-2022 Fraser Center Research Support Fraser Center Faculty Fellows Fraser Center Workshops Fraser Center Paper Series Certificate Program in Communications, Conflict Resolution, Negotiations, and Team-Building for Healthcare Professionals 15

16. Looking For: 1.Conference Co-Sponsors 2.Healthcare Industry Panel Members 3.Research Funding Ideas and Opportunities 4.Interest in Certificate Program 16

17. Thank You 17