FROM THE GROUND UP

A psychologist and a psychiatrist offer a playbook to revolutionize America’s inadequate health care system.

Lazes and Rudden want to fix the malfunctioning health care system that has not met the needs of patients. They provide a flexible game plan to unify frontline staff (nurses, doctors, pharmacists, phlebotomists, physician assistants, receptionists, aides, security guards, and environmental workers) and employers through labor-management partnerships. While LMP is not a new concept, the authors’ perspectives on it are fresh, which makes their message particularly relevant today during the Covid-19 pandemic fight. Because frontline workers interact directly with patients and have to function within the day-to-day practices of health care facilities, they know what changes are necessary to improve treatment. The handy playbook is tailored to the health care universe, but Lazes and Rudden maintain that their methodology may be successfully applied to other industries, such as automotive manufacturing. The authors take a panoramic view of their program and assess the merits and deficits of standard health care practices over time and the evolution of LMP. The book is organized into three parts that examine labor practices through the lenses of the past, present, and future. Each chapter concludes with a helpful summary that is meaty yet streamlined. Two extensive case studies conducted at Maimonides Medical Center in Brooklyn and the Los Angeles County Department of Health Services add dimension and support for LMP. Results of the studies are discussed in depth and summarized in useful tables that cite the triumphs of various strategic alliances (for example, at Maimonides, absenteeism was reduced by 25% and grievances by 63%). Based on several groups of core practices they have developed and implemented, the authors outline worthy strategies to overcome resistance to positive organizational disruption, which has revolutionized other industries. Chapter 2, which skillfully examines employee involvement practices that have been effectively implemented in forward-thinking nations in Scandinavia since the 19th century, suggests models that could improve today’s health care delivery system. The comprehensive manual is straightforward and simple to follow, presenting technical information in a refreshingly readable form.

Health care professionals, managers, and educators should welcome these eye-opening and valuable strategies.