Fewer contract workers, higher satisfaction scores in Downey
Staff overtime soared. Patient satisfaction scores plunged. Large numbers of contract nurses filled shifts each day to keep up with patient care.
By the end of 2022, staffing challenges at the Kaiser Permanente Downey Medical Center in Southern California called for drastic action.
Today, those struggles have eased, thanks to more staff nurses and a workplace innovation that tracks staffing data. Stakeholders from the executive suite to the front lines credit one thing for the turnaround: partnership.
“We worked closely with labor unions, made agreements, and stuck to them,” says Mitch Winnik, senior vice president and area manager for Downey. “The results have been amazing.”
“Patient care is getting better because labor and management are working together,” adds Paul Ciriacks, a registered nurse at Downey and UNAC/UHCP member.
How the change happened
The solution started with a simple step: setting up monthly meetings between hospital and union leaders to discuss staffing.
At these meetings, they quickly agreed on 2 main goals:
- Hire more nurses to reduce overtime and rely less on contract workers. A key tactic was attracting hundreds of applicants through day-long hiring events organized by management and labor.
- Follow existing staffing agreements to ensure frontline workers have a say in decisions. Make sure they arrive on time, take breaks, and avoid unnecessary overtime.
The results
Success by the numbers:
- Six hiring events helped bring in about 1,000 new nurses.
- Contract nurses dropped from 270 at the end of 2022 to just 20 in 2024.
- Patient satisfaction scores at the hospital hit an all-time high — rising 35% in 2 years in the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey.
Building trust through transparency
Supporting Downey’s success is a new staffing dashboard that covers all job classifications. It allows managers to share real-time data about staff vacancies, hiring progress and overtime usage with frontline workers.
Downey and Panorama City Medical Center are piloting the dashboard. By 2026, the staffing dashboard will be available to all Kaiser Permanente hospitals in Southern California.
Managers access the dashboard — containing sensitive personnel data — using a password. Entering a unit-based team’s name and ID number initiates an automated process that pulls recruitment and payroll data from HRconnect.
The result is an up-to-the-minute glimpse of the team’s staffing situation — and a comparison to the previous month to highlight personnel trends.
Charlene Young, a nurse manager, used the dashboard to explain a recent rise in overtime. It showed that 2 open positions were in the process of being filled. "That should help with the situation," she told her team in Downey’s medical-surgical-telemetry unit.
Andre Welch, a nurse assistant and SEIU-UHW member, says seeing the data makes him feel more confident. “For me, it always helps when they show me the hard numbers.”