Negotiations between hospitals and unions have always been complicated. Today, they are regularly becoming longer in duration, more contentious, and receiving a higher level of public scrutiny. How does a health system communication leader develop strategies to communicate effectively with internal and external audiences? And what’s the impact that these situations and communications have on your brand.
Join Alan Shoebridge, Associate Vice President – National Communication at Providence and podcast host, Alan Tam, as they discuss the challenges and explore the strategies for effective communication during times of crisis and unrest.
This conversation is brought to you by Actium Health in partnership with the Forum for Healthcare Strategists.
Subscribe to receive emails when new episodes are released.
AVP – National Communication
Chief Marketing Officer
Alan Shoebridge (00:00):
Much of what’s happening is taking place in a bargaining table. What do you really want to send out? You want to send out your reports, but you want to be very targeted, very specific about it. That can be hard for some people to understand of like, well, maybe the union’s out there on Facebook and they put out this huge thing and it’s very negative about our organization. Why aren’t we out there countering? Why aren’t we hitting back? The question communicators have to ask is, is it valuable at the table? Is it going to help? If we do that, is it going to help close a deal?
Alan Tam (00:39):
Hello Healthcare. Negotiations between hospitals and unions have always been complicated. Today, they’re regularly becoming longer in duration, more contentious, and receiving a higher level of public scrutiny. How does a health system communication leader develop strategies to communicate effectively with internal and external audiences? And what’s the impact that these situations and communications have on your brand?
I’m joined here today with Alan Shoebridge, Associate Vice President National Communication at Providence. Alan has always been one of our favorite repeat guests and has shared some amazing insights on a range of topics that include patient activation, navigating the talent crisis, and connecting with Gen X healthcare consumers. Alan, welcome back again. It’s great to have you and reconnect with you.
Alan Shoebridge (01:29):
Thanks. I’m excited to be here and talk about this subject.
Alan Tam (01:32):
Awesome. It’s a new role for you at Providence. Tell me about this transition and how you came about into this new role.
Alan Shoebridge (01:41):
Well, I’ve heard some people describe it as a rebound employee. I actually worked at Providence for about 12 years, and then I went on a little bit different journey. I came back and I came back first as a chief communications officer for the State of Oregon. Providence has pretty big operations there, but we went through some changes and did some restructuring throughout our organization to become more efficient. As part of that, a new role opened up on the national team. I’m taking on a variety of issues and subjects at a national level across all of our seven states.
Alan Tam (02:12):
Awesome. One of the things that is top of mind for our audience is why has labor unrest become so pervasive and frequent nowadays?
Alan Shoebridge (02:22):
Yeah. Well, I think a lot has come out of the pandemic. You think about disruption that came out of the pandemic, new models of care, doing things differently, but also just a lot of stress on the workforce. Workforce issues have become really pronounced. As part of that, there’s just been a lot of energy around organizing new unions, existing unions asking for more benefits, higher pay. And again, the health systems a lot of times want to work with caregivers and employees to do that, but it’s taken a different turn.
It’s become very public, and I think it’s really been driven by the pandemic. We talk about various types of disruption that came out of the pandemic, but I think what’s happening with labor and the workforce is one of the top things. Most people might not think about it all the time because it could be a little bit under the surface, but then it flares up. We saw a lot of activity and we saw a pickup in activity really pre-pandemic and then especially ’21 and ’22, and this year the activity is much more increased.
Alan Tam (03:16):
Wow. How does your communication strategy change between the internal and external audiences from this?
Alan Shoebridge (03:24):
When I think about communication strategy, there’s a fundamental principle that I think holds for whatever we do. And that’s like your staff, your employees, your caregivers, they need to know what’s going on first. That’s what we prioritize. We first want to make sure that we’re getting the right information out. If there’s active labor negotiations going on, we want to make sure that we’re giving our caregivers updates, here’s what’s happening, here’s the proposals that are on the table, and doing those regular updates so they know.
But then when things maybe are going to get out in the public a little bit, we want to think about what’s going on there. So much of union and labor negotiations, most people never see it. But if there’s an action going to be taken, if there’s an informational picket or a potential strike threat, well, that is going to get out in the public. We want to make sure we have our messaging ready to go and, again, tell our side of the story, what we’re doing, gives the real facts on what’s being offered to the union, and we do that proactively.
But I would say we always go back to making sure the internal audience is never surprised and they’re getting the right information. That’s the core foundation.
Alan Tam (04:23):
Absolutely. Which audience would you say is more challenging to communicate with?
Alan Shoebridge (04:28):
Oh my gosh, I think it’s maybe equal. But if you look at caregivers, especially frontline caregivers, let’s take nurses, I mean, they’re not sitting at a computer looking at email all day. Making sure that we get the report of what’s going on to them can be challenging. A lot of times we have to do things like town hall meetings or just ways to get the word out differently. The public is some of the same challenges, they’re dispersed, there’s different channels to get to them, but I think our messaging is most critical internally.
If we don’t hit that internal audience, they don’t understand what we’re doing, that’s going to have a spillover effect. People who go into our facilities, they might hear about it, they might not get the right information. Both audiences are really challenging, but I think I’ve got to go back to the internal audience in this one because they just have to know. They can be challenging to reach and we have to think about different ways to do it. We pull out the whole arsenal of getting information out to them.
Alan Tam (05:21):
That makes sense. I think internal alignment is definitely a key to the successful strategy, but then I also think about what the impact would be to the healthcare consumers. Not only do you have your internal audience that you’re serving, but also how does it impact your healthcare consumers?
Alan Shoebridge (05:39):
I think the big challenge is if you were to take a strike. We saw many healthcare systems in 2022 especially get threatened with strikes. There was a few that actually happened and those can be very disruptive, because you’re going to shut down a facility from anywhere between one to 10 days is usually how long these strikes work. And that becomes very disruptive. You have to figure out how to get patients on and off your campus. You might have strike lines that people have to cross. You have to figure out staffing. That’s really disruptive.
I think we see that when these things are in the news, they may last like a day, the cycle may last a day when there’s… Let’s say they’re doing informational picket or something. But if they actually go to a strike and actually walk out, then you have a lot of operational impacts. And that’s where I think things can go… You have to be very careful with your brand and what people are hearing in the community so that you reassure people that things are safe, what you’re trying to do to resolve the situation, but that’s where you could take a real hit to the brand.
Alan Tam (06:37):
Absolutely. But one of the things I’m curious about is your record and your past experience has really been on healthcare consumer communication. How has that experience helped you for this particular role?
Alan Shoebridge (06:54):
I think really just understanding what people need to hear, what type of messages they need to hear. The biggest thing is no matter what happens, even if there is a strike, the hospital facility is going to be safe. We’re going to have what people need. Wait times may be longer. We’ll just need to communicate exactly what’s happening.
I always go back to the fact that people need to understand clearly what you’re doing, make the points easy to understand, and just reinforce them. Again, just those foundational principles of how to communicate. Even though the situation is different, those really don’t change.
Alan Tam (07:26):
Absolutely. What role has technology played in this communication strategy? I’m sure it’s a little bit different than the role of technology for communicating with healthcare consumers.
Alan Shoebridge (07:38):
I think this one is interesting because it’s probably the least technologically advanced of our strategies. Because honestly, when we’re looking at that internal audience, we just need to get them information. We’re using email, do a lot of flyers. I know that sounds wild, printed flyers, but when you can put something out or distribute something out so they can get the information while they’re on their shift or whatever, that’s often a lot of effective ways to do it. We do mailing. Sometimes we’ll do mailings to people’s homes so they can really get the whole proposal.
We have stood up some digital assets and put up websites and things and those work, but you really have to get the tactics out there as broadly as you can to that internal audience. I wouldn’t say it’s the most exciting challenge, but it’s the fundamentals, just getting people the information in a variety of ways. And especially if you’re at the point where, wow, there really might be a strike or there’s been a strike authorization and we’re trying to close the deal, we’ve got to get the facts out so that people are voting because their membership is going to take a vote.
We need to make sure they understand exactly what’s on the table. Sometimes we’ll hear that they learned new things. Many times we’ll hear that they learned new things from our communication that they weren’t actually getting when they saw the proposal or the information from the union.
Alan Tam (08:51):
Based on your experience in some of these episodes, what has been some of the feedback from your internal audiences on what you guys are doing?
Alan Shoebridge (08:59):
Well, we’ve heard a lot that the communications help because you really are getting one side of the information if you’re only listening to what’s getting out from the union. We want to make sure we get our proposals out so people really understand, what are the financials on the table, what are the non-financial elements, what’s actually being negotiated?
We’ve heard that when we can put those messages out, people get them, that they often learn new things that they hadn’t heard before or maybe the rep hadn’t told them. It just gives a balanced picture. We really want to get that balanced picture out there so that when there’s a vote being taken, we feel like they’ve gotten all the information we’ve put out about our proposal.
Alan Tam (09:37):
That makes a lot of sense. In this particular sense, because it’s so analog, how do you measure the effectiveness and the success of your outreach?
Alan Shoebridge (09:46):
It depends on how the vote goes. I mean, ultimately that’s a big part of it. Did a contract get approved? Did the tides come to terms? A lot of that is part of the measurement, frankly, getting feedback from leaders on the ground, interacting with staff. You have a lot of chief nursing officers, chief HR officers. We get the feedback from them. They hear from people. We’re not necessarily collecting things in a digital way or traditional ways that marketers and communicators might do it. It’s a lot of just feedback on the ground, again, looking at how the results go.
And then whenever things do get into public, monitoring the media that’s out there, the positivity of the stories. Started to explore too some brand research on this topic. If you have a lot of union activity going on in the market, did it change any brand perceptions? We can look at that too. There’s all that, but I think this particular topic is the best when you’re actually getting feedback from people who are receiving the information and then watching how the negotiations and the votes actually turn out.
Alan Tam (10:43):
Has the feedback that you received help for more proactive and preventative approaches?
Alan Shoebridge (10:50):
Yes. Well, for sure. I think a big part of this is actually setting expectations for how visible the communications are going to be. Because honestly, much of what’s happening is taking place in a bargaining table. What do you really want to send out? You want to send out your reports, but you want to be very targeted, very specific about it. That can be hard for some people to understand of, well, maybe the union’s out there on Facebook and they put out this huge thing and it’s very negative about our organization. Why aren’t we out there countering?
Why aren’t we hitting back? The question communicators have to ask is, is it valuable at the table? Is it going to help? If we do that, is it going to help close a deal? We work really closely with our partners on legal and government affairs and others and just thinking through the strategy of how vocal should we be. Often we’ll just let things not say slide, but kind of really pick our battles as far as where we’re going to get very vocal in the community. But that takes a level set with your partners to understand that of here’s why you might not see us being really vocal in this.
We want to resolve this. We want to get this solved. We want to do it to the benefit of the caregivers in our communities. The best way to do that is not have it out there super public. That’s a consideration, but people don’t understand that. They always think, well, one message goes out, we’ve got to respond. We have to be very careful about that.
Alan Tam (12:09):
When you say partners, who are your internal partners that are helping you with this?
Alan Shoebridge (12:15):
Definitely legal and whoever’s negotiating the contract, the bargaining team who’s sitting down, and then human resources. Those are our key partners in this. And then also, it depends on what union it’s involved, if it’s nurses, chief nursing officers is a key piece of that. Those are the operational units that come together. And then if there’s actually a potential of a strike, that’s when a lot of planning has to go into, what’s going to happen? If we get that 10 day notice, immediately as you get that 10 day notice, you kick in and you say emergency communications start.
We stand up emergency communications center. There’s command center on campus, incident response, almost like you would respond to other problems that might pop up and say, how are we going to handle this? In 10 days, we’re not going to have a normal workforce. Work has been going on behind the scenes to make sure we’re ready for that, but now you’ve got to start implementing it. That means a lot of on the ground communications are happening every day. Just planning for that. There’s a lot of planning that goes into being ready.
Alan Tam (13:14):
Definitely not an easy job. I’m not sure why you took it.
Alan Shoebridge (13:20):
It’s just going to be something that communicators are going to deal with more and more, and we’re seeing the activity pick up other places. You’re seeing Amazon and Apple, but healthcare is happening too. It’s going to be something communities have to deal with and you need to be prepared. The best way to think it through is assess what’s going on in your community.
I hadn’t always thought about this at various positions in my career, but when you’re starting a communications role, probably be a good idea to figure out, do you have unions in place? When are their agreements coming up? Get to know the legal and HR people just to get ahead of it, because I think we’re going to see this activity. It’s continued to spike up this year. It’s not going to recede, I don’t think, in the near future.
Alan Tam (14:03):
That’s some really good advice in terms of someone who may be coming in and stepping in a role like yours. What would be the top three lessons that you’ve learned since you’ve assumed this role that can help someone who’s coming in?
Alan Shoebridge (14:17):
The biggest one is just to get agreement on expectations right off the bat about what your strategy’s going to be and are people comfortable. If you’re taking sort of a we’re going to try to really focus on the internal audience, and if we take a bad story or two in public, that’s okay. Because at the end of the day, we’re going to settle this contract. We’re not going to go to a strike. Just setting those expectations. That’s the number one thing. Not to take it personal. The other thing is some of these communications are pretty pointed and not always honestly fair.
They’re out there. They’re saying things about executives, organizations, people that work there. The communications can get really heated and not very friendly when contracts are up. But don’t take it personally. Because again, if you get angry and if you start responding with your communications with a negative tone, you don’t want to do that. I think don’t take it personal, set those expectations. Those are probably the two biggest thing. I guess the third one would be, again, really understand your landscape. What are you likely to face? Who are the unions that are in your area?
What are they doing with other systems? You can be out there looking at the news and saying, well, maybe they’re not in negotiation with us right now, but wow, they’re having a really contentious negotiation with another hospital or another healthcare system. Let’s start planning because we know when our contract’s up next year, this is probably what we’re going to have to prepare for. I guess it’s knowing the expectations, really thinking through what your strategy’s going to be, not taking it personally, and understanding your landscape. That’s the best way to go into this and prepare.
Alan Tam (15:47):
That sounds like really sound advice. What about impact to the brand? Do you guys see a impact to the brand from a healthcare consumer perspective?
Alan Shoebridge (15:55):
We’re starting to do some research into that a little bit. I think what I’ve noticed most often again is these things will flare up in public for a little bit, a day or two when there’s a protest, and that doesn’t really impact the brand. I don’t know the specifics of if you actually took a strike. If you actually took a 10-day strike and it was in the news every day for 10 days, could that have some impact? I think it probably could.
I do think, again, people, if they start out with a strong feeling of sentiment for their healthcare system and their hospital, I think they see this and understand this is something that’s going to get resolved and probably won’t have a long-term effect, but you do have to be really careful. And honestly too, knowing the political climate where you live. If you’re a blue or purple state, might be very different than a red state as far who’s going to come out on the public perception side of things. That’s a piece of this too.
Alan Tam (16:48):
Fascinating. Alan, thank you so much for your time and sharing these amazing insights. I think it’s really important and it’s something that is overlooked, I think, by a lot of marketing organizations, especially within healthcare. Thank you for sharing those insights. If folks in the audience would like to continue the conversation with you, what’s the best way for them to get ahold of you?
Alan Shoebridge (17:09):
I’d love to talk to people who need advice on this because I think this is a subject people don’t talk about too much. You could find me at LinkedIn, Twitter, also my website, alanshoebridge.com. I’d love to connect with people.
Alan Tam (17:20):
Thank you so much again, Alan. For those of you in the audience that want to continue the conversation on crisis communication, Alan is one of the best experts in the industry. Until next time, hello!
If you want more of the latest from healthcare’s thought leaders, subscribe using the button below, or you can visit hellohealthcare.com to get updates directly in your email.
Find the Clarity You’ve Been Missing
Learn how Actium Health is driving improved quality, outcomes, and revenue for innovative health systems nationwide.