Union hospitals better prepped for COVID: study
Illinois Economic Policy Institute charges coronavirus relief went to smaller, nonunion hospitals
Union nurses and other hospital workers call for better COVID-19 preparation during a protest in the early days of the COVID-19 crisis in March. (One Illinois/Ted Cox)
By Ted Cox
Unionized hospitals were better prepared for the COVID-19 pandemic than their nonunion counterparts, but those smaller hospitals received more benefits from congressional relief packages, according to a study released Tuesday.
The Illinois Economic Policy Institute published “Pandemic Preparedness in Illinois” on Tuesday, with the report’s subtitle stating directly: “Illinois’s Union Hospitals Were Better Positioned for the Public Health Crisis.”
The report points to how unionized hospitals have 45 percent lower vacancy rates for nurse positions, in part because their turnover rate is 14 percent lower than their nonunion competitors. Unionized hospitals report 15 percent fewer violations under federal Occupational Safety and Health Administration regulations, and 29 percent fewer “serious violations.”
On average, thanks to previous calls for “safe patient limits,” union nurses were able to spend one to four hours more with each patient than their nonunion counterparts, and “unionized hospitals employ more infection prevention and control staff — particularly in Cook County, which has seen two-thirds of the state’s COVID-19 caseload.”
“The coronavirus pandemic has put new strain on Illinois’s hospitals and a nursing workforce that was already facing severe shortages,” said study co-author and ILEPI Policy Director Frank Manzo IV in a statement accompanying the release of the study. “This report shows that unionized hospitals in Illinois were far better prepared to absorb the impacts of COVID-19. Our findings have important implications for the future of hospital staffing and how we manage public health crises.”
Unionized nurses and other hospital workers called early on in the COVID-19 crisis for paid sick leave, as well as hazard pay and more coronavirus testing, with obvious benefits not only to themselves, but to both those hospitalized and the general population.
“For caregivers and patients, these differences can literally mean the difference between life and death,” said study co-author and ILEPI Researcher Jill Gigstad. “Our hospitals are the front lines of this pandemic, and it is important to understand which staffing and care models are likely to deliver the best outcomes.”
Pre-COVID ILEPI studies urged the hiring of more nurses, finding the initiative would mostly pay for itself in improved care and lowered turnover rate, as well as other effiiciencies.
ILEPI cited data finding that “the coronavirus (COVID-19) pandemic has strained hospitals and exposed weaknesses in Illinois’s health-care system. By the end of June 2020, more than 142,000 people had tested positive for the virus and more than 7,000 residents had died. According to the Illinois Department of Public Health, more than 9,500 health-care workers in the state have tested positive and more than 60 health care workers have died.” Another 3,600, meanwhile, “have come out of retirement or volunteered from out of state to help Illinois deliver care during the pandemic.”
“Union hospitals were generally better prepared than nonunion hospitals. Union hospitals had better nurse staffing levels, better retention rates for registered nurses, and lower vacancy rates for registered-nurse positions.”
“While the strain of COVID-19 has again highlighted the importance of addressing the state’s acute shortage of registered nurses, it has also revealed the comparative strengths and weaknesses of the staffing models currently in practice at Illinois’s health-care facilities,” Gigstad added. “Ultimately, the data suggest that unionized hospitals are more resilient and better equipped for the demands of public health crises.”
The study grants that “further research is necessary to discuss the performance of Illinois’s hospitals during the COVID-19 pandemic,” but it pointedly adds that “the data suggest that union hospitals were generally better prepared than nonunion hospitals. Union hospitals had better nurse staffing levels, better retention rates for registered nurses, and lower vacancy rates for registered-nurse positions. Union hospitals also had slightly more infection prevention and control staff, particularly in Cook County. Finally, union hospitals in Illinois had safer and healthier workplaces for health-care professionals on the front lines of the COVID-19 pandemic.”
Yet the new study also found that smaller, nonunion hospitals benefited disproportionately from congressional coronavirus relief packages like the CARES Act. “Despite their weaker staffing and care outcomes,” ILEPI reported, “the state’s nonunionized hospitals have received 16 percent more funding per bed than unionized facilities from federal pandemic relief measures such as the CARES Act. All told, Illinois’s hospitals have received at least $1.1 billion, and small Illinois hospitals with under 100 beds have received more than four times the per-bed funding than their larger unionized counterparts.”
Nonetheless, the report concluded, “With hospitals receiving over $1 billion in federal subsidies and union hospitals being better positioned to deal with the pandemic, interest in union organizing is high in Illinois. Nurses’ unions are the most highly regarded type of union, enjoying positive net favorability ratings among both Republicans and Democrats. Additionally, union hospitals have been found to outperform nonunion hospitals on 12 out of 13 nurse-sensitive patient outcomes, including hospital-acquired pneumonia and in-hospital deaths.”
The study determined that “greater unionization of Illinois’s health-care workforce could be an effective tool for addressing the ongoing nursing shortage and ensuring that the state is better prepared for future public health crises.”