Collective Bargining Healthcare

Unionization Risk & Engagement Roadmap

This tool helps healthcare leaders assess unit-level susceptibility to union organizing or escalation and identify constructive, ethical engagement priorities. It is informational only and not legal advice. Consult labor counsel for specific situations.

1. Unit Information & Operational Metrics

Unit or Department Name

Annualized turnover (percent)

Overtime as percent of paid hours (last 90 days)

Unscheduled absence rate (percent)

Safety/violence incidents per 100 FTEs (12 months)

Engagement/voice score (0–100) for “my voice is heard”

2. Perceptions & Conditions by Driver

For each statement, rate how true it is for this unit in the past 3–6 months. 1 = Strongly disagree / not present; 5 = Strongly agree / very often.

This dashboard is an informational decision-support tool. It does not replace legal advice. Always involve labor counsel before responding to active organizing or bargaining situations.

Staff frequently describe workload as unsafe or unmanageable.	1 2 3 4 5
We regularly operate below what frontline staff view as safe staffing levels.	1 2 3 4 5
We rely heavily on overtime or agency coverage to meet minimum staffing.	1 2 3 4 5
Staff cannot reliably take breaks or meal periods due to workload.	1 2 3 4 5

Staff often compare their pay unfavorably to local employers or systems.	1 2 3 4 5
Employees raise concerns about wage compression or inequities between tenured and newer staff.	1 2 3 4 5
Complaints about rising health insurance costs or benefit cuts have increased.	1 2 3 4 5

Staff say they do not feel heard when they raise concerns or suggestions.	1 2 3 4 5
Decisions affecting daily work are often made without meaningful frontline input.	1 2 3 4 5
Employees describe interactions with leaders as dismissive or overly directive.	1 2 3 4 5
Staff feel they lack a real voice in scheduling, workflow changes, or quality initiatives.	1 2 3 4 5

Verbal or physical aggression from patients, families, or visitors is a common concern.	1 2 3 4 5
Staff doubt the adequacy or availability of PPE or safety equipment.	1 2 3 4 5
Safety or violence incidents do not receive timely follow-up or feedback.	1 2 3 4 5
Staff frequently report burnout, emotional exhaustion, or moral distress.	1 2 3 4 5

Clinicians say administrative decisions are compromising patient care quality.	1 2 3 4 5
Staff feel productivity or throughput targets conflict with safe practice.	1 2 3 4 5
Clinicians report limited ability to use their professional judgment without pushback.	1 2 3 4 5