"You have to assume that any time you implement any change or cost reduction you are also creating uncertainty," he says. "Unfortunately a lot of employers wait until that change is about to occur before they communicate with employees. You have to explain it well in advance through business literacy what the environment is and where you are in the marketplace. It is about being proactive in communication and then creating a compelling case for why you have to make the changes you do."
Trivisonno says unionization efforts are rarely about wages and hours.
"The union turns it into treatment and respect," he says. "They haven't treated you properly. They don't respect you enough to give you a pension that is going to support you when you retire. That is how they flip it. They turn it from a rational issue to an emotional issue and that is in their wheelhouse. Without the emotion the union's got nothing."
He says unionization drives fall short when they run up against hospitals that have spent years building trust and communication between leadership and staff.
"Create a culture where people say 'Hey, I'm good. My problems are being solved. They're listening to me.'You can't do that overnight," he says. "The union messages sort of clang rather than ring true – to use a bell analogy – when you have a situation where someone says 'that doesn't sound right. I know this guy. He wouldn't break that way.' So for those organizations that try to suddenly overnight create this communication mechanism and engagement mechanism it becomes much more difficult."