ZSFG worked closely with UCSF leadership, DPH’s Public Health Emergency Preparedness and Response and others during a two-day strike in November by UCSF employees represented by the University Professional and Technical Employees and the American Federation of State, County and Municipal Employees unions who work at ZSFG. This impacted several hundred UCSF employees at ZSFG who perform various roles in Clinical Laboratories, Respiratory Care, Operating Rooms, Dialysis, Psychiatry and Social Work. While impacts included limited services in hematology and general delays in the clinical lab, biomed and pathology, generally the impacts were minimal thanks to ZSFG’s contingency planning. ZSFG activated HICS at Level 1 and successfully minimized impacts to patients. The hospital remained fully operational and there were no impacts to Emergency Department, trauma care or inpatient care. During the two-day labor action, ZSFG also hosted a successful survey from the California Department of Public Health.