WASHINGTON 

More than 75,000 health care workers at one of the US' largest medical systems began to strike Wednesday in the largest walkout of health care workers in the nation’s history.

Negotiations with Kaiser Permanente executives remain ongoing as workers in Colorado, Oregon, Virginia, southwest Washington state and Washington, D.C took to the picket line. Workers authorized the strike in late September as their contract was set to expire at month's end.

The strikes in Virginia and Washington, D.C. will only run one day, but each of the other states will see three-day walkouts. Kaiser's health facilities in other states will not be affected.

At issue for workers represented by the Coalition of Kaiser Permanente Unions is a shortage of workers that staffers say has contributed to unsafe working conditions, "dangerously long wait times, mistaken diagnosis, and neglect."

Workers are also seeking to have the company reinstate protections prohibiting outsourcing of work to outside firms, ensuring union protections are extended to any firms Kaiser acquires, boosts to bonuses and improvements to retiree medical plans.

SEIU-United Healthcare Workers West said in a statement last month, as the union issued a 10-day strike notice to Kaiser executives, that the coronavirus pandemic and "chronic understaffing" would lead to the work stoppage.

"Kaiser executives refuse to acknowledge how much patient care has deteriorated or how much the frontline healthcare workforce and patients are suffering because of the Kaiser short-staffing crisis,” said union president Dave Regan in a statement.

“The patient care crisis cannot be solved unless Kaiser executives follow the law by bargaining with healthcare workers in good faith, and take dramatic action now to solve the crisis by investing in its workforce," he added.

In an email to patients Monday, Kaiser warned that should the strike take place, "we may need to reschedule some nonurgent appointments and procedures," and warned of longer wait and hold times.

"We’ll keep bargaining until we reach an agreement. We’ll continue to bargain in good faith until we reach a fair and equitable agreement to ensure Kaiser Permanente continues to attract and retain the best people in health care — and remains a best place to work and get care," said the company.

The strike is the latest in the US as workers across multiple industries seek better wages amid soaring inflation and ballooning executive pay.