Posts from — December 2008

Wellness programming means different things to different corporations. Effective wellness initiatives  can be as simple as bringing baskets of fresh fruit into break rooms to encourage better eating. They  can be as extensive as building fitness facilities onsite or paying for obesity treatments.

A driving factor behind the push toward wellness spans corporations of all types, sizes and cultures:  that is, health care expenses are spilling over the organization belt buckle. The annual cost of  medical services in the United States is increasing at seven times the rate of inflation. And the rise  in medical costs is one boom pundits expect our economy to sustain.1

This trend makes it increasingly challenging for corporations to maintain current levels of insurance  coverage. In 2003, health care inflation forced 65% of corporations to increase employees’ share of  health costs.

Seventy-nine% of large firms said they will increase workers’ share of health costs in 2004.2 But with  lost benefits and increased financial burdens come lost morale and productivity.

Companies are searching for another way. While corporations cannot control many of the supply-side  elements contributing to increasing health care costs—malpractice insurance rates, the nursing  shortage—they can help curb demand. That’s why efforts are being redirected from illness to wellness.

The case for Employee Wellness Programs is supported by an ever growing body of evidence demonstrating  the high costs associated with controllable health risks:

• One research study reports that obesity raises health care costs by 36% and medication costs by 77%.
• Michigan officials estimate physical inactivity cost the state nearly $8.9 billion in 2002, a cost  estimated to be largely borne by corporations through insurance premiums and lost productivity.
• The not-for-profit National Committee for Quality Assurance reports that the estimated average cost  for postnatal care for women who did not receive prenatal care was $2,341 more than for women who had.  And the indirect costs of unhealthful behavior can be just as high.

Information shows that healthier employees are more productive, spending more time at work and showing  increased “presenteeism,” or productivity, while there. Further, healthier employees use fewer medical  services. The five leading causes of death in the United States — heart disease, cancer, stroke,  chronic obstructive pulmonary disease and diabetes —  are directly linked to unhealthy lifestyles.  Clearly, encouraging healthful habits presents an opportunity to improve employees’ well being, reduce  the need for health care services and help control costs.

Offering worker wellness benefits — large or small — represents an intersection between organization  social responsibility and responsibility to stakeholders. Between worker health and corporate health.  It’s often the right thing to do for employees and corporations.

Research by Traveler’s Corp. shows a $3.40 return for every dollar invested in Employee Wellness  Programs. For many corporations, the choice to offer worker wellness benefits is easy—one where  conscience and pragmatism align.

The challenge arises in selecting the initiatives that will deliver the most impact based on trends in  your employees’ health risks and medical claims costs. From large corporations to the corner deli,  employer owners welcome ways to boost productivity, reduce absenteeism and cut costs. Likewise,  Employee Wellness Programs can range from modest to elaborate.

In deciding where to focus a employer’s limited resources, looking at benefits, costs and best  practices is a good starting point. This section profiles six aspects of wellness and explores their  benefits to employees and corporations.

When it comes to working wellness into your workforce, you want someone who knows the ins and outs of  health promotion, and who can counsel employees and provide primary care – all within the context of  the current regulatory and legal environment.

AAOHN’s survey reported that more than half of employees (61%) want to receive health and wellness  information from a health care professional, such as a consultant or an on-site occupational health  nurse (OHN), compared to pamphlets or brochures (18%) or human resources staff (15%).

OHNs can develop, begin and evaluate components of work site Employee Wellness Programs such as testing  initiatives, exercise/fitness courses, Stress Management Programs, tobacco use cessation, nutrition and  weight control initiatives, as well as chronic illness management initiatives. Plus, OHNs can help  employees navigate through complicated health plans and may even serve as a triage point between  employees and their own health care providers.

Employees might refrain from seeing their health care provider when it means time away from work,  inconvenient parking, waiting time in the office and co-pays. In situations where employees are under  treatment for chronic diseases like heart disease, on-site nurses can routinely monitor risk factors  such as blood pressure or cholesterol on a regular basis.

It’s often easier for an worker to ask an on-site nurse for information about symptoms or prescription  medication than it is to schedule a follow-up visit to a own health care provider. Advantages realized  by corporations include improved worker morale and retention, a recruitment advantage, increased  productivity and decreased time away from work.

In corporations with a safety department, the OHN can evaluate and address work-related health issues,  including participation in workstation evaluations to correct potential ergonomic problems, and  proactively addressing muscle strains by developing stretching initiatives and involving employees in  leading stretches.

Good for waistlines & your bottom line

By Sandra Simpson, APRN, BC, COHN-S, manager in Occupational Health Services at a Fortune 500 employer  in Memphis, Tenn., and a member of the board of directors of the American Association of Occupational  Health Nurses (AAOHN). For a copy of the AAOHN wellness survey, visit www.aaohn.org, or call (800)  241-8014, x0.

In today’s hectic world, most of us are spending more time at work, and have increasingly less time to  look after our health. For a long time, corporations have understood the benefits associated with  keeping workers well – increased productivity from reduced absenteeism and lowered disability claims.  For these reasons, coupled with the fact that many corporations realized double-digit health care costs  last year, corporations should consider Employee Wellness Programs as a way to keep employees healthy.

But just how important are these initiatives to employees? How often are they willing to take part in  initiatives designed to positively impact their health and wellness? Who do employees trust to provide  them with important information about their health?

Answers to these questions and more were recently garnered from a research study commissioned by the  American Association of Occupational Health Nurses Inc. (AAOHN).

The AAOHN survey questioned 500 employees nationwide about their perceptions of Employee Wellness  Programs. More than three-quarters of all participants indicated these initiatives are a good way to  improve their overall health, and nearly 60% consider these offerings an incentive to remain with their  current employer. worker retention and turnover impact the bottom line, so building Employee Wellness  Programs into the work site culture is a valuable way to help retain talented employees in addition to  enhancing personal health and worksite productivity.

The Health wish list

Employees appear to have their own agenda when it comes to their health. With new economic pressures,  national security threats and work/balance issues, it’s not surprising that 85% of survey respondents  cited Stress Management Programs as a priority topic for work site wellness.

In addition to stress, other preferred topic areas include testing initiatives (84%), exercise/physical  fitness initiatives (84%), medical insurance education (81%) and disease management seminars (80%).

In addition to lifestyle and personal health issues, those asked expressed concern about work-related  health issues, including strains and injuries resulting from lifting or task-oriented muscle  repetition, exposure to harmful substances, personal injury, vision changes due to computer work and  worksite violence.

What you should do

With such a broad range of health concerns, a key goal for corporations is finding a way to proactively  address the health and wellness needs of the largest number of employees, and effectively change  unhealthy behaviors, promote wellness and ward off disease and illness.

Printed materials such as brochures, posters, fliers or pamphlets present an easy solution. But it’s  important to remember that different staff members require different formats for learning. A good rule  of thumb: provide information in a variety of learning formats such as videos, pamphlets,  health-related quizzes, display boards, Lunch & Learn presentations and reimbursement or incentive  programs.

This assumes you’ve overcome the first hurdle – getting staff members to sign on to a Employee Wellness  Program. While survey respondents indicated health and Employee Wellness Programs are important, just  six out of 10 (60%) reported that they participated in the Employee Wellness Programs at their  corporations. The other 40% cited lack of interest and lack of time as deterrents.

This points to the need for a comprehensive, structured Company Health and Wellness Program using a  innovative approach, with an incentive for participation and effective program marketing.

By investing in an organized Company Health and Wellness Program headed by a qualified health care  professional such as an on-site nurse, corporations can give employees the access to the health  information they want, and increase participation and generate interest at the same time.

The result: employees become savvier health care consumers who feel more in charge of their own health.  And healthier employees make for a healthier bottom line.

Stress continues to drive employees’ work-related health concerns, which is probably why most  respondents (78%) in a recent survey claim they would take part in a Company Health and Wellness  Program to help their overall health and wellness.

In a recent research study commissioned by the American Association of Occupational Health Nurses, Inc.  (AAOHN), 500 full-time employees nationwide were interviewed telephonically.

“Today’s employees are clearly dealing with a lot of pressures such as the effects of 9/11, an unstable  economy, national security threats and work/balance issues. There is a real opportunity for  corporations to serve as an ally to their employees by offering them with resources to better manage  their physical and emotional health – anything from stress management seminars to nutrition and  physical fitness counseling,” says Deborah V. DiBenedetto, president of AAOHN.

Nearly 80% of respondents believe their health would improve if they were offered the right information  and tools through a viable Employee Wellness Program.

Topping the list of most interesting Employee Wellness Programs cited by employees is stress management  (85%), closely followed by testing initiatives (84%), exercise/physical fitness initiatives (84%),  medical insurance education (81%) and disease management seminars (80%).

More than half of employees (61%) would rather receive health and wellness information from a health  care consultant or on-site nurse, compared to pamphlets or brochures (18%) or human resources staff  (15%).

Effective Employee Wellness Programs include the use of data sources in support of Company Health and  Wellness Program planning, implementation, and evaluation. Information sources can be used to complete  a community needs assessment, develop realistic Company Health and Wellness Program goals and  objectives, and gain Senior Management support.

Centers for Disease Control and Prevention (CDC): Information and statistics
• http://www.cdc.gov/DataStatistics/
• Information and statistics are available by topic (i.e., asthma, injuries, MRSA).
• Information access tools are available to customize data tables and query datasets (i.e., Healthy  People DATA2010, tobacco use-Attributable Mortality, Morbidity, and Economic Costs).
• Nationwide survey data is available (i.e., National Health and Nutrition Examination Survey  (NHANES)).

CDC Behavioral Risk Factor Surveillance System (BRFSS)
• http://www.cdc.gov/brfss/index.htm
• BRFSS is the world’s largest, ongoing telephone health survey system. BRFSS has been tracking health  conditions and risk behaviors in the US yearly since 1984.
• Chronic Disease Indicators are divided into seven categories: physical activity and nutrition,  tobacco and alcohol use, cancer, cardiovascular disease, diabetes, overarching conditions, and other  disease and risk factors.
• Prevalence data is also available (i.e., weight classification by Body Mass Index and age).

Company Health and Wellness Program data collection and analysis is often avoided because of a  perceived lack of resources for this very important Company Health and Wellness Program component. Use  the suggestions below to take advantage of a variety of resources available at your company or in the  local community.

Medical Interns and Residents
• If your Onsite Healthcare Center has an internship Employee Wellness Program, get to know the  Internship Director.
• Make use of these resources – including having the Director and/or interns/residents begin the  outcome data collection plan for your Employee Wellness Program.

Local college and graduate students
• Where appropriate volunteer agreements are in place, use local college/graduate students to help  collect, input, and assess Company Health and Wellness Program data.
• Make use of the fact that these students are often looking for projects.
• If there are no “health-related” students/interns in your area, consider using employer students. Let  them calculate a cost avoidance or return on investment (ROI) for your Employee Wellness Program.

Other Medical Personnel
• Partner with other Medical Personnel. Find out who is collecting data, what data they are collecting,  and how they are collecting it.
• If they are using a survey and the survey administration process is already in place, ask if you can  add a question or two.
• Be aware of other research going on at your facility. They may already be collecting data you need OR  may have analysis resources that can be shared.
• Make sure other departments in the Medical center know you can always use some extra help if they  have personnel with any down time. Use these resources for data entry or other administrative tasks.
• Make use of the volunteers to help collect and input data.

Previous Company Health and Wellness Program participants
• Previous Company Health and Wellness Program participants are also a good resource.
• They may be willing to lead a class session, provide encouragement to current Company Health and  Wellness Program participants, or help collect data.
You can improve data collection and analysis by taking advantage of local resources. Using these  resources expands the reach and impact of your Employee Wellness Program.

Keeping Company Health and Wellness Program data organized is essential in order to be able to  determine Company Health and Wellness Program impact and member progress. Use the simple steps below to  keep your data organized.

Manage Company Health and Wellness Program data electronically.
• Storing Company Health and Wellness Program outcomes data electronically is the best way to manage  that information.
• An electronic system will enable you to review and assess the data more efficiently.
• Scan old surveys and other Company Health and Wellness Program information that exist only on paper  into .pdf format for permanent storage.

Find the Company Health and Wellness Program system that works best for you.
• Some staff members are more comfortable with spreadsheet applications; others rather work with  database applications.
• You will be more likely to use a Company Health and Wellness Program that you are familiar and/or  comfortable with.
• Standardize data collection and organization. Keep data columns/fields in the same order for all  Employee Wellness Programs.

Keep the Company Health and Wellness Program as simple as possible.
• You do not have to be a Wellness Programming wizard or use complicated data entry interfaces in order  to manage Company Health and Wellness Program outcomes data.
• A simple spreadsheet is an excellent way to keep your data organized.

Store all Company Health and Wellness Program data numerically.
• Using numbers (instead of words) will make the data much easier to enter and assess. For example: use  “1” for yes; “0” for no OR “1” for male; “2” for female.
• Number survey responses that contain strings of words. For example: instead of entering the  responses: “patient education videos”, “news,” or “no TV,” number the responses so you only have to  enter “1,” “2,” or “3.”

Label all Company Health and Wellness Program data clearly.
• Make sure all the data columns, rows, or fields are labeled. The data is worthless if you don’t know  what data is in which column.
• The spreadsheet/database should include an explanation for column, row, field, and data abbreviations  and a key for numbered responses.

Use consistent Company Health and Wellness Program data units.
• Make sure all data entered into a given column is expressed with the same unit of measure. For  example, enter all heights as total inches, not as a combination of feet and inches.
Putting your data in order by using a simple system that works for you will enable you to track member  accomplishments. Keeping your data organized also makes it easier to communicate Company Health and  Wellness Program impact to leadership and make Company Health and Wellness Program improvements as  needed.

A gap analysis is an assessment tool that enables a employer to compare its current capabilities and  performance with industry benchmarks and expectations for performance. A gap analysis is used to  identify areas that have room for improvement.

Gap analysis can also be used for your Company Health and Wellness Program to determine where the  program stands now and how the Company Health and Wellness Program can better follow evidence-based  recommendations.

To start a gap analysis, ask these simple questions about your Employee Wellness Program:
• What is the current state of the Employee Wellness Program?
• How does the Company Health and Wellness Program measure up to evidence-based practices? (i.e., the  desired state)

The gap is the difference between the current and desired states.

After the gap has been identified, the next step is to determine the action steps that are needed to  close the gap. These actions answer the question: “How can the Company Health and Wellness Program move  forward towards the desired state?”

Sometimes the gaps that need to be filled can be addressed through Company Health and Wellness Program  changes; other gaps might require policy changes. However, using a gap analysis will help you identify  areas for Company Health and Wellness Program improvement as well as the actions needed to make  progress towards those goals.

Company Health and Wellness Program employer plan review (from Key #19)
• A Company Health and Wellness Program employer plan is a roadmap for success.
• Your Company Health and Wellness Program employer plan should convincingly demonstrate that your  Company Health and Wellness Program will help the organization to achieve its goals.

More smart Company Health and Wellness Program employer planning strategies

Planning the Company Health and Wellness Program
• Find out how your organization plans so that your planning process will be in sync with what already  happens in the organization.
• Involve other staff members. A planning team brings their combined experience and perspective to the  process. Including potential partners as you plan will make it easier to get their buy-in later.

Thinking of the big picture
• Look at the barriers and challenges that might be encountered during Company Health and Wellness  Program implementation. Develop strategies ahead of time to overcome these potential problems.
• Do a SWOT analysis and examine Strengths, Weaknesses, Opportunities, and Threats.

This analysis will help you identify potential problem areas or resource shortfalls as well as  opportunities for growth or increased partnerships with other company personnel.

The WORST employer planning strategy: sitting in your office; working by yourself.

The best Company Health and Wellness Program employer planning strategies
• Get out of your office; get out of the employer. The more staff members you involve in the Company  Health and Wellness Program planning process, the better. Always look for ways to expand your network.
• Keep your budget staff members informed. Get to know their philosophy of financial management.
• Be able to articulate the impact if your budget is not fully funded.
o Stay away from basing your impact-if-not-funded argument only on: “We have to.”
o Instead, describe the impact-if-not-funded with phrases like: injuries to workers, increased  compensation costs, increased medical care costs for patients, lost work time, loss of  licenses/accreditations, loss of workload to the Tricare network.
• Always have purchase requests ready to be submitted. There is often a short window of time to process  these requests. Having the information gathered ahead of time will make it easy to submit the  information right away.

A well thought-out Company Health and Wellness Program employer plan is essential in these times of  shrinking budgets and resources. A good employer plan will help you gain leadership support and help  you get and keep resources needed to begin the Employee Wellness Program.

A employer plan is a roadmap for success. Use the guidelines below to develop a realistic employer plan  and budget for your Employee Wellness Programs.

What is a employer plan?
• A plan for success
• A document that convincingly demonstrates that your Company Health and Wellness Program will help the  business to achieve its goals.

Questions to ask when developing a Company Health and Wellness Program employer plan
• Why do you need to do the Employee Wellness Program?
• What are you going to do?
• Where are you going to do it?
• Who is the target audience?
• How are you going to do it?
• Who is going to begin the Employee Wellness Program?
• How much will the Company Health and Wellness Program cost Senior Management?
• What is Senior Management going to get out of the Employee Wellness Program? Why should Senior  Management invest in the Employee Wellness Program?

Company Health and Wellness Program employer Plan Components
• Title and duration of the Company Health and Wellness Program
• Points of contact
• Background information (description of need; bibliography/literature review; how the Company Health  and Wellness Program will help achieve the organization’s goals)
• Company Health and Wellness Program description
• Goals and objectives
• Implementation site
• Target population
• Work plan
• Partnerships and collaborations
• Timelines and milestones
• Budget and resource requirements (dollars and staff members)

Gaining the support of leadership
• Clearly link the Company Health and Wellness Program goals and objectives to the organization’s  strategic plan.
• Focus on the desired outcomes.
• Use the right language for the right audience. For example, Senior Management is interested in  decreased clinic visits, increased provider productivity, management of the health of the population.  However, Senior Management is interested in increased readiness, decreased lost duty/training time, and  decreased disability and FECA claims.
A well thought-out Company Health and Wellness Program employer plan will help you gain leadership  support, help you get and keep resources needed to begin the Employee Wellness Program, and keep the  Company Health and Wellness Program on track towards meaningful outcomes.