Employer WellnessEmployer wellness programs and employer wellness consulting services

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, businesses have understood the benefits associated with keeping workers well – raised productivity from decreased rates of absence and lowered disability claims. For these reasons, coupled with the fact that many businesses realized double-digit healthcare costs last year, businesses should consider Employee Health Promotion Programs as a way to keep workers healthy.

But just how important are these initiatives to workers? How frequently are they willing to take part in initiatives designed to positively impact their health and wellness? Who do workers 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 workers nationwide about their perceptions of Employee Health Promotion Programs. More than three-quarters of all members 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. employee retention and turnover impact the bottom line, so building Employee Health Promotion Programs into the work site culture is a valuable way to help retain talented workers in addition to enhancing personal health and workplace 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 as a priority topic for work site wellness.

In addition to stress, other preferred topic areas include screening initiatives (84%), exercise/physical fitness initiatives (84%), health 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 workplace violence.

What you should do

With such a broad range of health concerns, a primary goal for businesses is finding a way to proactively address the health/wellness needs of the largest number of workers, 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 workers 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-and-learn presentations and reimbursement or incentive programs.

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

This points to the need for a broad-based, structured Employer Wellness Program using a innovative approach, with an incentive for participation and effective program marketing.

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

The result: workers become savvier healthcare consumers who feel more in charge of their personal health. And healthier workers make for a healthier bottom line.

Stress continues to drive workers’ work-related health concerns, which is probably why most respondents (78%) in a recent survey claim they would take part in a Employer 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 workers nationwide were interviewed telephonically.

“Today’s workers 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 businesses to serve as an ally to their workers 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 Health Promotion Program.

Topping the list of most interesting Employee Health Promotion Programs cited by workers is stress management (85%), closely followed by screening initiatives (84%), exercise/physical fitness initiatives (84%), health insurance education (81%) and disease management seminars (80%).

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

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

Centers for Disease Control and Prevention (CDC): Data and statistics

• http://www.cdc.gov/DataStatistics/
• Data and statistics are available by topic (i.e., asthma, injuries, MRSA).
• Data access tools are available to customize data tables and query datasets (i.e., Healthy People DATA2010, smoking-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).

Employer Wellness Program data collection and analysis is frequently avoided because of a perceived lack of resources for this very important Employer 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 Medical Center has an internship Employee Health Promotion Program, get to know the Internship Director.
• Take advantage of these resources – including having the Director and/or interns/residents begin the outcome data collection plan for your Employee Health Promotion Program.

Local college and graduate students

• Where appropriate volunteer agreements are in place, use local college/graduate students to help collect, input, and analyze Employer Wellness Program data.
• Take advantage of the fact that these students are frequently 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 for your Employee Health Promotion Program.

Other Medical Personnel

• Partner with other Medical Personnel. Determine 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.
• Ensure that 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.

Past Employer Wellness Program members

• Past Employer Wellness Program members are also a good resource.
• They may be willing to lead a class session, provide encouragement to current Employer Wellness Program members, 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 Health Promotion Program.

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

Manage Employer Wellness Program data electronically.

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

Find the Employer Wellness Program system that works best for you.

• Some workers are more comfortable with spreadsheet applications; others rather work with database applications.
• You will be more likely to use a Employer 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 Health Promotion Programs.

Keep the Employer 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 Employer Wellness Program outcomes data.
• A simple spreadsheet is an excellent way to keep your data organized.

Store all Employer Wellness Program data numerically.

• Using numbers (instead of words) will make the data much easier to enter and analyze. By way of example: use “1” for yes; “0” for no OR “1” for male; “2” for female.
• Number survey responses that contain strings of words. By way of 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 Employer Wellness Program data clearly.
• Ensure that 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 Employer Wellness Program data units.
• Ensure that all data entered into a given column is expressed with the same unit of measure. By way of 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 participant accomplishments. Keeping your data organized also makes it easier to communicate Employer Wellness Program impact to leadership and make Employer 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 Employer Wellness Program to determine where the program stands now and how the Employer Wellness Program can better follow evidence-based recommendations.

To start a gap analysis, ask these simple questions about your Employee Health Promotion Program:

• What is the current state of the Employee Health Promotion Program?
• How does the Employer 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 Employer Wellness Program move forward towards the desired state?”

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

Employer Wellness Program employer plan review (from Key #19)

• A Employer Wellness Program employer plan is a roadmap for success.
• Your Employer Wellness Program employer plan should convincingly demonstrate that your Employer Wellness Program will help the organization to achieve its goals.

More smart Employer Wellness Program employer planning strategies

Planning the Employer Wellness Program
• Determine how your organization plans so that your planning process will be in sync with what already happens in the organization.
• Involve other workers. 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

• Consider the barriers and challenges that might be encountered during Employer 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 and opportunities for growth or increased partnerships with other company personnel.

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

The best Employer Wellness Program employer planning strategies
• Get out of your office; get out of the employer. The more workers you involve in the Employer Wellness Program planning process, the better. Always look for ways to expand your network.
• Keep your budget workers informed. Get to know their philosophy of financial management.
• Be able to articulate the impact if your budget is not fully funded.
o Avoid basing your impact-if-not-funded argument solely on: “We have to.”
o Instead, describe the impact-if-not-funded with phrases like: injuries to workers, raised compensation costs, raised 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 frequently 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 Employer 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 Health Promotion Program.

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

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

Questions to ask when developing a Employer Wellness Program employer plan
• Why do you need to do the Employee Health Promotion 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 Health Promotion Program?
• How much will the Employer Wellness Program cost Upper Management?
• What is Upper Management going to get out of the Employee Health Promotion Program? Why should Upper Management invest in the Employee Health Promotion Program?

Employer Wellness Program employer Plan Components

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

Gaining the support of leadership

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

As they say: “timing is everything.” Use the guidelines below to guide the timing of Employer Wellness Program activities and data collection.

Timing: Employer Wellness Program Start-up

• Consider the optimal time to start a new Employee Health Promotion Program. Take into account preferences of the target population and other factors that could affect enrollment and participation.
• By way of example, coordinating the start of an adult weight management initiative with the start of school in August or September may be a good tie-in with a “fresh start.”
• On the other hand, starting an adult weight management initiative In January may not be a great idea because of the constraints that weather may put on exercising outdoors.
• Take advantage of other timing cycles at your company. Planning a marketing blitz just after the PCS turnover has been completed is a good way to let new personnel know what Employer Wellness Program options are available.

Timing: Employer Wellness Program Participant Support

• Consider how frequently Employer Wellness Program sessions should be offered to provide the best support and education for members and the best opportunity for success.
• Get feedback from members regarding what session frequencies work best for them.
• Consider the timing for other support mechanisms like email encouragement. What timing of those messages will benefit members most: Weekly? Bi-monthly? Monthly?

Timing: Employer Wellness Program Data Collection

• Collecting data is an excellent way to track participant progress and also to identify potential problems within a Employee Health Promotion Program. So, give some thought to the frequency and timing of data collection.
• Select metrics that can realistically change during the Employer Wellness Program implementation time period. By way of example, BMI and weight may not change very much during a 10-week Employee Health Promotion Program; however, step counts are more likely to noticeably change.
• Some data, such as participant responsiveness to out-of-class assignments (like food journals) and other interim data (like step counts) will provide important information needed to “adjust fire” as needed and make Employer Wellness Program changes if something is not working.
• Be flexible regarding data collection frequency. Instead of requiring that members complete an physical fitness log every day, for example, consider asking for a “snapshot” summary from two or three days during the week. You will still get information to review, but members will have an easier time complying with the assignment.

Timing: Employer Wellness Program Follow-up

• Because the we are such a mobile population, it’s best to plan some sort of post-Employee Wellness Program follow-up data collection within two to four months after the Employer Wellness Program ends.
• You can always try to collect additional follow-up data at 6 or 12 months after Employer Wellness Program completion. However, if you collect the data sooner, you’ll at least have collected some short term Employer Wellness Program impact information before members are lost to follow-up.

Employer Wellness Program communication is important to all facets of Wellness and preventive medicine and is relevant to:

• Healthcare provider-patient relationships
• An individual’s exposure to, search for, and use of Employer Wellness Program information
• Effective counseling and patient education for behavior change
• Content of public health messages and community campaigns

Effective health communication should have these attributes:

• Accuracy: content is valid and error-free
• Availability: delivered or placed where the intended audience can access the information
• Balance: content presents benefits and risks of potential actions
• Consistency: content is locally consistent over time and is also consistent with information from other reliable sources
• Evidence-based: content and methods of delivery are based on relevant scientific evidence
• Reach: content gets to or is available to as many workers as possible in the target population
• Reliability: content source is credible; content is kept up-to-date
• Repetition: delivery of/access to the content is continued over time, to reinforce the impact with the audience and to reach new members of the target population
• Timeliness: content is provided when the audience is most receptive to, or in need of, the specific information
• Understandability: reading, language levels, and format are appropriate for the specific audience (i.e., Employees, Family Members, Garrison leadership, etc.)

What the research says about health communication

• Health communication best supports Wellness when multiple communication methods are used to reach specific audiences.
• Effective Wellness and communication initiatives should reflect an audiencecentered perspective, and reflect the preferred formats, contexts, and way of communication for the intended audience.

Material adapted from: U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government Printing Office, November 2000.
http://www.healthypeople.gov/document/HTML/Volume1/11HealthCom.htm