Wellness ArticlesWellness Articles

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 staff members and provide primary care - all within the context of the current regulatory and legal environment.

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

OHNs can develop, implement and evaluate components of work site Employee Health and Wellness Programs such as testing programs, exercise/fitness courses, Stress management, smoking cessation, nutrition and weight control programs, as well as chronic illness management programs. Plus, OHNs can help staff members navigate through complicated health plans and may even serve as a triage point between staff members and their personal 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 staff members are under treatment for chronic diseases like heart disease, worksite nurses can routinely monitor risk factors such as blood pressure or cholesterol on a regular basis.

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

In companies 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 programs and involving staff members 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 business 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, employers have understood the benefits associated with keeping workers well - increased productivity from decreased rates of absence and lowered disability claims. For these reasons, coupled with the fact that many companies realized double-digit health care costs last year, companies should consider Employee Health and Wellness Programs as a way to keep staff members healthy.

But just how important are these programs to staff members? How frequently are they willing to participate in programs designed to positively impact their health and wellness? Who do staff members trust to provide them with important information about their health?

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

The AAOHN survey questioned 500 staff members nationwide about their perceptions of Employee Health and Wellness Programs. More than three-quarters of all members indicated these programs 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 Health and Wellness Programs into the work site culture is a valuable way to help retain talented staff members in addition to enhancing personal health and worksite productivity.

Health wish list

Employees appear to have their own agenda when it comes to their health. With new pressures resulting from an unstable economy, 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 testing programs (84%), exercise/physical fitness programs (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 worksite violence.

What you should do

With such a broad range of health concerns, a primary goal for employers is finding a way to proactively address the health needs of the largest number of staff members, 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 individuals 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 individuals to sign on to a Employee Health and Wellness Program. While survey respondents indicated health and Employee Health and Wellness Programs are important, just six out of 10 (60%) reported that they participated in the Employee Health and Wellness Programs at their companies. The other 40% cited lack of interest and lack of time as deterrents.

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

By investing in an organized Employee Health and Wellness Program headed by a qualified health care professional such as an worksite nurse, companies can give staff members the access to the health information they want, and increase participation and generate interest at the same time.

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

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

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

“Today’s staff members 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 employers to serve as an ally to their staff members by providing 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 and Wellness Program.

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

More than half of staff members (61%) would prefer to receive health and wellness information from a health care consultant or worksite nurse, compared to pamphlets or brochures (18%) or human resources staff (15%).

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

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

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

Local college and graduate students
• Where appropriate volunteer agreements are in place, use local college/graduate students to help collect, input, and analyze Employee Health and 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 business students. Let them calculate a cost avoidance or return on investment for your Employee Health and 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.
• 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 at your Medical Treatment Facility to help collect and input data.

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

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

Manage Employee Health and Wellness Program data electronically.
• Storing Employee Health and 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 Employee Health and Wellness Program information that exist only on paper into .pdf format for permanent storage.

Find the Employee Health and Wellness Program system that works best for you.
• Some individuals are more comfortable with spreadsheet applications; others prefer to work with database applications.
• You will be more likely to use a Employee 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 Health and Wellness Programs.

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

Store all Employee Health and Wellness Program data numerically.
• Using numbers (instead of words) will make the data much easier to enter and analyze. 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 Employee Health and 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 Employee Health and Wellness Program data units.
• Ensure that 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 participant accomplishments. Keeping your data organized also makes it easier to communicate Employee Health and Wellness Program impact to leadership and make Employee Health and Wellness Program improvements as needed.

A gap analysis is an assessment tool that enables a business 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 Employee Health and Wellness Program to determine where the program stands now and how the Employee Health and Wellness Program can better follow evidence-based recommendations.

To begin a gap analysis, ask these simple questions about your Employee Health and Wellness Program:
• What is the current state of the Employee Health and Wellness Program?
• How does the Employee 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 Employee Health and Wellness Program move forward towards the desired state?”

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

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

More smart Employee Health and Wellness Program business planning strategies

Planning the Employee 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 individuals. 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 Employee 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 installation personnel.

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

The best Employee Health and Wellness Program business planning strategies
• Get out of your office; get out of the business. The more individuals you involve in the Employee Health and Wellness Program planning process, the better. Always look for ways to expand your network.
• Keep your budget individuals 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 solely 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 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 Employee Health and Wellness Program business plan is essential in these times of shrinking budgets and resources. A good business plan will help you gain leadership support and help you get and keep resources needed to implement the Employee Health and Wellness Program.

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

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

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

Employee Health and Wellness Program business Plan Components
• Title and duration of the Employee Health and Wellness Program
• Points of contact
• Background information (description of need; bibliography/literature review; how the Employee Health and Wellness Program will help achieve the organization’s goals)
• Employee 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 individuals)

Gaining the support of leadership
• Clearly link the Employee 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 Employee Health and Wellness Program business plan will help you gain leadership support, help you get and keep resources needed to implement the Employee Health and Wellness Program, and keep the Employee Health and Wellness Program on track towards meaningful outcomes.

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

Timing: Employee Health and Wellness Program Start-up
• Look at the optimal time to start a new Employee Health and Wellness Program. Take into account preferences of the target population and other factors that could affect enrollment and participation.
• For 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 installation. Planning a marketing blitz just after the PCS turnover has been completed is a good way to let new personnel know what Employee Health and Wellness Program options are available.

Timing: Employee Health and Wellness Program Participant Support
• Look at how frequently Employee Health and 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.
• Look at the timing for other support mechanisms like email encouragement. What timing of those messages will benefit members most: Weekly? Bi-monthly? Monthly?

Timing: Employee Health and Wellness Program Data Collection
• Collecting data is an excellent way to track participant progress and also to identify potential problems within a Employee Health and Wellness Program. So, give some thought to the frequency and timing of data collection.
• Select metrics that can realistically change during the Employee Health and Wellness Program implementation time period. For example, BMI and weight may not change very much during a 10-week Employee Health and Wellness 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 Employee Health and 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: Employee Health and Wellness Program Follow-up
• Because the we are such a mobile population, it’s best to plan some sort of post-Employee Health and Wellness Program follow-up data collection within two to four months after the Employee Health and Wellness Program ends.
• You can always try to collect additional follow-up data at 6 or 12 months after Employee Health and Wellness Program completion. However, if you collect the data sooner, you’ll at least have collected some short term Employee Health and Wellness Program impact information before members are lost to follow-up.