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The Case for Worksite Wellness Programs

Wellness programming means different things to different organizations. Effective wellness initiatives can be as simple as bringing bushel 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 organizations of all types, sizes and cultures: that is, healthcare expenses are spilling over the corporate belt buckle. The annual cost of medical services in the U.S. is rising 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 employers to maintain current levels of insurance coverage. In 2003, healthcare inflation forced 65% of organizations to increase staff members’ 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.

Employers are searching for another way. While organizations cannot control many of the supply-side elements contributing to rising healthcare 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 Worksite Wellness Programs is supported by an ever growing body of evidence demonstrating the high costs associated with controllable health risks:

• One study reports that obesity raises healthcare 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 employers 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.

Data shows that healthier staff members are more productive, spending more time at work and showing increased “presenteeism,” or productivity, while there. Further, healthier staff members use fewer medical services. The five leading causes of death in the U.S. — 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 staff members’ well being, reduce the need for healthcare services and help control costs.

Offering employee wellness benefits — large or small — represents an intersection between corporate social responsibility and responsibility to stakeholders. Between employee health and corporate health. It’s often the right thing to do for staff members and employers.

Research by Traveler’s Corp. shows a $3.40 return for every dollar invested in Worksite Wellness Programs. For many organizations, the choice to offer employee 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 staff members’ health risks and medical claims costs. From large organizations to the corner deli, employer owners welcome ways to boost productivity, reduce rates of absence and cut costs. Likewise, Worksite Wellness Programs can range from modest to elaborate.

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

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Worksite Wellness Programs: Stress Management

Stress continues to drive staff members’ work-related health concerns, which is probably why most respondents (78%) in a recent survey claim they would take part in a Worksite 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 phone.

“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 Worksite Wellness Program.

Topping the list of most interesting Worksite Wellness Programs cited by staff members 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 staff members (61%) would prefer to receive health and wellness information from a healthcare consultant or on-site nurse, compared to pamphlets or brochures (18%) or human resources staff (15%).

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Bottom Line Up Front Worksite Wellness Programs

Keeping the bottom line up front Bottom Line Up Front in Worksite Wellness Program will help you get and sustain Upper Management support. A Bottom Line Up Front approach will also help you more realistically measure the impact of your Worksite Wellness Program.

The bottom line in Worksite Wellness Programs answer two primary questions:

• How will participant health be improved?
• What’s in it for Upper Management?

The ultimate bottom line: all roads should lead to readiness.

• Always be ready to communicate to leadership the ways that your Worksite Wellness Program impacts readiness.
• Think like Upper Management: what Worksite Wellness Program outcomes will be important from a Upper Management point of view?
• Develop line-centered language that communicates those outcomes.
• Ask participants how they think a particular Worksite Wellness Program enhances force readiness. This input is a valuable source of information.

Use the following steps as a Bottom Line Up Front approach to Worksite Wellness Programs.

Step 1: Think about the end of the Worksite Wellness Program first and plan backwards.
• It has been said, “If you don’t know where you’re going, any road will get you there.”
• Before planning or starting any part of the Worksite Wellness Program, be able to answer the questions: how will participant health be improved? What’s in it for Upper Management?

Step 2: Identify concrete Worksite Wellness Program outcomes.
• Identify up front what the Worksite Wellness Program is working towards.
o For example: will participants lose weight? Walk more steps? Decrease injuries? Move to another stage of change?
• Identify any processes or procedures that will be improved.
o For example: which pharmacy operations will become more efficient? How will record-keeping be streamlined?

Step 3: Determine what will be measured to show that Worksite Wellness Program goals were met.
• Look at what information is really needed to show Worksite Wellness Program effectiveness. Avoid the temptation to collect every possible piece of data. Choose a handful of important information points and stick to those.
• Think backwards when determining what information to collect – consider how easily follow-up information can be collected when a Worksite Wellness Program ends. Getting follow-up information is often a challenge.
• Only collect information for health behaviors or indicators that the Worksite Wellness Program actually affected.
o For example: if the main Worksite Wellness Program goal is that participants will walk more steps, then it may be better NOT to choose changes in cholesterol level as a Worksite Wellness Program outcome (unless the Worksite Wellness Program specifically addresses cholesterol).
• Avoid measuring outcomes that the Worksite Wellness Program cannot (or did not) affect.

Step 4: Determine what Worksite Wellness Program elements must be included to move participants towards the Worksite Wellness Program goals.
• The concrete Worksite Wellness Program outcomes identified in Step 2 are the compass for keeping the Worksite Wellness Program on track. All Worksite Wellness Program elements should lead towards that ultimate goal.

Working backwards when planning and starting Worksite Wellness Programs is really forward thinking. Keeping the bottom line up front is a smart approach to Worksite Wellness Programs.

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Keys to Effective Worksite Wellness Programs

Collaboration and Effective Worksite Wellness Programs

Why should you collaborate?

Active, ongoing partnerships and cooperative efforts multiply Worksite Wellness Program resources in order to better serve Employees and their families.

How can you build collaboration into a Worksite Wellness Program?

Get Ready…
• Brainstorm a list of every potential Wellness partner you can think of. Be creative!
• Be a politician: introduce yourself to everyone BEFORE you need their help.
• Develop a plan to get Upper Management support from as high up the chain as possible. Make sure to include specific ways that your Worksite Wellness Program will impact force readiness.
• Determine how YOU can help your partners (not just what they can do for you).

Be Steady…
• Get input from everyone that your Worksite Wellness Program will affect. Make a special effort to talk to the workers closest to Worksite Wellness Program implementation (those with “boots on the ground”).
• The most frequently asked questions should be: “What would you suggest?” and “How do you think this would work best?”
• Locate someone who has done the same type of Worksite Wellness Program before and ask their advice. (Hint: the Worksite Wellness Program has a list of many Wellness POCs.)
• Plan NOW to show Worksite Wellness Program effectiveness. Identify who may ALREADY BE COLLECTING information that will show the Worksite Wellness Program is working.

Get Set…
• Step back and look at your Worksite Wellness Program from a potential partner’s point of view.
• Brainstorm questions your collaborators might have, and have the answers ready.
• Be ready to frame your “selling points” in terms that are important to each specific partner.
• Put the Worksite Wellness Program benefits in language your collaborators will understand.
• Emphasize to potential partners how this Worksite Wellness Program will provide benefit to them.

And Go…
• Build as many partnerships as you can BEFORE you implement a Worksite Wellness Program.
• Make your partnerships a two-way street: always let your collaborators know what you can do for them – then follow-up and do what you say you would do.
• Maintain Upper Management support by providing a regular flow of information. Invite Upper Management participation in the Worksite Wellness Program and special events whenever possible. (Hint: they make great judges if you have a contest.)
• Offer regular feedback to your collaborators.
• Don’t hog the spotlight: let your collaborators share in the visibility of the Worksite Wellness Program.

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Worksite Wellness Programs – The Good and The Bad

Worksite Wellness Programs at the corporate level are beneficial, right? Wellness statistics clearly show that such Worksite Wellness Programs are not only cost-effective to the organization but can assist the employee in developing a healthier lifestyle. With the rising cost of healthcare, Worksite Wellness Programs simply make sense. So where does the problem come in? Let’s examine the topic from both perspectives.

Worksite Wellness Programs: The Good

• A sampling of return on investment for Worksite Wellness Programs: Bank of America: 600%; General Motors:370%; Pepsico: 300%; Citibank: 465%; and the Washoe County School District leading the pack at a whopping 1,560%. (Campbell,J., Wellness Improvement Experts, www.wellnessimprovementexperts.com, Albuquerque, New Mexico.)
• Companies with Worksite Wellness Programs have realized a 28% reduction in sick leave, a 26% reduction in adjunctive healthcare costs and a 30% reduction in disability and workers compensation costs. (Health Affairs, Volume 21, No.2, March, 2002.)
• The Washoe county School District in Northern Nevada realized a $15.60 return on investment for every dollar spent due to a 20% reduction in rates of absence. (Hardy,A. (2005). At the Top Of The Class. WELCOA’s Absolute Advantage Magazine, 5(1), 14-20.)
• Worksite Wellness Programs provide the structure, encouragement, incentives and ongoing support that many individuals need in order to make lifestyle changes.
• Employees also realize returns on their efforts. FiServ, a financial services technology employer, gave staff members who filled out a health risk assessment a significant discount on their health insurance premium. (Holland, Kelley, The New York Times, July 22, 2007.)

Worksite Wellness Programs: The Bad

The flip side of the argument centers on basic human rights. Do we want/need our employer to tell us to eat our veggies or lose 30 pounds? Some organizations are doing just that and at least one lawsuit has resulted because of it.
• Three hundred organizations have requested assistance from a national employment and labor law firm to institute more aggressive Worksite Wellness Programs.(Cornwell, Lisa, Associated Press, Albuquerque Journal, September 10,2007.)
• Clarian Health, based in Indianapolis, Will begin lowering employee paychecks by $10.00 for every employee who has a Body Mass Index (BMI) of greater than 29.9 because not enough staff members were utilizing their wellness services.(Cornwell, Lisa, Associated Press, Albuquerque Journal, September 10,2007.)
• Scott Rodrigues filed a suit against his prospective employer, Scotts Miracle-Gro, because he believed the employer’s antitobacco use policy violated his civil rights. The employer has a policy against hiring staff members who smoke and Mr. Rodrigues’drug screen was positive for nicotine.(Holland, Kelley, The New York Times,July 22,2007.)
• employee advocates are concerned that health discrimination may not be covered under the Americans with Disabilities Act.(Cornwell, Lisa, Associated Press, Albuquerque Journal, September 10,2007.)

Penalizing staff members by hitting them where it hurts the most, in their pocketbook, does not appear to be a favorable approach to molding human behavior.
Such tactics may result in increased resentments and retaliation, primarily in the form of rates of absence and presenteeism (decreased productivity on the job.) Voluntary, incentive-based initiatives, such as the one in the Washoe County School District, can and do produce results. A positive attitude on the part of management along with an opportunity for staff members to have a stake in the decision-making may yield the greatest dividends to both employer and employee.The motivation and resolve needed to change unhealthy lifestyle habits can best be derived from the basic tenets of encouragement, respect and support.

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Worksite Wellness Programs: employer Flu Shots

Flu Shot Facts & Myths

Myth: The flu isn’t a serious disease.
Fact: Influenza (flu) is a serious disease of the nose, throat, and lungs, and it can lead to pneumonia. Each year about 200,000 workers in the U.S. are hospitalized and about 36,000 workers die because of the flu. Most who die are 65 years and older. But small children less than 2 years old are as likely as those over 65 to have to go to the hospital because of the flu.

Myth: The flu shot can cause the flu.
Fact: The flu shot cannot cause the flu. Some workers get a little soreness or redness where they get the shot. It goes away in a day or two. Serious problems from the flu shot are very rare.

Myth: The flu shot does not work.
Fact: Most of the time the flu shot will prevent the flu. In scientific studies, the effectiveness of the flu shot has ranged from 70% to 90% when there is a good match between circulating viruses and those in the vaccine. Getting the vaccine is your best protection against this disease.

Myth: The side effects are worse than the flu.
Fact: The worst side effect you’re likely to get from a flu shot is a sore arm. The nasal mist flu vaccine might cause nasal congestion, runny nose, sore throat and cough. The risk of a severe allergic reaction is less than 1 in 4 million.

Myth: Only older workers need a flu vaccine.
Fact: Adults and children with conditions like asthma, diabetes, heart disease, and kidney disease need to get a flu shot. Doctors also recommend children 6 months and older get a flu shot every year until their 5th birthday.

Myth: You must get the flu vaccine before December.
Fact: Flu vaccine can be given before or during the flu season. The best time to get vaccinated is October or November. But you can get vaccinated in December or later.

For more information, ask your healthcare provider or call 800-CDC-INFO (800-232-4636). You can also get more information about flu vaccinations by visiting the following Website: www.cdc.gov/flu

Source: The Department of Health and Human ServicesCenters for Disease Control and Prevention

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Advantages of Worksite Wellness Programs

Advantages of Worksite Wellness Programs: Easy to Find

Employer’s are learning that Worksite Wellness Programs is an effective way to increase productivity, improve employee health, reduce healthcare costs and reduce rates of absence.

A report published in 2003 by the U.S. Department of Health and Human Services (HHS) highlighted how important it is for employers to incorporate Worksite Wellness Programs as part of their corporate strategy. The report asserts that chronic diseases which are largely preventable place a heavy toll on employer, including lower productivity and higher health insurance costs.

The Department of Health and Human Services estimates that $1.66 trillion was spent on healthcare in 2003 and it attributes a majority of those costs to chronic diseases and conditions such as heart disease, diabetes, obesity and asthma. Sadly, the money allocated for preventing or controlling these conditions is negligible.

In a recent article, American Cancer Society CEO John Seffrin reported two thirds of cancer deaths in the U.S. could be prevented through lifestyle changes in diet, physical fitness, cancer screening and “especially” tobacco use. A well-designed Worksite Wellness Programs initiative serves the best interests of staff members and employers alike.

Advantages of Wellness Progams: Return On Investment (ROI)

Ron Goetzel, a nationally recognized expert in the field of health management, information analysis and applied research, said in a recent interview that with an investment of $100 to $150 per employee per year in Worksite Wellness Programs, an employer can expect an average return on investment of approximately $3 for every $1
invested ($300 to $450 savings per employee per year). Goetzel says, however, that these returns are not typically realized until two to three years into the Worksite Wellness Program.

Advantages of Wellness Progams: Tax Breaks

Sen. Tom Harkin (D-Iowa) has been an outspoken proponent in seeking legislative solutions for a strained healthcare system.

“As a nation, we have a ‘sick care’ system that is focused on helping workers after they get sick, rather than a ‘health care’ system which focuses on keeping healthy workers healthy,” he says.

Harkin introduced the Healthy Lifestyle and Prevention (HeLP) America Act of 2004. One of the initiatives under Title II – Healthier Communities and Workplaces, provides tax credits to organizations that offer comprehensive programs to promote employee health and grants for small employer.

Advantages of Wellness Progams: Getting Started

Implementing a Worksite Wellness Programs can be accomplished with simple, low-cost strategies.

• Offer incentives for participation.
• Establish a wellness informational campaign.
• Schedule wellness seminars on diabetes, nutrition, physical fitness and cholesterol.
• Establish initiatives such as fitness, sleep diary, tobacco use cessation and injury prevention.
• Offer onsite chair massages or simple stretching exercises to do at the desk.
• Change vending machine options to offer healthier, low-fat snacks and drinks.
• Actively promote employee participation in all Worksite Wellness Programs.

A successful Worksite Wellness Program can boost employer morale, enhance productivity, reduce organizational conflict, attract superior workers and reduce the rate of employee turnover. The case for starting a Worksite Wellness Program is well worth the effort.

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Worksite Wellness Programs: Integration of employer and Community Resources

Worksites do not exist in a vacuum. They are part and parcel of the community in which they are located. Successful corporate administrators are cognizant of the need for positive community relations and should do what is necessary to promote good will. What better way to bridge relationships than by utilizing existing community Worksite Wellness Program services and initiatives whenever possible (e.g., voluntary, private and public health agencies) and providing health related services back to the community. Since the community is also the home of the employee, an effective mode of health promotion is through programming directed at the larger community. Sponsorship of community related health fairs is one example more are listed below.

• Encourages employee/employer involvement in the community
Blood drives
Sponsorship of fund raising for community schools and social services
Community recycling initiatives
Youth league sports sponsorship
Job training initiatives
• Public relations and media initiatives advertising a healthy employer image
• employer newsletters and press releases on health issues to local media
• Environmentally sound use of waste disposal and community resources

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Worksite Wellness Programs: Health Related employer Policies and Procedures

At times Worksite Wellness Programs have been instituted as public relations vehicles intended to enhance the corporate image with little concern for improvements in employee health. Companies who are truly committed to enhancing employee health and wellness, are organizations who have worked to include Worksite Wellness Programs into the employer’s mission statement. With this commitment, policies and procedures can be written to address short and long term goals of increased employee health, productivity, and morale. These policies and procedures are critical to the establishment of supportive organizational cultures conducive to employee health and wellness.

• Active employee involvement in Worksite Wellness Program committees and employer decision making
• Availability of flextime work schedules
• No tobacco use policy
• Drug use policy and drug screening
• Motor vehicle seatbelts and the use of other protective/safety equipment
• Sexual harassment policy
• Family leave initiatives
• Consistent and frequent awards and recognition of employee work efforts

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Worksite Wellness Programs: Safe and Healthy Work Environment

The environmental conditions of the worksite can be divided into both physical and psychosocial domains, both of which influence the climate and culture of a worksite. The cultural norms of a worksite have been identified as powerful determinants of worker health and behavior (Baum, 1995). Ultimately, workers benefit most from a healthy, supportive; eustressful worksite community was they feel valued and respected. Since adults spend approximately one third of their waking hours at work, one would hope that staff members view work as less of a necessity and more of an enjoyable experience.

The climate of a worksite is also more conducive to enhancing health and human performance when the environment is safe, clean, aesthetically pleasing and ergonomically engineered. While some occupations maybe inherently dangerous (e.g., fire fighter, military personnel) all comprehensive Worksite Wellness Programs should control exposure to unhealthy conditions including: hazardous chemicals, noise, temperature, radiation and other risky conditions. Program examples include:

• Worksite Wellness Programs grounded in supportive cultural change strategies
• Environmental and safety compliance measures
Lighting
Ventilation
Heating
Control of toxic substances
Noise
Universal precautions
• Ergonomically designed workstations
• Sanitary, clean, well maintained physical environment
• Recycling promoted initiatives
• employee & management training in emergency procedures

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