missing link in workplace wellness culture
PSE for integration of wellness into culture
today’s session programming vs. PSE defining culture 6 sources of influence working well PSE strategies for
integrating wellness into culture
implementation examples
contacts
programming vs PSE
what is programming? awareness
campaigns education sessions screenings challenges participation based
activities
what is PSE? flex time policy for
physical activity tobacco free campus ID tobacco users, refer
to resources, F/U healthy food option
every time food is served
walking trail POD prompts at
elevators/stairs wellness in org
strategic plan benefit/incentive tie-in
audience response
does your organization have written wellness policies? yes no we have practices but not written policies
why policy?
what purpose do workplace policies serve? policies exist to shape behavior
health policy shapes health behaviors not an elimination strategy provides choice (evidence based) access, marketing, education, environment, and
benefit structures make healthy choice easy choice most prominent, easily identifiable, most affordable
policy ensures practice is universal and sustainable policy sets up systems that are supported by
environment…creates culture
defining culture
what is culture?
“Culture refers to the social forces that shape behavior and beliefs through norms, support, modeling, training, rewards, and communication.” Achieving a Culture of Health. Health Enhancement
Systems. 2008.
“How things get done around here” Bob Allen
what is a culture of wellness?
focuses on the organization, not just the individual makes wellness a part of your organizational
structure and your day-to-day operations wellness becomes a part of the fabric of the
organization a comprehensive approach that focuses on policy,
systems, benefits, and environment to support healthy living
fills the gap between stated values and how things actually get done
defines the employee experience
key components of a culture of wellness
missing link in worksite wellness
HRA + Indiv feedback
Programs & Campaigns
Benefits & Incentives
Policy & Environmental Support
mixed messages
SABOTAGE
audience response
does your organization’s strategic plan include employee health/wellness goals? yes no
employee wellness in multi-year strategic plan impacts bottom line key strategy for achieving mission and vision
establish clear goals and metrics for wellness monitor at least annually
offer preventive benefits to employees and dependents
ensure that senior leaders have visible roles in wellness use cost vs. ROI, comparison to peers, current employee
health status, competitive advantage potential to gain interest and buy in
evidence based best practices
evidence based best practices
allocate funding for wellness into budget creative funding strategies identify free community resources
include employee wellness in the job description of at least one employee
build a wellness committee diverse and representative all levels and key departments meet regularly assess, plan, implement, communicate, evaluate
wellness efforts
evidence based practices
allow employees to attend wellness activities during work hours
incorporate wellness goals into job performance criteria of key staff HR, senior leaders, wellness staff accountability/responsibility
conduct an annual health risk assessment use aggregate data to tailor efforts use trend reports to justify efforts to leadership
conduct an annual employee interest survey
evidence based practices
measure impact of wellness on health care costs medical and pharmacy
measure impact of wellness on productivity short/long term disability work comp sick leave
measure the direct impact of wellness initiatives on employees process measures- participation rates, health behaviors and
outcomes, etc
evaluation demonstrates value measure what you treasure and treasure what you measure-
Melva Fager Okun, PhD
promising practices
consistently communicate wellness policies, programs, and benefits multi channel, multi modal communication several times
a year “stealth benefits” benefit no one
assess community for local resources maximize free resources (hospitals, AHA, ESMMSC)
appoint wellness champions to promote wellness initiatives throughout departments and locations increases socials support and promotion
general recommendations
communicate the value of wellness to your employees include in annual benefit statement to employees
consider offering incentives for participation, progress, or outcomes assess what will work for your population tie to proper use of benefits or healthy behaviors instead
of random cash or gift cards
recognize and reward wellness champions big impact, no cost letter from CEO, success story in newsletter, etc
creating a culture of wellness helps you …
achieve consistent communication
align activities with stated values
make the healthy choice the easy choice
increase employee engagement, drive intrinsic motivation and peer support
move from siloes to a comprehensive approach
enhance and sustain existing efforts
be an example to the community
invest in human capital create a healthier, more
productive and energized workforce
enhance outcomes create a competitive
advantage impact entire workforce
personal…and organizational wellnessimpact of culture
not the absence of disease
wellness = optimal health
audience response
why is health behavior change so difficult? lack of willpower lack of skill
why is change so difficult?
is it will?or
skill?
the willpower trap
know-do gap simplistic view of willpower is wrong and
incomplete teach skills for willpower to accept
delayed gratification- Bandura mastering temptations is more than
personal motivation, skill plays an important role
primary problem isn’t weakness, its blindness (to sources of influence)
if blind to why we succeed, we can’t prevent failure
six sources of influence1- personal motivation2- personal
ability3- social motivation4- social
ability5- structural motivation6- structural ability
MOTIVATION ABILITY
PERSONAL
1 2
SOCIAL
3 4STRUCTURAL
5 6
blind and outnumbered scientist & subject
know your own influences
find crucial moments and turn into vital behaviors
keep it real tell whole vivid story invalidate excuses
accomplices to friends
control your space control sources you
can see engage all 6
sources of influenceact on them…
or be acted on by them
six sources of influence1- personal motivation crucial moments vital behaviors interrupt impulses
by connecting with goals
inspiring quotes personal
motivation statement
tell the whole vivid story
MOTIVATION ABILITY
PERSONAL
1 2
SOCIAL
3 4STRUCTURAL
5 6
six sources of influence2- personal
ability do what you can’t skill scan deliberate practice
practice for crucial moments
break into small pieces
prepare for setbacks
learn the will skill
MOTIVATION ABILITY
PERSONAL
1 2
SOCIAL
3 4STRUCTURAL
5 6
six sources of influence3- social motivation bad habits almost
always a social disease
accomplices to friends accomplice-
entice/enable unhealthy behavior
friend- fans and coaches
transformation conversation
MOTIVATION ABILITY
PERSONAL
1 2
SOCIAL
3 4STRUCTURAL
5 6
six sources of influence4- social
ability redefine “normal”
Beware of the “everyone” excuse
transformation conversation
distance yourself from the unwilling
add new friends
MOTIVATION ABILITY
PERSONAL
1 2
SOCIAL
3 4STRUCTURAL
5 6
six sources of influence5- structural motivation environment invert the
economy to subsidize/reward good habits
loss aversion higher premium on
loss than on gain
reward in moderation and combination link to
personal/social motivation
reward small wins process goals
MOTIVATION ABILITY
PERSONAL
1 2
SOCIAL
3 4STRUCTURAL
5 6
six sources of influence6- structural ability environment build fences manage distance
good close and convenient, bad distant and difficult
change cues visual reminders of
vital behaviors during crucial moments
engage autopilot structure good
choices with standing commitments
use tools apps equipment
control your space
MOTIVATION ABILITY
PERSONAL
1 2
SOCIAL
3 4STRUCTURAL
5 6
will you act on them…or will they act on you?
personal and organizational wellness what do you want to change, personally? what changes needs to take place in your
organization? will you be an accomplice or a friend?
audience response
realistically, what % of the employee population can you hope to reach with a comprehensive wellness strategy? 40% 55% 80% 100%
working well
effective cross-sector strategy implementing key components of healthy eating & active, tobacco free living in worksites, establishing cultures of wellness where the healthy choice is the easy choice organizational commitment to integrate wellness into strategic
plan, changing the employee experience investment in human capital; most valuable asset seamless integration with programming and chronic condition
management aligns policy and environment with desired health behaviors,
creating support for and likelihood of healthy choices PSE implementation impacts all employees whereas
programming only impacts those who choose to participate, often missing those who need it most
creates consistent message throughout org that healthy behaviors are supported and expected
cost of doing nothing
Behavior % in SC Cost/ EmployeeCost/Business
of 100 Employees
Smoking 21.6% $5,800 $125,280
Overweight/Obesity 67% $2,676 $179,292
Physical Inactivity 50% $1,984 $99,200
TOTAL $10,460 $403,772
CDC Office of Smoking and Health, Smoking Attributable Morbidity, Mortality, and Economic Costs (SAMMEC), 2002.Be Active North Carolina, Inc., The Economic Cost of Unhealthy Lifestyles in North Carolina, 2005.
investing in wellness
Avg. Cost Savings of a Comprehensive Worksite Wellness Program
Health Care Costs 26% reduction
Absenteeism 27% reduction in sick leave
Disability/Worker’s Compensation 32% reduction
$3-$1 avg. savings-to-cost ratio of implementing a comprehensive worksite wellness program
Partnership for Prevention. Leading by Example: The Value of Worksite Health Promotion to Small and Medium Sized Employers, 2011. http://www.prevent.org/data/files/initiatives/lbe_smse_2011_final.pdf
investing and ROI invest in human capital (your most valuable asset)
salary/benefits often more than 60% annual cost to do business
reasonable ROI expectations comparable to other capital investments
core elements of working well
executive leadership strategic partnerships detailed & tailored
technical assistance mapping of progress &
success celebration & recognition
goals of working well
assist worksites to assess, implement, and maintain evidence-based and effective policies designed around the three pillars of an effective worksite wellness culture: tobacco-free people and
places delicious and affordable
healthy food environments access and opportunity for
physical activity during the workday
implement low/no cost, effective wellness policies, systems, environments and benefits that help ALL employees live healthier lives identify missing wellness
opportunities align current efforts evaluate progress sustain wellness culture over
time
working well resources
WHA assessment recs/action plans online toolkits webinars workshops sharing/learning
network site visits individual, customized
assistance working well and
prevention partners staff
implementation strategies for excellence
tobacco cessation systems
healthy food environments
worksite of active employees
tobacco free people and places
help every employee lead a tobacco-free life
key components: policy system approach benefits incentives evaluation
key components quit tobacco system policy
100% tobacco free property wide consistent enforcement communicate policy to employees; empower
employees to approach violators adequate signs throughout property
system approach ID tobacco users (HRA/attestation) assess readiness to quit, refer to multiple
resources, f/u often
benefits counseling, OTC NRT insurance benefit or
equivalent, FDA RX meds on formulary multi-channel communication & promotion of
benefits (employees & covered spouses)
incentives incentives for tobacco free emp disincentive for tobacco using emp (motivate quit) incentives for enrollment in quit tobacco program
evaluation
healthy food environments (HFE)
provide access to delicious, affordable healthy items in all worksites
key components: access pricing marketing benefits education
key components HFE access
adopt healthy food nutrition criteria implement a healthy food policy requiring healthy options
whenever/where ever food provided ensure vendors provide healthy options all hours of operation train food service staff on prep & portion control partner with local farmers or CSA’s onsite gardens
pricing use pricing structure to incentivize purchase of healthy options increase price of unhealthy
marketing point of decision nutrition info identify foods meeting healthy nutrition criteria with consistent
icon use product placement to make healthy options more prominent
and accessible benefits
provide nutrition counseling to all employees as insurance benefit or benefit equivalent
use benefit design & wellness incentives to encourage behavior change
constantly communicate benefits and equivalents to employees and covered spouses in multiple formats
education implement HFE promo campaign lunchNlearns, cooking demos, evidence based weight mgmt
worksite of active employees
create a culture where being active is the easy norm
key components: policies environment education benefits & incentives
key components active worksite policy
use PA resources on clocked time paid work time set aside for PA flexible work hours to allow PA before, after, lunch time encourage paid break use for PA consider culture of wellness & safety policy combo
environment access to PA facilities/equipment during/after work hours
– walking trails, workout video library
encourage alternate commutes– access to bike racks/showers
accommodations for special needs– “sit and be fit”- PMC
education point of decision prompts
– elevators, stairs, break rooms, etc
communicate policies consistent messaging promo campaign of PA resources management lead walking mtgs
benefits & incentives discount access to local or onsite fitness facilities onsite classes at low/no cost insurance benefits that support PA communicate benefits & equivalents promotion of benefits & incentives through wellness
programming
MUSC board of trustees resolution
beaufort jasper water sewer authority
4.5 Develop a comprehensive wellness program—initial plan stages
4.5.1 Design and support a sustainable wellness team structure and function
GOAL 4: HEALTH AND SAFETY
Provide an environment that supports the physical and psychological well-being of all our human resources.
Organize and create an employee driven wellness team that has the capacity to sustain itself on a volunteer basis; leverage resources for Wellness activities and events and advocate for system-wide wellness improvements· Establish a communication process that effectively recruits and keeps Wellness Team Members informed of events, activities, progress and meetings· Name the program and compile ideas for marketing it to employees—align policies and procedures to support initiatives (Logo/Slogan Contest)· Develop, track and report on the achievement of the Wellness Annual Work Plan. Specifically, track the impact of wellness activities on health care costs, employee productivity (short and long term disability, workers compensation claims and sick leave) and employee participation rates· Based on projected first year plans, secure budget to support goals and revise for subsequent years as the program evolves· Creatively use the Employee Newsletter to engage employees, celebrate successes and spotlight wellness
4.5.3 Promote health and wellness at BJWSA to our employees, leadership and visibly participate in promoting wellness to the public (Culture of Wellness)
Create a dynamic marketing program designed to build awareness, engage employee involvement and promote the value of wellness to employees, leadership and the greater public· Create a wellness homepage on the company intranet or sharepoint (if available) that displays Wellness Mission and Values, Wellness Team members and existing programs with links, access from home and email response capability· Present the new Wellness Program to the Board of Directors· Communicate the value of wellness benefits to employees through the annual Total Compensation Statements· Implement healthy food (and beverage) policy (including approved vendors) and ensure healthy options are available - fruit baskets/farm boxes
mars, inc- scorecard for executives
practicing what we preach @ scha
initial assessment… physical activity F nutrition D tobacco D
3 years later… physical activity
A+ nutrition A tobacco A culture A
implemented strategies policies
tobacco, nutrition, physical activity
environment onsite fitness classes (WoW) onsite walking trail no junk food dumping CSA farmer’s market
system diverse & representative
wellness committee executive support multi-channel
communication
branded wellness program benefit incentive onsite screenings health coaching
SCHA policies & standards of behavior
culture of wellness policy tobacco nutrition physical activity
standards of behavior tobacco nutrition physical activity
nutrition criteria on and offsite events
liability waiver for activity annual tobacco
attestation surcharge and requirement
for cessation to earn benefit incentive
wellness in SCHA strategic goals & priorities
culture of wellness: promote and implement a tobacco-free environment
with a comprehensive tobacco cessation system, delicious and affordable healthy food environment, and opportunity for physical activity during the work day
provide excellent preventive benefits, supported by policies, and consistent throughout environment
executive-level endorsement with communication to management and staff
consistent messages and enforcement comprehensive wellness team/committee incorporate “6 sources of influence”
Patterson, Grenny, Maxfield, McMillan, Switzler, Change Anything- The New Science of Personal Success, 2012. www.changeanything.com
best practices
policy sets up systems, supported by environment…creates culture
PSE impacts 100% of workforce creating a culture of wellness is about population health, starting
at the top and impacting entire organization culture should support, not sabotage, workplace wellness
programs approach organizational health from a strategic perspective workplace culture is part of a larger, integrated health and
productivity strategy organizational health can be a competitive advantage does your workplace culture support or sabotage? are you an accomplice or friend
final thoughts
Working Well Staff- SCHA & Prevention Partners
Jen Wright, Program Director, Working WellSCHA • 803.744.3553 • [email protected]
Stephanie Hudson, Program Business Manager, Working WellSCHA • 803.744.3531• [email protected]
Emily O’Sullivan, Program Manager, Working WellSCHA • 803.454.6969 • [email protected]
Lindsey Bickers Bock, Prevention Partners919-969-7022 x225 • [email protected]
www.ncpreventionpartners.orgwww.twitter.com/ncpreventionwww.facebook.com/ncpreventionpartners
www.scha.org/working-wellwww.twitter.com/SCHospitals #workingwellwww.facebook.com/schospitals