Sibley Heart Center Cardiology - Employee Wellness Program

MODERN INITIATIVES WELLNESS TEAMJOYE HURLING, CRYSTAL COHEN, APRIL DANIELS, CANDACE MASON, TALEESA

PECK, EMMANUEL TOEDR. MICHAEL DALMAT

CLAYTON STATE UNIVERSITY

Sibley Heart Center Cardiology About

Sibley Heart Center Cardiology is a group of more than 40 pediatric cardiologists in 19 locations across Georgia.

Provides comprehensive services for patients from before birth to age 21 with congenital or acquired heart defects.

The Emory/Sibley Adult Congenital Cardiac Program is one of the largest programs in the U.S. - and the only one in Georgia - specializing in the treatment of adults with congenital heart disease (CHD).

Mission To enhance the lives of children through excellence in patient care,

research and education. Values

Service Team Integrity

Sibley Heart Center Cardiology Locations❏ Sibley has a total of 224

employees❏ There are 95 employees

working at the Corporate Office in Atlanta❏ This number comprises

approx 42% of all Sibley employees.

Zip Code Spot Map

Sibley Heart Center Benefits❏ Employee Health Benefits

❏ Blue Cross/Blue Shield Health Insurance❏ Employee Wellness Program in addition to health insurance

Current Wellness Activities❏ Tuesdays 5:15 - 6:15 Cardio Fusion Aerobic Class - At Sibley Corporate Site

All Sibley Location Employees are welcome.

❏ Discount Gym Memberships (34 gyms within the Atlanta area) - Globalfit.com

❏ Wellness Challenge - Once a year❏ Make it a Habit - (Exercise, Eating and Drinking Water Regularly) - Once a year❏ Maintain Don’t Gain - (Weekly holiday emails on healthy eating)❏ Host Family Fitness Month❏ Nutrition Month (March) - Nutritionist sends nutrition questions weekly for entire month

of March person with the most correct answers wins a fruit and vegetable box.

❏ Healthy Vending Snacks (Identified by healthy sticker)❏ Filtered Water

Modern Initiatives Wellness Team Objectives

❏ To assist Sibley Heart Center Cardiology in the continued development of their Employee Wellness Program by determining strategies that will:❏ Provide data regarding the current health and well-being of its

employees.❏ Increase employment participation in Sibley’s Employee

Wellness Program.❏ Be supported and championed by upper management.❏ Be accepted and used regularly by at least two-thirds of

employees.❏ Be practical, accessible, inexpensive and maintainable.❏ Show proven improvement in employee health and well-being.❏ Be replicable at all Sibley sites.

Overview of Methods1. Determine and obtain necessary information from Sibley representative(s) regarding:

a. Employee Benefits (i.e., Health Insurance Coverage, wellness initiatives, etc.)b. Employee countsc. Employee demographics including:

i. Zip Codesii. Race/Ethnicityiii. Genderiv. Age

2. Analysis of employee demographics3. Research and analysis of mortality and morbidity rates

a. National Center for Health Statistics (2010)

b. Georgia Department of Public Health (OASIS, 2011)4. Creation and presentation of Health and Wellness Survey to Sibley employees via

Qualtricsa. Flier Announcing Wellness Survey b. Release of online anonymous surveyc. 7 day completion deadline

5. Analysis of survey responses 6. Recommendations to enhance health and wellness of Sibley employees

a. Survey responsesb. Evidence based research practices

Demographic cohorts: Age & gender

AGE COHORT FEMALE MALE TOTALS

20-29 19 0 19

30-39 57 17 74

40-49 54 14 68

50-59 39 7 46

60-69 3 10 13

70-79 1 3 4

173 51 224

Demographic cohorts: age & race

American Indian

orAlaskan

Native

Asian Black or African-America

n

Native Hawaiia

n or Pacific

Islander

Not Specifie

d (Latino)

2 or more races

White

20-29 0 0 5 0 3 2 9

30-39 0 4 34 0 2 2 32

40-49 2 3 27 2 3 0 31

50-59 0 2 19 0 0 2 23

60-69 0 0 2 0 1 0 10

70-79 0 1 0 0 0 0 3

2 10 87 2 9 6 108

Demographic cohorts: race and gender

RACE FEMALE MALE TOTALS

American Indian or Alaskan Native

1 1 2

Asian 5 5 10

Black or African-American

83 4 87

Native Hawaiian orPacific Islander

0 2 2

Not Specified (Latino) 8 1 1

Two or More Races 6 0 6

White 70 38 108

173 51 224

Sibley Heart Center CardiologySummary & Target Population

● White employees: 48.2% ○ 64% female○ 35% male

● Black: 38.8%○ 95% are female

● Age: 30-39: 33.0%40-49: 30.4%50-59: 20.5%

83.9%

● Female: 77% ○ 48% Black○ 40% White

Female 30-59

Black/White Female

Captures 67% of the employee

population

Captures 68% of the employee population

Top 10 Health Issues for Women(National Center for Health Statistics, 2010)

Heart DiseaseAccounts for around 27 percent of all female deaths

CancerSecond most dangerous threat to a woman’s health, accounts for 22 percent of female deaths

Stroke Responsible for almost 8 percent of all female deaths

Chronic obstructive pulmonary disease (COPD) Makes up about 5 percent of all female deaths.

Alzheimer's DiseaseResponsible for about 4 percent of all female deaths in the United States each year.

Top 10 health issues for women(National Center for Health Statistics, 2010)

Unintentional InjuriesAccidents — car collisions, falls, and poisonings account for about 3 percent of all female

deaths in the United States each year — more than 37,000 women.

DiabetesResponsible for around 3 percent of all female deaths in the United States

Influenza and PneumoniaCombined account for just under 3 percent of all American female deaths

Kidney DiseaseAccounts for almost 2 percent of all female deaths in the United States.

Blood Poisoning (septicemia)Responsible for the deaths of 1.5 percent of all U.S. females.

COHORT 1: FEMALE, AGE 30-39(Georgia Department of Public Health, 2011)

AFRICAN AMERICAN/BLACK Heart Disease Cancer Unintentional Injuries Homicide HIV/AIDS Pregnancy Complications Diabetes Stroke Kidney Disease Anemia

CAUCASIAN/WHITE Heart Disease Cancers Unintentional injuries Suicide Pregnancy Complication Homicide Stroke Diabetes Chronic Liver Disease Chronic Lower Respiratory Disease

COHORT 1: FEMALE, AGE 40-49(Georgia Department of Public Health, 2011)

AFRICAN AMERICAN/BLACK Cancer Heart Disease Unintentional Injuries Stroke Diabetes HIV/AIDS Kidney Disease Homicide Chronic Lower Respiratory Disease Chronic Liver Disease

CAUCASIAN/WHITE

Cancer Heart Disease Unintentional injuries Chronic Liver Disease Chronic Lower Respiratory Disease Suicide Stroke Diabetes Kidney Disease Influenza & Pneumonia

COHORT 1: FEMALE, AGE 50-59(Georgia Department of Public Health, 2011)

AFRICAN AMERICAN/BLACK Heart Disease Cancer Diabetes Stroke Kidney Disease Chronic Lower Respiratory Disease Septicemia Unintentional Injuries Hypertension HIV/AIDS

CAUCASIAN/WHITE Heart Disease Cancers Chronic Lower Respiratory

Disease Unintentional injuries Diabetes Stroke Chronic Liver Disease Septicemia Kidney Disease Influenza & Pneumonia

Survey Response Rate

Survey was distributed to 95 employees at the Sibley Heart Center Corporate Office 33% response rate

1 dropout/1 incomplete 45% in the 40-49 age range 91% of respondents were female

100% covered by health insurance 94% covered by Blue Cross/Blue Shield 6% covered by some other insurance

In general, how would you describe your health?

1 Excellent 4 12%

2 Very Good 14 41%

3 Good 15 44%

4 Fair 1 3%

5 Poor 0 0%

Total 34 100%

Issues of Low to Moderate Concern

0% smokers

76% engage in at least 3 days of exercise per week 44% engage in exercise 5-7 days per week

73% reported not having any of the top 10 chronic illnesses Only 1 participant reported receiving a cancer

diagnosis within the last 12 months

Issues of High Concern 88% identified stress as a moderate concern

46% specify identified work related stress as a moderate concern

56% identified themselves as being overweight

69% stated that they were trying to lose weight

18% identified an “Other” health issue: Hyperlipidemia, GERD chronic migraines asthma (2 participants) ADHD Nonspecific inflammatory process

Identify which of the following wellness activities would you be most willing to commit to doing on a regular basis, and indicate where you would be most likely to participate in this activity on a regular basis at or near your home or at or near your office (Check all that apply)

ARE YOU AWARE OF THE EMPLOYEE WELLNESS PROGRAM AT SIBLEY HEART

CENTER CARDIOLOGY?100% of survey respondents indicated that they were

aware of the wellness program.

63% of survey respondents ARE willing to pay

EMPLOYEES’ RECOMMENDATIONSHealthy Eating Exercise Team

FocusOther

Cater healthy lunches

Anytime Fitness Discounts

Team Sport Longer lunch break/flex time to focus on exercise

Nutrition education Fitness Challenges Standing deskPhysical Therapy No smoking in

outside areas A variety of exercise classes offered (i.e. yoga, pilates, etc)

Gift card incentives

Education on proper exercise techniques

Focus on Continuity for Success

1. Keys to maintaining a permanent Wellness Program:❏ Wellness Committee

❏ Consists of a mix of top management and employees interested in wellness and health.

❏ Individuals from the Human Resources department, health and safety department and employee assistance program may also be considered.

❏ Have consistent programs and rewards to increase and retain employee participation in the wellness program.

❏ Ensure that there is an activity scheduled on a weekly, monthly, quarterly basis

Wellness Bulletin Board2. Develop wellness bulletin board or digital screen that displays Sibley’s wellness policy.

a. This board highlights important messages from the policy once a week where suggestions for healthy activities will be posted along with pictures displaying employees post pictures of them engaging in these healthy activities

Quarterly incentive: the family who incorporates the most activities in a photo album will win a small quarterly prize

At the end of the year the family that has completed the most activities wins a grand family prize

Examples include:

Employees bring family recipes to place on wellness bulletin board or email fellow employees

Sibley employee family day at your local, state park or other venues

Wellness Committee and Sibley employees can send out suggestions for physical activities families can do at home.

Stress Management3. Appoint wellness committee advocate to become familiar with a free worksite stress management training program to inform Sibley employees of ways to reduce stress. Once the program has been introduced to Sibley employees can access the link from their home or work computer at their leisure.

Links for worksite stress management:www.cdc.gov/niosh/topics/stresswww.webmd.com/a-two-v-guides/video/farrell-stress-reductionwww.webmd.com/10-relaxation-techniques-reduce-stress-spot

3. Stress Reduction:❖ Spa’s for Massage• The Atlanta Institute of Massage and Institute of Aestheticshttp://www.sensability.com/50 min $40 student massages

• Gwinnett Collegehttp://www.metroatlantacollege.com/index-5.html60 min $40 student massages

• Georgia Massage Schoolhttp://www.georgiamassageschool.com/student-massage-clinic50 min $35 student massages

❖ Quiet Meditation Room❖ Free Yoga at Kaiser Permanente: Crescent Medical Center, Glenlake, and

Gwinnett Facilities

Stress Management

More Competition, More Rewards

4. Incorporate more competitive challenges with monthly reward incentives and a larger reward for an annual challenge.

❏ Examples:❏ Gifts cards for healthy eating places❏ Spa certificates❏ Workout gear❏ Water bottles

Allot flex time to allow employees to engage in onsite physical activity

Employees develop walking teams Wellness Committee build relationships with community partners for

group discounts.

Chronic Disease Prevention & Self Management

5. Chronic disease prevention and self management through evidence based programs:

Health coaching - Motivational Interview Technique The Game of Health - Game Based on Social Cognition Sibley’s Wellness Program should incorporate an education

component that offers monthly informational classes or sessions about chronic disease prevention.

Health Coaching5. Motivational Interviewing Based on Health Coaching (Butterworth, Lindeu, &

McClay, 2007) Only technique to have demonstrated causality Only technique to have shown to be independently associated with

positive behavioral outcomes Components of Effective Health Coaching Interventions:

At risk individuals should be identified Recruitment efforts must be maximized Use of various communication modules

E-mail Blasts, E-Letters, Phone Call, Person to Person Incentives Valid Coaching Methods should be used:

Motivational Interviewing Whole Person Interviewing Shared Decision Making

Evaluation

·

Game Of Health5. Implementation of programs designed to modify behaviors to achieve a

healthier lifestyle and improve body compositionGame of Health (Courtney, Conrad, Dunn, & Scarborough, 2011)

Study: Effectiveness of 12 wk. lifestyle change program targeted to patients w/ chronic disease Based upon social cognitive theory Emphasis on enhancing a patient’s behavior capability and self-

efficacy Goal setting Monitoring Personalized Feedback

Game of Health also used baseball game metaphor in which the patient “joined the team” to play against the “opponents” of chronic diseases and symptoms.

Game players also introduced to 7 healers – specific behavioral areas in which to improve health

For more information visit the website at www.gameofhealth.com

BC/BS Complex Care

6. People who are at risk for chronic diseases or have a chronic disease can sign up for BCBS complex care or condition care programs in order to receive personalized health management.

Complex Care is for individuals who are at risk of developing a chronic disease, while Condition Care is for individuals who have already been diagnosed with a chronic disease. With both programs, individuals get a team of nurses to help manage their health.

*For more information regarding care programs

http://www.bcbsga.com/wps/portal/chpfooter?content_path=shared/noapplication/healthyliving/nosecondary/notertiary/pw_a087142.htm&label=360%5Edeg%20Health%5Ereg%20Program

Sibley may look at Anthem.com for employers to see most recent updates on plan incentives offered by BCBS.

- MOU & CA- demographics (zip

codes)- Retrieved mortality &

morbidity rates based on data in GA

- Construct Survey- Implement and Analyze

Survey- Formulate

Recommendations

What we will do

--Improve upon current employee wellness planFamily Involvement:

-Develop a bulletin board that displays families engaging in healthy activities & highlights important aspects of the wellness policy

-Email healthy family recipes and healthy family activities

-Have a Sibley Family Day at the parkStress Reduction:

-Self stress reduction techniques-Affordable Spa’s

-Quiet meditation room-Yoga

Increasing Employee Participation:-Offer more incentives and competitive

challenges-Allot for flex time to allow time to engage in

fitness activities-Employee walking teams

Chronic Disease Prevention:-Offer education classes/programs about the

prevention of chronic diseasesBlue Cross Blue Shield Tools:

-Complex-Care Program-Condition-Care Program

-Anthem.com for Employer and Employee use

-Employee Participation-Reduce employee workplace stress-Increase family

involvement-Increases in employees who exercise at least 4

times a week-Decrease employees

eating out--Increase employees who

eat healthy-Increase use of BCBS tools

-Overall weight reduction of employee’s.

- Walking Teams-Increased

amounts of sleep-Increase in

employee energy

--Reduction in medical claims cost

-Lower absentees and higher presenteeism

-Higher productivity-Fewer workers compensation

and disability claims--28% decrease in sick leaves-26% reduction in health care

costs-30% reduction in workers compensation & disability

claims

ROI$5.93 to every $1

MOREPROFITABLE

BUSINESS

Activities OutputsTEAM FOCUS

What we will propose to put in

place

Short-termOutcomes

What the short-term outcomes are

Medium-termOutcomes

What the medium-term outcomes are

Long-termOutcomes

What the long-term outcomes are

Sibley Heart Center Cardiology Logic Model

Long Term Outcomes Reduction in the cost of medical claims Lower absentees and higher

presenteeism Higher productivity Fewer worker’s compensation and

disability claims - decrease by 30% 28% decrease in sick leave 26% reduction in healthcare costs

Which Recommendations Would You Like to Adopt?

ReferencesAHRQ. (2012, October). Cardiovascular disease and other chronic conditions in women: Recent Findings.

12(13), 1-6. Rockdale, Maryland: Agency for Healthcare Research and Quality.

Berry, L. L., Mirabito, A. M., & Baun, W. B. (2010). What's the hard return on employee wellness programs.

Harvard business review, 88(12), 104-112.

Butterworth, S. W., Lindeu, A., & McClay, W. (2007). Health coaching as an intervention in health

management programs. Disease Managment and Health Outcomes, 15(6), 299-307.

Churchill, S. A., Gillespie, H., & Herbold, N. H. (2014). The Desirability of Wellness Program and Incentive

Offerings for Employees.Benefits Quarterly, 30(1), 48-57.

Courtney, M., Conrad, S. E., Dunn, P., & Scarborough, K. (2011). The game of health: An innovative lifestyle

change program implemented in a family practice. American Academy of Nurse Practitioners, 23, 289-

297.

Flaxman, P. E., & Bond, F. W. (2010). Worksite stress management training: Moderated effects and clinical

significance. Journal of occupational health psychology, 15(4), 347.

Fogarty, S. (2007). Evaluating ROI for Wellness Programs. Benefits & Compensation Digest, 22-25.

References

Gatewood, J. G., Luchfield, R. E., Ryan, S. J., Myers-Gradelmann, J. B., Prudergast, J. F., & Ullom, K. K. (2008).

Perceived barriers to community-based health promotion program participation. American Journal of

Health Behavior, 32(3), 260-271.

Georgia Department of Public Health. (2011). Online Analytical Statistical Information System. Retrieved

from OASIS: http://oasis.state.ga.us/oasis/

Gillan, W., Naquin, M., Zannis, M., Bowers, A., Brewer, J., & Russell, S. (2013). Correlations among Stress,

Physical Activity and Nutrition: School Employee Health Behavior. ICHPER-SD Journal of Research, 8(1),

55-60.

National Center for Health Statistics. (2011). Retrieved from CDC: http://www.cdc.gov/nchs/

Shah, J. (2014). Three Styles of Communication that Will Keep Your Employees Engaged in Your Wellness

Program. Employee Benefit Plan Review, 68(7), 25-26.

Washoe County Health District. (2014, April 18) . Engaging families in health and wellness:Tips to help get

families involved with health and wellness. Retrieved from http://www.GetHealthyWashoe.com

Willingham, R. (2013). Using Incentives within the New Regulatory World of the ACA to Improve Employee

Wellness and Productivity. Employee Benefit Plan Review, 68(4), 7-11.

Winterdyk, J., Ray, H., Lafave, L., Flessati, S., Huston, M., Danelesko, E., & Murray, C. (2008). The Evaluation

of Four Mind/Body Intervention Strategies to Reduce Perceived Stress among College Students. College

Quarterly, 11(1).

References

To Sibley Heart Center Cardiology and Ms. Lisa

Martin, Senior Manager of Human Resources and Director of the Wellness

Committee

&

To Hearts To Nourish Hope for Hosting