who healthy workplace model from strategy to action

8/9/2019 WHO Healthy Workplace Model From Strategy to Action

1/50

The WHO Healthy Workplace ModelFrom Strategy to Action

Nico Pronk, Ph.D.HealthPartners andHarvard School of Public Health

Stephanie Pronk, MA Ed Aon-Hewitt


2/50

2011 © HealthPartners 2

Agenda

• Introduction to the WHO Healthy Workplace Model

• How to get started

• Individual Health Resources and Psychosocial Work Environment

• Evaluation and Measurement• Open Dialogue

• Concluding Comments


3/50


WHO Healthy Workplace Model

WHO action objectives:1. To devise and implement policy instruments on workers’ health 2. To protect and promote health at the workplace

3. To improve the performance of and access to occupational health services4. To provide and communicate evidence for action and practice5. To incorporate workers’ health into other policies


4/50


WHO Global Model


5/50


4 Avenues of Influence

Structure, air, machinery,furniture, products,

chemicals, materials, andproduction processes in

the workplace

Organizational culture aswell attitudes, values,

beliefs, and daily practicesin the company that affectmental and physical well-

being of employees

The health services,information, resources,opportunities, flexibility,

and other supports tomotivate employees to be

healthy, live a healthy

lifestyle and monitor theirmental and physical health

The activities in which acompany might engage, orexpertise and resources itmight provide to support

the social and physicalwell-being of the

community in which itoperates


6/50


The Process

A model ofcontinuous

improvement•Mobilize workers to invest in

change—

identify needs,values and priority issues

•Form a team to do the work•Assessment and data

collection•Focus and prioritize action

•Develop an implementationplan•Do the work

•See what works and whatdoesn’t

•Improve based on data

•Continue


7/502011 © HealthPartners 7

The Underlying Principles

Keys to Success•Leadership based on corevalues•Involve workers and theirrepresentatives•Gap analysis (comparativeanalyses)•Learn from others•Sustainability (manage withdata, etc.)•Integration•Adapting to local contextsand needs


8/50

• Practical Application



Create Focus to Drive Population Health Improvement

80% of totalchronic

illnessesworldwide

By focusing on threemajor risk factors

employers can save anaverage of $700 peremployee per year inhealth care costs and

productivity improvements

Source : 2010 World Economic Forum



Engaged Employees are Healthy and Productive

Engaged employees:• have healthier habits and are in better health• have lower incidences of chronic health problems• are more likely to be involved in employer sponsored wellness programs

Engaged employees (high vs. low wellbeing):• 46% fewer unhealthy days as a result of physical or mental illness• 39% less likely to be diagnosed with new disease in the next year• 43% less likely to be newly diagnosed with anxiety and depression

Source: Gallup, 2013. Purchasing Power white paper Financial Wellness: Power Behind the Purchase , July 2013.

Employees with strong overall wellbeing are nearly 6X as likely to be engaged to those who are at risk



Global Framework to Deploy Focus on Health andWellbeing

Using all Spheres of Influence to Create a Healthy and High Performing Workforce

Source: Adapted from 2010 WHO Healthy W orkplace Framework and Model

Incorporateappropriate

activity and health

practices intodaily job functions

Supporting healthpractices outside

of the workenvironment

Making servicesaccessible, easy,meaningful,

confidential andpersonal

Health andwell-being

part of DNA

Wellbeing Categories

Physical

Emotional

Social

Financial

Environment

Career

Community


12/50

Best Practice in Worksite Health Promotion



Best Practices for Worksite Health Promotion

Best Practice Element 1 Organizational commitment to a healthy culture (mission and

vision) 2 Program connected to company mission, vision and business

objectives3 Adequate resourcing

4 Strategic plan (goals and objectives)

5 Operations work plan

6 Implementation management system

7 Program branding

8 Year-round, comprehensive program communications

9 Human-centered culture

10 Supportive physical work environments and organizational policies

11 Supportive psychosocial work environments and organizationalpolicies

12 Leadership engagement

13 Multi-level leadership

14 Participatory practices

15 Worker involvement and representation

16 Health and wellness committee

17 Assigned program accountability

18 Meaningful and relevant participation incentives

19 Regulatory compliance ( e.g. , HIPAA, GINA, , PPACA, State Law)

20 Measurement and evaluation

21 Analysis and reporting

22 Assessment of health risks with feedback23 Organizational environmental and policy assessment

24 Population triage, segmentation

25 Wellness champions network

26 Easily accessible program options

27 Effective program options (evidence-informed)

28 Targeted outreach

29 Tailored programmatic solutions for individuals

30 Supporting self-care and self-management

31 Integration of programs and vendors (linkages to EAPs, etc.)

32 Continuous improvement model

33 Awareness and education programs

34 Behavior change programs

35 Multiple program delivery options and modalities

36 Multi-level programming

37 Dedicated onsite staff

38 Community connectedness

39 Family involvement

40 Partnership and team oriented (internal and external)

41 Data security

42 Data integrity

43 Data integration

44 Data confidentiality

Source: Pronk NP. Health & Fitness Journal, in press



Best Practice Governance Structure

C-Suite &Executive

Sponsorship

Management& Site

Leaders

HumanResources,

Facilities,OnsiteServices

Live HealthySite

Coordinators& Teams

Mission/VisionExecutive sponsorshipFinancial commitmentOrganizational, health-related policySet culture, tone, give permission

Program strategy, design, delivery,measurement & evaluationFinancial planningHealth-related policyReinforce culture

Tie to business strategy

Reinforce culture & setclimate Adopt health-relatedpolicyMonitor & communicateprogram performance

The ult imate SocialNetworkers Marketers, logisticalcoordinatorsTrusted resource tocapture feedback; securetestimonialsCapture local-levelparticipant data


15/50

How to Get Started


16/50


Steps in Developing a Successful Program

Discover

Design

Deliver

Determine

1

2

3

4

S t e p s

Data and Information Assessment

Program Strategy and Tactical Plan

Implementation and Engagement

Reporting, Measurement and Outcomes


17/50


Data and Information Assessment Discover1

Analysis Inventory Interviews Survey

TimeFrame

4-5Months


18/50


Multi-Year Strategy/Tactical Plan Design2Time

Frame2-3

Months

Strategy Design TacticalPlanLegal & Financial

Review Business Case


19/50


20/50


Results and Outcomes Determine4Time

Frame2-3

Months

VendorReporting

Optimal HealthMetrics Scorecard

SpecialStudies


21/50

Let’s Focus on 2 of the 4 Avenues of Influence

Psychosocial Work

Environment

Individual HealthResources

2

1


22/50


According to Aon Hewitt’s 2013 Health Care Survey outcomes andchallenges are all about changing behavior

Source: Aon Hewitt 2013 Health Care Survey

Desired Outcomes and Major Challenges of Employers


23/50


How Employees View the Challenge of Behavior Change

Source: 2012 Consumer Health Mindset Survey – Aon Hewitt, National Business Group on Health, The Futures Company

Source: The Futures Company, US Monitor, 2012.

Stressed Fun Deprived Willing to ChangeStress causes a significant negativeimpact on at least 1 area of my life

(most often physical health)!64%

…and 5 of 6 top ways to deal withit are sedentary behaviors

I took some positive action basedon HRQ results!

86%

…and 50% think employers shouldreward for positive health

outcomes but money isn’t alwaysthe answer


24/50


Simplicity Facilitates Behavior Change

Select aPrecise

Behavior

Make Sure aTrigger is in

Place

Make theBehavior Easy

to Do

What behavior do

you want tochange?

Translate goalsand outcomesinto behaviors

How can you

make thebehavior easy todo?

Remembersimplicity changesbehavior

What will prompt

the behavior?Some triggers arenatural and someyou will need tocreate


25/50

• Practical Application Individual Health Resources


26/50

WellnessImprove the Health of BSAM Teammates

Awareness

Teammate knows theimportance of being fit(physically, emotionally,

financially) and hasaccess to personalizedinformation/data

Understanding

Ability to translateinformation/data into“what is in it for me”knowledge

Action

Sustained participationin and personalresponsibility for one’s

own health

Today Ideal State

L M d t HighR ti g S l


27/50

27Consulting | Health & BenefitsProprietary & Confidential | BSAM Workforce Resiliency Strategy 5.24.13

Tactical PlanWork Environment Workplace Culture

Considerations

Locations willingness to participate in health & resiliencyenvironment and culture auditsSpeed at which guidelines can be implemented and adhered to

Rationale

According to the 2013 Aon Hewitt Health Care Survey 83% ofemployers believe workplace culture and 79% work environment canhave the greatest influence in impacting worker health and changingbehaviorsTo understand location-specific needs and challenges throughout theday that will influence how health can be incorporated into daily jobfunctionsTo personalize an approach that will meet specific division orlocation needs

R

e c omm

en

d a t i on

s

Incorporating Health into the Work Day and Guidelines

2013 2014 2015 2016Complete a health & resiliencyenvironment and culture audit at allmajor locations and at a samplingof retail locationsGain input from teammates

Perform “a day in the life”visits for key job functionsat operating units of BSAMCreate simple, easy ways toincorporate health into job functionsCreate and implement physicalactivity break guidelines Assessment of worksite food

options

Develop and implement 10minute movement breakbased on job function andtypeCreate and implement guidelines forhealthier food options in vendingmachines and onsite cafeterias

Develop and implement a 3-5 minute stretching andstrengthening programbased on job typeEstablish health food guidelines formeetings and events

Effort

CostEstimate

$$ $$ $ $

Work Environment Workplace Culture

$$$$$$

Low Moderate High

Effort

Cost

Rating Scale


Low Moderate HighRating Scale


28/50

28Consulting | Health & BenefitsProprietary & Confidential | BSAM Workforce Resiliency Strategy 5.24.13

Considerations

Unknown requirements for print and new media campaigns mayimpact costs

Some job functions may find participation challenging

Screening logistics may be challenging

Tactical Plan

R e c omm

en

d a t i on s

Build Awareness and Individual Behavior Change

2013 2014 2015 2016Vendor selectionHealth benefit plan design changesto include personal training andnutritional counseling for all coveredlives

Conduct Health Assessment (HA)Conduct biometric screenings: bloodpressure, fasting glucose, waistcircumference, height, weight, lowHDL cholesterol, triglycerides, steptestEngage at-risk individuals in-person,web and mobile coaching programsPromote comprehensive web portalfor all teammatesImplement physical activitychallenge (e.g., HealthEnhancement Systems Get Fit onRoute 66 )

Conduct Health Assessment (HA)Conduct biometric screenings: bloodpressure, fasting glucose, waistcircumference, height, weight, lowHDL cholesterol, triglycerides, steptest and sit-and-reach testEngage at-risk individuals in-person,web and mobile coaching programsIntroduce traveling lifestyle coach forphysical activity and healthy eatingat locationsImplement healthy eating challenge(e.g., Health Enhancement SystemsColorful Choices)

Conduct Health Assessment (HA)Conduct biometric screenings: bloodpressure, fasting glucose, waistcircumference, height, weight, lowHDL cholesterol, triglycerides, steptest and sit-and-reach testEngage at-risk individuals in-person,web and mobile coaching programsContinue to promote the travelinglifestyle coach for physical activity,healthy eating and weight lossImplement physical activitychallenge (e.g., HealthEnhancement Systems Spring IntoMotion)

Effort

CostEstimate

$$ $$$ $$$ $$$


Rationale

Measuring effectiveness of program requires assessment andbiometric screening

Increases visibility of health across BSAM

Increase awareness of health and taps the competitive nature ofsome departments

$$$$$$

Low Moderate High

Effort

Cost

Rating Scale


29/50


Employer View of Greatest Influence on ChangingBehaviors

83% believeworkplaceculture and

79% workenvironmentcan have the

greatestinfluence inimpacting

worker healthand changing

behavior

Source: Aon Hewitt 2013 Health Care Survey


30/50


A Culture of Health

BusinessPerformance

PersonalValues

Organizational

Values

“A workplace ecology inwhich the dynamicrelationship betweenhuman beings and theirwork environment nurtures

personal andorganizational values thatsupport the achievement of

a person’s best self whilegenerating exceptionalbusiness performance”

Source: Pronk NP. ACSM’s Worksite Health Handbook, 2 nd Ed., 2009


31/50

2011 © HealthPartners 31Engagement

Environment

Skills(ability)

Motivation(energy)

Employee Engagement

Is it:

• Possible?

• Simple?

• Socially rewarding?

• Financially rewarding?• Personally relevant?

• Organizationally relevant?

• Community connected?

Health

Individual Organizational+


32/50

• Practical Application Psychosocial WorkEnvironment


33/50


Creating Policy and Guidelines


34/50




35/50




36/50


Sustainable Engagement


37/50

Measurement and Evaluation


38/50


Workplace Health Evidence of Effectiveness

• Recommendations of selected interventions thatwork from a health improvement perspective

• Health risk assessment with feedback (questionnaire and screening)• Incentives and competitions to reduce tobacco use• Smoke-free policies to reduce tobacco use• Use of decision prompts to increase stair use• Obesity Prevention: Worksite Programs to Control Overweight and

Obesity• Interventions with On-Site, Reduced Cost, Actively Promoted

Vaccinations• Creation Of or Enhanced Access To Places for Physical Activity

Combined with Informational Outreach Activities

Source: www.thecommunityguide.org/worksite/index.html


39/50


ROI Literature Review

Systematic review and meta-analysis

Conclusion: Worksite Health Promotion programs

can generate positive ROI for medical-

and absenteeism-related savings:Medical: 3.27 : 1

Absenteeism: 2.73 : 1

Workplace Health Evidence of Effectiveness


40/50


Value through Design

Companies across a variety of industries reportbenefits:• Lower health care costs• Greater productivity• Higher morale

ROI can be as high as 6:1

Six Essential Pillars for Successful Programs:1. Engaged leadership at multiple levels2. Strategic alignment with the company’s identity and aspirations 3. A design that is broad in scope and high in relevance and

quality4. Broad accessibility5. Internal and external partnerships6. Effective communications


41/50

• Practical Application of Measurement andEvaluation


42/50


Actual Causes of Death in the U.S.

Source: Mokdad, A.H. JAMA 2004;291;1238-1245 [Errata, JAMA 2005;293:293-294].

4 behaviorscause nearly40% of all deathsin the U.S.(year 2000)


43/50


Optimal Lifestyle Metric (OLM)

• Being physically active

• Not smoking/no tobacco use

• Eating 5 fruits and vegetables each day

• Drinking alcohol in moderation


44/50


The Impact of health behavior adherence:The EPIC-Norfolk Prospective Population Study

• 11-Year follow-up of 20,244men and women aged 45-79years

• All-cause mortality adjustedfor age, sex, BMI, social class• The difference between a

health score of 4 and 0 isequivalent to 14 years inchronological age

• Analyses for those with chronicdisease (N=2,057) showedsimilar results

Source: Khaw, et al. PLoS Medicine 2008; 5(1) e12: 0001-0009. www.plosmedicine.org

http://www.plosmedicine.org/http://www.plosmedicine.org/


45/50


Adherence to OLM and New Disease

Source: Pronk NP, et al. Pop Health Manage 2010;13:289-295.

Difference in 2-year incidence of new disease between people who adhere toOLM 0 or 1 and OLM 3 or 4 ( % )


46/50


47/50


Adherence to OLM and Productivity Loss

Impact on excess health-related productivity loss

• Absenteeism

• Presenteeism

Based on 33,956 employees (Sample company,assuming $50,000 average salary, expressed asper person per year productivity loss in 2009dollars)

Source: Pronk NP. ACSM’

s Health & Fitness Journal 2012;16(3):39-43.


48/50


Changing Behavior: 3-Year OLM Results

Source: ACSM’

s Worksite Health Handbook, 2 nd Edition, 2009. Chapter 36

93% are very satisfied or satisfied with the programExperience

Tobacco use 37% improvementPhysical activity 58% improvementFruits and vegetables 89% improvementAlcohol use 2% improvement

Health andproductivity

Demonstrated savings and ROI over three yearsMedical $1.3 MProductivity $1.1 MEstimated ROI 2.9:1 M

ROI


49/50


50/50

Open Dialogue

who healthy workplace model from strategy to action

Documents