Employer Wellness

In addition to looking at the health behaviors of staff members, take a good look at your business. The following questions can help you identify opportunities for your business to support and encourage healthy behaviors among staff members.

A strong foundation for employee health improvement

1. To what extent does the senior management in your business actively and visibly support the Employee Wellness Program?

__ No support for the Employer Wellness Program
__ Support, but not at senior level
__ Support at senior level, but not visible to staff members
__ Strong and visible Employer Wellness Program support
Comments:

2. Is the Employer Wellness Program tied to your business’s mission statement?

__ No
__ Yes, the Employer Wellness Program is tied to business plan OR mission statement
__ Yes, the Employer Wellness Program is tied to both business plan and mission statement
Comments:

3. Is there an staff member within your business whose job responsibilities include Employer Wellness Program coordination?

__ No
__ Yes, but has little time available to dedicate to Employer Wellness Program
__ Yes, and has at least part of the job dedicated to Employer Wellness Program
__ Yes, and has at least one full-time position dedicated to Employer Wellness Program
__ Yes, and has at least part of the job dedicated to wellness AND has a background that includes Employer Wellness Program qualifications
__ Yes, our business has at least one full-time position dedicated to health improvement AND the staff member’s background includes Employer Wellness Program qualifications
Comments:

4. Does your business have an active wellness committee with diverse representation?

__ No (does not have a Health and Wellness Committee, or has a committee that doesn’t meet)
__ Yes, we have a Health and Wellness Committee, but with limited representation
__ Yes, we have a Health and Wellness Committee with widespread representation
__ Yes, we have a Health and Wellness Committee with widespread representation AND committee involvement is part of each representative’s job responsibilities
Comments:

5. Does your business have an annual budget for Employer Wellness Program expenses? (Employee Wellness Program expenses may be associated with providing a health assessment, paying for behavior change programs/coaching programs, covering incentives and rewards that encourage healthy behaviors, subsidizing healthy food options, communications and activities around specific health topics, fitness centers/walking paths, etc).

__ No
__ Yes, but funds are earmarked for Employee Wellness Programs (e.g. only for Weight Watchers or fitness discounts) and do not meet all existing Employer Wellness Program needs
__ Yes, funds are available to meet current Employer Wellness Program needs
Comments:

6. Does your business have a plan for engaging staff members in the Employee Wellness Program?

__ No
__ Yes, we have a communications plan for our Employer Wellness Program
__ Yes, we have a communication plan AND we offer meaningful incentives or rewards (such as premium discounts or debit cards) for the Employer Wellness Program to engage in healthy behaviors.
Comments:

A data-based approach to the Employer Wellness Program

7. Does your business have clearly stated Employer Wellness Program goals and priorities for employee health improvement?

__ No
__ Yes
__ Yes, data (e.g. HRA, claims, productivity) are the basis for defining Employer Wellness Program goals or priorities
__ Yes, data AND evidence-based best practices are a basis for defining Employer Wellness Program goals or priorities
__ Yes, data and best practices are basis for defining Employer Wellness Program goals or priorities as well as measuring Employer Wellness Program progress (evaluation)
Comments:

8. Has your business completed a Health Risk Assessment?

__ No
__ Yes, but more than 2 years ago
__ Yes, within the last two years, and achieved a participation rate of less than 50%
__ Yes, within the last two years, and achieved a 50% – 79% participation rate
__ Yes, within the last two years, and achieved an 80% or greater participation rate
Comments:

A worksite setting that supports healthy behaviors

9. Does your business’s tobacco reduction strategy reflect best practices?

(Check all that apply)
__ A no-tobacco use policy that includes both buildings AND grounds
__ 100% coverage for the cost of over-the-counter nicotine replacement therapy
__ Employee access to – and strong promotion of — a tailored stop-smoking program
Comments:

10. Does your business provide opportunities (time and places) for physical activity during the work day?

__ No
__ Yes, indoor places for physical activity (on-site fitness center) OR outdoor places for physical activity (walking paths)
__ Yes, both indoor AND outdoor places for physical activity
__ Yes, indoor and outdoor opportunities AND workers can use work time for physical activity
Comments:

11. Does your business promote healthy eating by providing access to fruits and vegetables?

__ No
__ Yes, fruits and vegetables are available at the worksite (in vending machines, break areas, or cafeterias)
__ Yes, fruits and vegetables are available and discounted at the worksite
Comments:

Benefits that support employee health improvement

12. Does your business provide staff members with self-care resources?

(Check all that apply)
__ Distribution of self-care books
__ online access to health information
__ Nurse advice line
Comments:

13. Which of the following preventive services are covered at 100% by your business’s health benefits?

(Check all that apply)
__ Vision screening
__ Hearing
__ Immunizations (per CDC/ACIP recommendations)
__ Radiology
__ Laboratory services
__ STD screening
__ Preventive medical examination for adults
__ Cancer screen (includes: colon, cervical, breast, prostate and ovarian cancers)
__ Contraceptive management
Comments:

14. Which of the following are included in your business’s pharmacy benefit?

(Check all that apply)
__ Mail order or other 90-day supply option for medications
__ Specialty pharmacy network
__ Incentive-based tiered formulary design
Comments:

15. Do your business’s health benefits provide coverage for behavioral health (such as depression, mental illness, counseling, stress management, and chemical dependency)?

__ Yes, at the same level as medical benefits
__ Yes, but at a lower level (less coverage) than medical benefits
__ No coverage for mental or behavioral health
Comments:

Health Information Technology can make the entire health care system more effective and efficient by enhancing:
• Documentation (lab and test results, clinic notes, consult recommendations)
• Communication (provider to patient, provider to provider)
• Information input (templates to facilitate data entry)
• Delivery of care (documenting all patient-provider interactions in a single system)
• Chronic disease risk identification (evaluation of risk factors, recommendations for appropriate preventive services and screenings)
• Consistent recording of correct billing codes

But, adapting to Health Information Technology is a challenge.
• Health Information Technology almost always involves a “new system.” Consequently, the entire staff, from health care providers to IM/IT personnel is on a learning curve.
• Existing IT infrastructure may not be adequate, so the Health Information Technology system may be very slow, or may frequently crash.
• The new system may not have all the forms you need already in place. New forms may be needed.

Lessons learned from Health Information Technology implementation

Make use of as many training opportunities as possible.
• Learn as much as you can about the Health Information Technology that you need to use. Become an expert.
• Ask questions if you are unsure how to navigate the system.

Keep the big picture in mind.
• Be aware that those keeping the Health Information Technology system up and running may have a very different set of priorities. The IM/IT staff may not see your request as a priority when it is taking all their manpower to trouble shoot the new system each day.
• Other changes to the Health Information Technology system may be in line in front of yours, so be patient.

Think through changes thoroughly.
• Take time to think through a new form thoroughly. Know exactly what you want before talking to the developer.
• Don’t think in a vacuum. If you build a form, make sure it is one your staff will use and find efficient.
• Make a draft version of the form and use it before requesting that it be put into the new system.
• Be prepared to build a good case for why your form should be created. Build a stronger case if your form should be developed ahead of other requests in the queue.
• Be patient and persistent when working with a programmer/developer on a new form. Meet frequently and set up timelines and deadlines.
• Coordinate with IM/IT and the Health Information Technology contractor to see if they can support a new project in the required time frame.

For more information about Health Information Technology implementation, go to the Agency for Healthcare Research and Quality (AHRQ) National Resource Center for Health Information Technology at http://healthit.ahrq.gov.

Employee Health Services
• worksite medical services
• worksite medical examinations
• health risk testing and counselling:
• blood pressure testing,
• blood cholesterol testing,
• blood glucose testing clinics,
• thyroid testing,
• bone density testing,
• prostrate cancer testing
• promote self-exams – breasts, testicles
• medical surveillance Programs
• immunizations and flu shots
• Disability Management
• Active rehab
• Return to work Programs
• Self-care Programs
• Disease management information and presentations:
• diabetes,
• stomach disorder,
• arthritis,
• asthma,
• allergy,
• foot and back care Programs,
• chronic tiredness,
• migraines
• Online health and wellness education with continuous learning/reminders/tips
• Daily/weekly/monthly email tips or news bulletins
• Excercise appraisals
• Health and safety fairs
• Hand-washing tips and reminders
• Visiting your doctor guide – tips to efficiency
• links and information on help lines

• clearly communicated vision and mission
• clear and accurate job descriptions
• supportive appraisal system
• employee empowerment through decision-making, pace of work and connection to business goals, (on-line tools that connect to goals such as Baxter Healthcare)
• two-way communication training
• ‘no lunch hour’ meeting rules unless it is a lunch ‘n’ learn
• absenteeism and attendance program
• career tracking, (on-line tools like Pfizer)
• continuing education
• job rotation, special project assignments
• time management
• creative ideas program
• change and complaint process
• email guidelines
• technology courses and assistance
• vacation useage
• shift work rotations and breaks
• conflict management skills
• handling negative attitudes workshops

Occupational Wellness Strategies: Management Training

• scheduling
• incentive and recognition Programs
• workload impact
• communication and feedback skills
• conflict management skills and support skills
• priority setting
• all of which are apart of the four employment relationship factors (trust, commitment, influence, and communication – from Canadian Policy Research Network)

Occupational Wellness Strategies: Remuneration and Benefits

• massage – try an worksite massage therapist or seated massage breaks
• orthotics
• orthodontics
• gym membership subsidies
• education subsidies
• tobacco cessation and weight control partial reimbursement incentives
• safety shoe reimbursement
• out-of-country coverage
• vision care
• alternative therapy coverage

Occupational Wellness Strategies: Support Building
• exercise  breaks and stretches
• team challenges
• business sport teams such as soccer, volleyball, and hockey
• use employees who are in-house experts e.g., gardening, yoga, construction
• celebrate birthdays, anniversaries – other significant dates and achievements
• 5 minute catch-up at beginning of work week
• pot lucks and food for meetings
• green room for time outs and regrouping self
• encouraging face to face communications
• learn names

**The creation of health or harm within an organization depends on how work is managed.  Workplace Culture Strategies must address high demand/low control, high effort/low reward, fairness, purpose and trust.

• childcare Programs and information
• family planning information
• parenting classes
• Senior care Programs and information
• retirement planning
• personal responsibility leave
• alternative work arrangements such as telecommuting, job sharing
• work-family-life transition support
• anger management and family violence
• family counselling programs
• budgeting and financial counselling
• understanding credit reports
• money safety tips – ATMS, credit cards
• advertising and promotion of community support groups
• cafeteria take-out program
• tax preparation programs
• will, power of attorney, and estate experts
• vacation planning and safe travel
• interpersonal relationship speakers
• motivational speakers
• bereavement information
• shift work and lifestyle Programs
• limit overtime
• family wellness days – bike rodeos, BBQ, picnics
• swimming pool safety
• charity information – United Way, MADD
• other information sessions on:
• chemical free lawn and garden care,
• menopause,
• infertility,
• poisoning,
• fire safety programs
• seat belts and booster seats,
• playground safety,
• internet safety,
• home safety and energy efficiency

• violence in the worksite
• equity in the worksite programs
• harassment policy and training
• literacy/numeracy Programs
• professional development and skill enhancing training
• air quality and sick building testing
• smoke-free worksite
• fire safety programs
• hazard control and WHIMS Training
• injury prevention, CPR/First Aid, emergency response Programs
• enhanced signage
• installing guard rails
• work station design, ergonomic and repetitive strain reduction training
• stretching programs
• health and safety written and implemented policies
• Safety Audits
• access to bike racks, showers and change areas
• make stairs attractive and post signs to promote their use
• proper lighting
• monitoring noise levels
• shift work strategies related to lighting, noise, air, breaks etc.

• Add Stress management and mental health Programs
• Add substance use and abuse Programs
• Add smoking cessation and control
• Add nutrition counselling
• Add weight control Programs and counselling
• Add promote use of food logs
• Add posting BMI charts
• Add juice dispensing machines
• Add water coolers
• Add snack machines with low-calorie snack choices
• Add snack machines with fruit, vegetable and calcium choices
• Posting nutritional information on snack machines
• Add color-coded cafeteria choices
• Encourage breakfast – suggest choices to start the day
• healthy packed lunch ideas for adults and kids
• partnering with local restaurants for healthy lunch choices
• healthy recipes on-line
• healthy or low-cost cooking Programs
• healthy shopping instruction
• naturopaths, homeopaths, herbal remedies and vitamins
• Add information sessions on fad diets
• Add disease prevention information
• STD’s
• active living and fitness Programs such as a aerobics, walking or cycling clubs
• Add self-defense training
• Add relaxation training
• chiropractors
• relaxation and energy specialists
• Add stretching classes such as yoga, tai chi
• Add active living challenges
• walking challenges with pedometers
• stair climbing challenge
• sleep and sleep disorders e.g. snoring
• napping information and sleep rooms
• alertness and driving sessions
• encouraging light breaks
• create a wellness Yellow Pages
• information sessions on
• insect bites,
• memory enhancement,
• motion sickness,
• nose bleeds,
• healthy skin,
• frost bite,
• gingivitis and mouth care,
• hair loss,
• ear infections,
• fever,
• psoriasis,
• TMJ,
• varicose veins,
• shingles,
• defensive driving,
• sun safety,
• avoiding home and vehicle theft,
• food safety
• handwashing

**Healthy Living Programs should assist in the development of self-efficacy which means that the individual has a senses that they can influence the course of events in their normal daily life, that they can deal with their normal consequences, that they feel confident and sure of themselves.

Why Complete a Employer Wellness Program Environment Assessment?

The purpose of completing the assessment is to identify your jobsite’s strengths and areas in need of improvement. The assessment will lead your workgroup to recommend actions for changes to make the worksite more supportive of healthy behaviors (i.e. healthy food choices in snack machines, policies to enforce no tobacco use on worksite grounds or encouraging walking during break times). You may find some of the actions for supporting healthy behaviors are easy to do and others may not be feasible or efficient in your worksite.  The assessment results can also be used as a baseline measure for evaluation.  The initial assessment can later be compared with a follow-up assessment several months later to note progress.

Who should do the Employer Wellness Program Environment Assessment?

Identify a workgroup (at least 4-5 workers) who will be accountable for completing the assessment.  This may be a subset of your wellness workgroup.  Forming a diverse group from all areas and levels of your organization is important for meaningful assessment and successful planning and implementation. Suggested members include: human resources, employees from various departments, administrators, supervisors, employee or wellness staff.

When should the Employer Wellness Program Environment Assessment be Done?

Use the assessment as a starting point for your Employee Wellness Program. Once you have completed the assessment, determine which areas the workgroup will focus on (i.e. healthy eating, physical activity, general health, etc.). Establish a time for the workgroup to meet and monitor the progress. Also determine a schedule for annual assessments, so that the assessment can serve as a tool for continuous improvement and accountability over time.

Part 1 – Employer Wellness Program Assessment Checklist

Complete a Worksite Wellness Assessment Checklist to determine what wellness components you currently have at your worksite.   This can be done with the full workgroup or you may want a few key personnel (such as the Human Resources lead, Wellness Coordinator or Workgroup Coordinator) to do a preliminary scan based on information they gather and then let the full workgroup react to their findings. Ask your broker for a sample wellness assessment checklist or create your own.

Completion of the checklist provides a reference point of the wellness functions that are currently in place or in process and it provides an overview of some of the items that should be considered for a broad-based Employee Wellness Program.

Employer Wellness Program Checklist Components:

Categories.  There are six major categories (General, Physical Activity, Nutrition, Health Screening, Tobacco Use and Emergency Response Plan).  Each category has several questions that address what you currently have in place at your worksite.

Current Status.  Initially, list whether you have the component (Yes), are in the process of instituting the component or you are planning for the component (In Process) or don’t have the component at all (No).  At the end of each category, sub-total the number in each column and then total all of the categories at the end of the checklist to get an overview of where your worksite Employer Wellness Program currently rates. You should also use this baseline measure as a benchmark for later evaluation.  By evaluating where your worksite is on each wellness component, you will be able to get a general idea of your status across each category and all 57 items.

Potential Priorities.  After you have completed the assessment and the employee interest survey, you can use the potential priority column to indicate what components you might want to focus on that are either currently in process or don’t exist.  This can serve as a first testing of possible areas to focus on as you develop your action plan.

Part 2: employee Input

Why would we want to do an employee survey?

You should conduct an employee survey to get a better understanding of your target audience (your organization’s employees) and get an initial idea of their current health habits and interest areas.  The survey can be tailored to your worksite and can be done in paper form or through the use of survey instruments on the internet or that can be purchased.   You can create your own employee survey or ask your broker for a Workplace Wellness Needs and Interest Survey.

As was the case with the worksite environmental assessment, the employee survey results can also be used as a baseline measure for later evaluation.  The initial survey results can later be compared with a follow-up survey several months later to note progress.

Consider engaging employees in focus groups or informal interviews to gather information on their wants and needs.  This can be done either before or after the survey, or if you don’t have the resources to survey employees, you could use this method to gather information in place of the survey.

Whatever method you use to gather information, make it as easy as possible for employees to complete and submit the information so you get a high return rate.  Look at offering an incentive or prize for workers who complete the survey.

Once you start a Employer Wellness Program you will have a range of employee members.  Some will already be very engaged in being active and eating well and your program will only reinforce and enhance their health.  On the other end of the spectrum will be workers who may not engage no matter what you do.  The remaining group is probably the largest group in most employers: workers who are at various stages of readiness to improve their health given the right type of programming and motivation.   Summarized below are some tips you may want to employ once your program is up and running.

Key Factors in Employer Wellness Program

In today’s society there are many key factors that influence people’s health behaviors.  Look at the following list in maintaining participation in your program:

1.    TIME.  Staff members are busy, so the more you can work activity and healthy eating into their existing schedules, the better your chances for success.  Example: A walk at lunch doesn’t take away from existing time, it just uses it differently.  Also look at the time of the day and length of any activity you might be promoting, since both time components may be factors.
2.    ACCESS.   How accessible is your Employee Wellness Program.  Is it onsite or at a nearby site?  Do you offer access at breaks or outside of normal work hours?
3.    KNOWLEDGE.  Staff members need to know “Why” they are taking part in (the benefits) and also will need information about the “How to” in areas that are not commonly known.
4.    COST.  Make sure that you can provide no cost or decreased cost Employee Wellness Programs will help participation rates.  Coupled with incentives for participation, rates of participation will likely increase dramatically.
5.    INCENTIVES.  Some workers need incentives to get started in a Employee Wellness Program.  A full list of Employer Wellness Program incentive options can be on the website.

Key Time Periods in Employer Wellness Program

Good habits are frequently difficult to develop.  There tends to be some critical times when workers drop out or fall off of a physical activity or diet program.   The first key time zone seems to be around 6 weeks.   If workers can start and stay consistent with a program through the first 6 weeks, they have made a fairly serious commitment to incorporate the habits into their lifestyle.  The second key time is at about 6 months.  Those who made it past 6 weeks may get bored and/or distracted from their program after several months.  If workers can get past 6 months and sustain behavior through a full set of weather seasons, they have a very good chance of making the changes permanent.

Look at these time periods and think about how you can “boost” your employees to get them past these critical time markers.  Promoting individual or group “challenges”, using incentives, or increased publicity/marketing are a few of the things you can do to help get your employees through these key time periods

Goal Setting for Employer Wellness Program

Setting goals has been shown to lead to better participation and more workers making a strong commitment.  Whether it be a team goal of walking the equivalent of once around your state or an individual goal of so many miles or minutes of activity, the fact that there is something concrete to shoot for increases the likelihood workers will stick with the program.

Buddy Systems or Team Goals for Employer Wellness Program

The social aspects of improving one’s health cannot be underestimated.  Many studies point to tight social groups being the backbone for a successful campaign because each individual has a commitment to something bigger than themselves and besides, it’s just more fun for most workers. Build your program around some type of teams or partners and see what happens.

Team “Campaigns” for Employer Wellness Program

Some workers like competition and others don’t.  Nevertheless, a worksite wide campaign has the advantage of keeping the message more visible and alive.  Encourage campaign participation, but make it voluntary so that those who prefer that type of motivation can join while others can take part in their own way and at their own pace.  If the idea of a campaign seems like too much work, consider tapping into existing campaigns where someone else provides resources for you.

Incentives for Employer Wellness Program

Incentives are frequently helpful in maintaining or raising interest.  Significant incentives such as cash or health insurance rebates have proven to be very strong motivators for employee participation.  However, even smaller incentives can be beneficial.  Listed below are some sample incentives:
• Achievement awards. Verbal praise and a pat on the back are motivational to some, but a token of recognition of achievement may offer more. A colorful certificate to congratulate an employee for achieving a health-related goal is one example.
• Public recognition.  Announced recognition at campaign mid-point or wrap-up festivities.
• Food.  Include some healthy foods to kick-off, revitalize or wrap up a wellness campaign.
• Entertainment.  Events serve a purpose in jump-starting, reenergizing or wrapping up a campaign.  Having entertainment of any kind can boost morale.
• Merchandise.  There is a long list of merchandise incentives, including sports equipment and small gift certificates to use at local merchants.
• Monetary rewards.  Nothing says incentive better than cash.  Worksites that have used cash or rebates as an incentive have shown much higher participation rates.
• Time off.  Maybe the next best incentive to cash, or for some workers even better.  This type of incentive makes good business sense if the number of absences drops significantly and attendance is used as one of the criteria.

1.    Have a current policy outlining the requirements and functions of a broad-based Employee Wellness Program.
2.    Have a wellness plan in place that addresses the purpose, nature, duration, resources required, members in, and expected results of a Employee Wellness Program.
3.    Orient employees to the Employer Wellness Program and give them copies of the physical activity, nutrition, and tobacco use policies.
4.    Promote and encourage employee participation in the physical activity/fitness and nutrition education/weight management program.
5.    Provide health education information to employees.
6.    Have a Employee Wellness Programs committee that meets at least once a month to oversee the Employee Wellness Program.
7.    Provide regular health education presentations on various physical activity, nutrition, and wellness-related topics. Ask voluntary health associations, health care providers, and/or public health agencies to offer on-site education classes.
8.    Host a Health and Wellness as a kick-off event or as a celebration for completion of a wellness campaign.
9.    Designate specific areas to support employees such as diabetics and nursing mothers.
10.    Conduct preventive wellness screenings for blood pressure, body composition, blood cholesterol, and diabetes.
11.    Provide confidential Health Risk Assessments (HRAs).
12.    Provide on-site weight management/maintenance programs for employees.
13.    Add weight management/maintenance, nutrition, and physical activity counseling as a member benefit in health insurance contracts.