No Picture
Health Food

Creating a Culture of Health and Wellness

I deal mainly with small-to-medium sized employer groups and every time I broach the subject of creating a company culture that promotes the health and wellness of their employees – I usually get the same response. It goes something like this; “Are you kidding? It’s not good enough that I provide a good paying job with a great employee benefits program, now you want me to promote healthy lifestyles for my employees? Forget it!” Coincidentally, my response is always the same. “As long as you [the employer] have a fiduciary responsibility for your companies health plan, meaning, it’s your name on the plan and you’re the one they ultimately look to for payment – then you have an incumbent responsibility to shield your company finance’s against premium increases. Think about it for a moment. If the majority of your employees are living unhealthy lifestyles (i.e. they’re over-weight, they smoke, live sedentary lives) then you’ll be bearing that burden in the form of higher health insurance premiums year after year.
It’s not just higher premiums that become the negative outcome. It’s also the fact that unhealthy employees tend to be more unproductive than their healthy counterpart employees. They have a higher absenteeism rate and they have a tendency to be less productive even when they’re at work. Ignoring a robust health and wellness component to complement your employer-sponsored health plan just doesn’t make good business sense.
Here are some chilling facts:
A recent analysis of data from the National Health and Nutrition Survey (NHANES), which is conducted regularly by the National Center for Health Statistics, warns that middle-aged individuals may be at greater health risk than anyone anticipated. In comparing the results of two large-scale studies of the U.S. population in 1988 to 1994 and in 2001 to 2006, the report shows that the number of people aged 40 to 74 adhering to healthy lifestyle habits has seriously declined.
* The percentage of surveyed adults with a body mass index greater than 30 has increased from 28 percent to 36 percent *
* Physical activity 12 times a month or more has decreased from 53 percent to 43 percent *
* Eating five or more fruits and vegetables a day has decreased from 42 percent to 26 percent *
* Moderate alcohol use has increased from 40 percent to 51 percent *
* Smoking rates have not changed (26.9 percent to 26.1 percent) *
*The Vitality Group ” CREATING A NEXT-GENERATION HEALTH AND WELLNESS PROGRAM: Why employers should take the lead, and how to do it
While it’s true that Americans are living longer today (life expectancy for males is 75 years and for females it’s 80 years), it’s also true that more Americans suffer from chronic and debilitating diseases such as diabetes, hyper-tension, acid reflux, heart disease, mostly stemming from too many Americans being obese. In fact, it’s estimated that obesity alone accounts for 147 billion dollars a year in health care related costs. Now, I’m not an economist by any means but I can figure out that if we created a culture of health and wellness in this country that seeks to stem the negative affects of obesity, we wouldn’t need the government to get involved with health care at all.
Business owners, maybe it’s time to make some radical changes in your workplace like, don’t just ban smoking in the building but eliminate the 35 smoke breaks that take place throughout the day. After all, if I came to you with a request to go into the break room to eat something every 30 minutes you would probably suggest that maybe this job’s not for me – and you would have every right to suggest that! Studies have shown that it’s well worth the investment with ROI’s sometimes being $3.27 reduction in medical costs for every dollar spent on health and wellness, as well as, reducing absenteeism costs by $2.73 for every dollar spent. Just some healthy food for thought.
If you would like to learn more about how to cultivate a culture of health and wellness at your company; email me at [email protected]

No Picture
Nutrition

Hospital Leadership, Strategy, And Culture In The Age of Health Care Reform

With just eleven months to go before the Value-Based Purchasing component of the Affordable Care Act is scheduled to go into effect, it is an auspicious time to consider how health care providers, and hospitals specifically, plan to successfully navigate the adaptive change to come. The delivery of health care is unique, complex, and currently fragmented. Over the past thirty years, no other industry has experienced such a massive infusion of technological advances while at the same time functioning within a culture that has slowly and methodically evolved over the past century. The evolutionary pace of health care culture is about to be shocked into a mandated reality. One that will inevitably require health care leadership to adopt a new, innovative perspective into the delivery of their services in order to meet the emerging requirements.
First, a bit on the details of the coming changes. The concept of Value-Based Purchasing is that the buyers of health care services (i.e. Medicare, Medicaid, and inevitably following the government’s lead, private insurers) hold the providers of health care services accountable for both cost and quality of care. While this may sound practical, pragmatic, and sensible, it effectively shifts the entire reimbursement landscape from diagnosis/procedure driven compensation to one that includes quality measures in five key areas of patient care. To support and drive this unprecedented change, the Department of Health and Human Services (HHS), is also incentivizing the voluntary formation of Accountable Care Organizations to reward providers that, through coordination, collaboration, and communication, cost-effectively deliver optimum patient outcomes throughout the continuum of the health care delivery system.
The proposed reimbursement system would hold providers accountable for both cost and quality of care from three days prior to hospital admittance to ninety days post hospital discharge. To get an idea of the complexity of variables, in terms of patient handoffs to the next responsible party in the continuum of care, I process mapped a patient entering a hospital for a surgical procedure. It is not atypical for a patient to be tested, diagnosed, nursed, supported, and cared for by as many as thirty individual, functional units both within and outside of the hospital. Units that function and communicate both internally and externally with teams of professionals focused on optimizing care. With each handoff and with each individual in each team or unit, variables of care and communication are introduced to the system.
Historically, quality systems from other industries (i.e. Six Sigma, Total Quality Management) have focused on wringing out the potential for variability within their value creation process. The fewer variables that can affect consistency, the greater the quality of outcomes. While this approach has proven effective in manufacturing industries, health care presents a collection of challenges that go well beyond such controlled environments. Health care also introduces the single most unpredictable variable of them all; each individual patient.
Another critical factor that cannot be ignored is the highly charged emotional landscape in which health care is delivered. The implications of failure go well beyond missing a quarterly sales quota or a monthly shipping target, and clinicians carry this heavy, emotional burden of responsibility with them, day-in and day-out. Add to this the chronic nursing shortage (which has been exacerbated by layoffs during the recession), the anxiety that comes with the ambiguity of unprecedented change, the layering of one new technology over another (which creates more information and the need for more monitoring), and an industry culture that has deep roots in a bygone era and the challenge before us comes into greater focus.
Which brings us to the question; what approach should leadership adopt in order to successfully migrate the delivery system through the inflection point where quality of care and cost containment intersect? How will this collection of independent contractors and institutions coordinate care and meet the new quality metrics proposed by HHS? The fact of the matter is, health care is the most human of our national industries and reforming it to meet the shifting demographic needs and economic constraints of our society may prompt leadership to revisit how they choose to engage and integrate the human element within the system.
In contemplating this approach, a canvasing of the peer-reviewed research into both quality of care and cost containment issues points to a possible solution; the cultivation of emotional intelligence in health care workers. After reviewing more than three dozen published studies, all of which confirmed the positive impact cultivating emotional intelligence has in clinical settings, I believe contemplating this approach warrants further exploration.
Emotional intelligence is a skill as much as an attribute. It is comprised by a set of competencies in Self-Awareness, Self Management, Social Awareness, and Relationship Management, all leading to Self Mastery. Fortunately, these are skills that can be developed and enhanced over the course of one’s …