Wellness Assessments

 

Most organizations do not have the Workplace Wellness Program resources to address all of their health needs at once. Priorities must be set to determine the most pressing health needs. Use the steps below to prioritize installation Wellness needs. 

Assess the health needs of the population. 

Collect data about the health needs in the community. How? 

• Community- or target group-specific surveys 

Identify health needs and at-risk populations. 

Use the data to identify leading health needs and also high risk populations. By way of example:

      • Obesity and overweight

 

      • Injury prevention

      • Self care 

Reduce the list.

Not every health need can (or should) be addressed. Use the following questions to determine which health needs should be addressed first.

 

• How does the health need impact operational readiness? How big is the impact?

• What are the Upper Management priorities? How does the health need fit into those priorities?

• What are the behavioral factors affecting the health need? What is the proof that a behavior change will make a difference? Has the behavior been successfully changed by other Workplace Wellness Programs?

• What other social, physical, or environmental factors influence the health need or the target population?

• Is the health need a greater problem at the local level than in the U.S. population as a whole? 

• Does the company have the subject matter expertise and resources to address the health need? 

Develop Workplace Wellness Program recommendations. 

Only a handful of specific health needs should be focused on in a given year. Keep the following in mind as recommendations are developed as to which specific health needs will be addressed:

• Avoid duplication of other ongoing Workplace Wellness Programs whenever possible. Identify Workplace Wellness Programs already addressing the health need and/or the target population.

• Identify and assess available resources. Build on existing services whenever possible. 

Use the recommendations to offer tailored, targeted, integrated initiatives to address the prioritized list of health needs. Prioritizing health needs will keep Workplace Wellness Programs focused, maximize efficient use of resources, and align Wellness efforts with Upper Management goals and priorities. 

References

• US Department of Health and Human Services, Planned Approach to Community Health, http://www.cdc.gov/nccdphp/publications/PATCH/index.htm.

• Implementing a Comprehensive Community Wellness and Well Being Program, presentation by CHPPM-EUR at the 2006 Force Health Protection Conference

Keeping the bottom line up front Bottom Line Up Front in Workplace Wellness Program will help you get and sustain Upper Management support. A Bottom Line Up Front approach will also help you more realistically measure the impact of your Workplace Wellness Program. 

The bottom line in Workplace Wellness Programs answer two primary questions:

      • How will participant health be improved?

      • What’s in it for Upper Management? 

The ultimate bottom line: all roads should lead to readiness.

      • Always be ready to communicate to leadership the ways that your Workplace Wellness Program impacts readiness.

      • Think like Upper Management: what Workplace Wellness Program outcomes will be important from a Upper Management point of view?

      • Develop line-centered language that communicates those outcomes.

      • Ask members how they think a particular Workplace Wellness Program enhances force readiness. This input is a valuable source of information. 

Use the following steps as a Bottom Line Up Front approach to Workplace Wellness Programs. 

Step 1: Think about the end of the Workplace Wellness Program first and plan backwards.

      • It has been said, “If you don’t know where you’re going, any road will get you there.”

      • Before planning or starting any part of the Workplace Wellness Program, be able to answer the questions: how will participant health be improved? What’s in it for Upper Management? 

Step 2: Identify concrete Workplace Wellness Program outcomes.

      • Identify up front what the Workplace Wellness Program is working towards.

            o By way of example: will members lose weight? Walk more steps? Decrease injuries? Move to another stage of change?

      • Identify any processes or procedures that will be improved.

            o By way of example: which pharmacy operations will become more efficient? How will record-keeping be streamlined? 

Step 3: Determine what will be measured to show that Workplace Wellness Program goals were met.

      • Look at what data is really needed to show Workplace Wellness Program effectiveness. Avoid the temptation to collect every possible piece of data. Choose a handful of important data points and stick to those.

      • Think backwards when deciding what data to collect – consider how easily follow-up data can be collected when a Workplace Wellness Program ends. Getting follow-up data is frequently a challenge.

      • Only collect data for health behaviors or indicators that the Workplace Wellness Program actually affected.

            o By way of example: if the main Workplace Wellness Program goal is that members will walk more steps, then it may be better NOT to choose changes in cholesterol level as a Workplace Wellness Program outcome (unless the Workplace Wellness Program specifically addresses cholesterol).

      • Avoid measuring outcomes that the Workplace Wellness Program cannot (or did not) affect. 

Step 4: Determine what Workplace Wellness Program elements must be included to move members towards the Workplace Wellness Program goals.

      • The concrete Workplace Wellness Program outcomes identified in Step 2 are the compass for keeping the Workplace Wellness Program on track. All Workplace Wellness Program elements should lead towards that ultimate goal. 

Working backwards when planning and starting Workplace Wellness Programs is really forward thinking. Keeping the bottom line up front is a smart approach to Workplace Wellness Programs.

Health Information Technology can make the entire healthcare 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 healthcare 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 

Take advantage 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.

To effectively manage your Workplace Wellness Program resources, first determine the resources you need and the resources you have. Then develop a plan to fill the resource gaps. 

What Workplace Wellness Program resources do you need?

      • Make a list of workers, materials, equipment, space, and logistical support.

      • Be as specific as possible.

      • Include partnerships that will be needed to make the Workplace Wellness Program happen. 

Identify available Workplace Wellness Program resources.

      • Use materials that exist or are already on hand. Resist the temptation to start from scratch!

      • Find out what other departments already have.

      • Contact DHPW/HPPI to find out what other installations have done.

      • Know where to borrow or get free materials.

      • Use local or internal resources whenever possible.

      • Look for opportunities to cut and/or share costs. 

Develop a strategy to fill Workplace Wellness Program resource gaps.

      • Partner with as many workers and organizations as you can. Emphasize what’s in it for them.

            o Example: use a Physical Therapist to teach a back health class.

      • Take advantage of community organizations and coalitions.

      • Use volunteers as frequently as possible.

            o Red Cross volunteers, medical interns or nursing students can supplement your manpower. 

Former Workplace Wellness Program members make good guest presenters.

      • Keep a list of subject matter experts who will provide input for free so you can avoid the expense of an outside contractor or consultant. 

Look for innovative Workplace Wellness Program opportunities.

      • Other funding opportunities may exist at your facility.

            o Example: if there is a book fair, see if you can apply to receive some of the proceeds.

      • Ask the unit to contribute resources to Workplace Wellness Programs directly started at the unit level.

      • Get to know the contracting person at your installation. They frequently know the least expensive places to obtain many different kinds of materials.

      • Look for “recycling” possibilities.

            o Example: IMD may be able to give you old computer workstations for use with electronic health assessments. 

Good communication will help you find more partners and volunteers.

      • Get the word out to the community about your Workplace Wellness Programs.

      • Describe what you are doing and how you are doing it.

      • Presentation is everything. Keep information current and use lots of visual aids. 

All Workplace Wellness Programs require resources. Some resources you will already have. Some resources you will have to find. Sometimes you will have to make something out of very little. Smart strategies can maximize your Wellness resources.

Business processes are structured activities that achieve a specific result. By way of example, scheduling appointments is a company process that results in an orderly work flow and timely patient care. 

Workplace Wellness Program implementation frequently requires changes to established company processes. These changes may be simple, such as adding prescreening appointments to the scheduling process, or more complicated, like determining how time devoted to a particular Workplace Wellness Program will be coded. 

Not all change can be affected painlessly. However, developing a plan for achieving change will overcome barriers like: 

      “But we’ve always done it that way” or “But we’ve never done it that way.” 

Each change situation will be different. The path to achieving change may not always be straightforward. 

Lesson learned: Making small, incremental changes will be easier than trying to make one big change. It is also easier to modify a current process than to introduce a brand new one. 

Develop a road map for change. 

Describe the current company process.

      • By way of example: what is the current registration process for the weight management program? Include steps for both members and staff. 

Identify where the new or modified company process could fit into the current process.

      • By way of example, prescreening appointments for the weight management program could be scheduled when members sign up OR the prescreening could be done at the first class. 

Collaborate.

      • Look at the change process to be a team effort. Determine everyone who will be affected by the change and get their input.

            o By way of example, be sure to ask the personnel that set up the prescreening appointments AND the personnel that would do the prescreening for their ideas.

      • Recruit one or more champions for the change. It helps if the champion has some clout.

      • Get buy-in from as many workers as you can – including those that might be most resistant to the change. 

Communicate.

      • Don’t keep the change a secret. The more workers know, the more likely they will support a change.

      • Anticipate barriers ahead of time. Be ready to articulate concrete benefits that will result from the change – especially advantages such as costs avoided or training time conserved.

 

Workplace Wellness Program evaluation is critical for effective Wellness and will help you get Upper Management support. 

Why evaluate your Workplace Wellness Program? 

Workplace Wellness Program evaluation answers these questions:

      • What change(s) occurred in the target population?

      • ‘What’s in it’ for Upper Management?

      • Are the resources that are being used worth the outcomes that are reached?

      • Were Workplace Wellness Program outcomes expected? (Unexpected outcomes may have occurred.)

      • What Workplace Wellness Program areas need improvement? 

Workplace Wellness Program Fact of Life: 

Workplace Wellness Program evaluation left to “chance” or until “there is time” will never happen. 

      • Workplace Wellness Program evaluation should be considered as an essential part of the whole plan for Wellness and not as something extra. 

Where do you start? 

Keep it simple. Workplace Wellness Program evaluation does not have to be complicated.

• Get baseline data.

      • Baseline data is the health status of the target population at the beginning of the Workplace Wellness Program.

      • Begin by collecting just 3 or 4 primary items as the baseline. You will have better success collecting follow-up information later if you only need to get a few pieces of data.

      • Don’t rely only on health indicators that require lab evaluation. Also use self-report information and health indicators that are measurable without lab tests. 

• Collect data that relates to readiness.

      • You should always be ready to communicate to leadership the ways that your Workplace Wellness Program impacts readiness. Plan ahead to collect data that will demonstrate this connection.

      • Think like Upper Management: what Workplace Wellness Program outcomes will be important from Upper Management point of view? 

• It’s never too late to incorporate Workplace Wellness Program evaluation into Workplace Wellness Programs.

      • If your Workplace Wellness Program is already up and running and you didn’t plan for data collection ahead of time, start collecting data NOW.

      • If you don’t have baseline data, then collect interim data and compare that to end-of-program data.

      • Or, you can compare final Workplace Wellness Program outcomes to similar programs elsewhere. 

If you can’t make any comparisons to other data, use resources like The Community Guide (http://www.thecommunityguide.org/ ) that have already evaluated the effectiveness of Workplace Wellness Program components. Compare the components of your Workplace Wellness Program to those that have been proven effective elsewhere.

Think ahead: what unexpected challenges might come up as you implement your Workplace Wellness Program? How could you adapt and change the Workplace Wellness Program to meet those challenges? 

• Look at the “what if’s?”

      • What if your classroom space is suddenly no longer available?

      • What if you can’t hold the Health and Wellness in the usual place?

      • Have a ‘Plan B’ (or even Plan C or Plan D) in mind for when the “what if’s” happen. 

• Build a team that can help with the Workplace Wellness Program

      • Who else could teach the health education class if the regular instructor cancels at the last minute?

      • Know what areas of expertise your staff has besides their ‘main’ job. By way of example, find out who has excercise instructor credentials besides just the physical therapist.

      • Don’t wait for a crisis before you build a network of workers that you can call on. 

• Be ready to roll your sleeves up

      • Jump in to fill a gap if you need to.

      • YOU may have to help restock the milk case in the dining center when the Dairy Month ‘Milk Mustache’ contest results in increased sales during lunch. 

• Be willing (and ready) to respond to feedback about the Workplace Wellness Program

      • Get participant feedback while the Workplace Wellness Program is ongoing. Then be ready to adapt to those suggestions.

      • By way of example, if kids in a pediatric obesity Workplace Wellness Program fight the idea of completing physical excercise logs, then get a verbal summary of their activity for the week instead. 

• Simplify Workplace Wellness Program

      • If part of your Workplace Wellness Program is not working, try making that part less complicated.

      • By way of example, if getting follow-up information is not going the way you planned, then make the process to get information easier OR decrease the number of pieces of information that you collect. 

• Use lemons to make lemonade

      • What do you do when the Workplace Wellness Program doesn’t turn out exactly as you planned? Look for what did turn out. Often, the ‘unexpected outcomes’ produce positive results.

      • By way of example, one installation’s database to collect sick call data was made obsolete by a regional system. However, the installation database was able to be used in a different way to track vaccination information that improved delivery of care to Employees.

      • At another installation, world events halted a new physical training program. Instead, Workplace Wellness Program materials were made into a excercise guide.

Take the time to plan Workplace Wellness Programs before they are started. 

Effective planning enables better use of all your resources. Include all the steps below when you plan a Wellness activity.

• Do your homework – Identify the science and research that support your initiatives. Look for similar Workplace Wellness Programs that already exist.

• Determine the specific health need(s) – Use these needs to target initiatives to problems that are an issue for your population.

• Organize a team – A team is a resource multiplier. Network and build as many partnerships as you can.

• Make a plan, but don’t start completely from scratch. Make a written plan for your Workplace Wellness Program. Look for every opportunity to take advantage of resources that already exist. Don’t reinvent the wheel.

• Select a focus – Choose one or two main target areas for Workplace Wellness Programs. Address all five stages of change in the target areas rather than trying to hit every possible Wellness topic.

• Determine your resources – What assets do you have? What assets will you need? How can you fill the gaps?

• Get Upper Management support – Think like Upper Management. Communicate the value of Wellness from Upper Management’s perspective.

• Begin the activity- Be flexible. Be prepared for unexpected challenges.

• Market the activity – Keep your Workplace Wellness Program visible for Upper Management, line and medical personnel, Workplace Wellness Program members, and potential partners and volunteers.

• Collect and analyze outcomes – Outcomes indicate Workplace Wellness Program impact. Begin with just a few outcomes – you don’t have to collect everything. Remember that it’s never too late to start measuring Workplace Wellness Program impact.

• Assess, improve and re-evaluate – Use participant feedback and Workplace Wellness Program outcomes to determine Workplace Wellness Program impact. Identify areas in need of improvement. Use outcomes to determine if expended resources were worth the results.

Why use small steps toward behavior change? 

Small steps give members immediate feedback on the changes they make towards better health. Measuring these small steps is also an excellent way to collect interim Workplace Wellness Program effectiveness data. 

Workplace Wellness Program small steps make a big difference 

Small steps for Workplace Wellness Program members

• Walk to work.

• Use fat free milk instead of whole milk.

• Each day think of two things you are grateful for.

• Do sit-ups while you watch TV.

 

• Drink water before a meal.

• Take 10 deep breaths to relieve tension.

• Eat half your dessert.

• Skip second helpings and buffets. 

Measuring small Workplace Wellness Program steps

• Use short pre- and mid-point surveys to ask:

• How many glasses of water do you drink a day?

• How frequently you do eat fast food?

• How frequently do you skip a meal?

• How frequently do you engage in physical activity?

• How many servings of fruits and vegetables do you eat each day? 

Use the results to show members how their health behaviors are changing for the better. 

• Ask members to rate their health status and/or stress levels before and after an intervention.

• Add up individual (or team) steps and mark the progress on a map towards a far away destination.

• Be innovative! Do not rely only on weight loss, BMI, or cholesterol tests as health status progress indicators or behavior change feedback. 

Wise words for taking small Workplace Wellness Program steps     

 

• The first wealth is health. (Ralph Waldo Emerson)

• We are what we repeatedly do. (Aristotle)

• The victory is not always to the swift, but to those who keep moving. (CDC)

• There are 1440 minutes in every day…schedule 30 of them for physical activity. (CDC)

Workplace Wellness Program Follow Up 

Why Workplace Wellness Program follow up? 

Getting feedback from Workplace Wellness Program members serves two purposes: to obtain data that quantifies a Wellness Program’s impact, and to find ways to improve a Workplace Wellness Program. 

Building follow up into your Workplace Wellness Program 

Keep it simple

• Keep follow up to information you absolutely require. A three-question survey is more likely to get a response than one with 20 questions.

• Use email or phone for follow-up. Use personal, AKO, and installation email addresses; use cell phone and unit phone numbers.

• Go to the Employees: go to the unit or somewhere else they will all be gathered (like the APFT test location), and get follow up information there.

• Give members a stamped envelope addressed to you, with a printed form listing the information you will need. 

Keep it structured

• Tell members right from the beginning that you will be doing follow up after the Workplace Wellness Program is finished. Be specific about the information you will collect.

• If you need to do hands-on measurements, find out if members will be coming back to your location for another reason (like another clinic appointment). Ask them to stop by while they are in the building – or, better yet, go to where they will be.

• Ask members where they will be the next time you will be collecting data. They may already know their next duty station if they will be PCSing soon.

• Plan ahead for follow up and put it on the schedule. Planning to do follow up “when you have time” usually means follow up will never get done.

 

Keep it catchy

• Give members something to go along with the request for information. By way of example, if you send an email to ask for information, send along a yummy recipe or a timely excercise tip.

• Schedule a ‘reunion’ day to collect follow up information. Invite members to come back and share successes and challenges. Have some (healthy) munchies available.

• Have a silly contest – the team with the most follow up data wins something, like having their photos posted on a prominently-placed bulletin board or an eggplant trophy, or some other fun thing.