3 steps to get back lost productivity

To tackle presenteeism, assess it first, and then use the information wisely. Take these three steps:

1. Use a validated tool.

Joseph Fortuna, MD, co-chair of the Health Steering Committee of the Automotive Industry Action Group, says that the best way to measure presenteeism is by using validated health-related productivity measurement tools and instruments, such as the Work Limitations Questionnaire, the Health and Work Performance Questionnaire, and the Stanford Presenteeism Scale.1,2,3 Results are self-reported by the employee, with the results given in aggregate.

"You don't want to do a questionnaire on your own. There's a big problem with self-administrated questionnaires. If it's not a validated instrument, it's not worth the paper it's written on," says Fortuna.

2. Figure out why employees are less productive.

A worker may be significantly less productive up to 24 hours before and 48 hours after a migraine, for example, says Fortuna.

To learn the underlying reasons for lost productivity, Fortuna recommends going out to talk to supervisors and employees. "You can intervene to an extent, by steering them to better treatment mechanisms. The problem is, that gets a little intrusive, and people might not particularly like having that done," says Fortuna. "You are walking a fine line between trying to help them and prying into their lives."

3. Use your data to develop programs.

Once you have some hard data, use it to target anything you believe is resulting in lost productivity, such as smoking and obesity, recommends Fortuna. "Some companies are going after smokers really aggressively," he says. "A lot of people frown on it, but the truth of the matter is that smokers are a lot less productive."

Stress, whether work or home-related, is another key culprit. "This is probably one of the biggest things that makes people less productive," says Fortuna. "It's not a stretch to figure out that a 'lunch and learn' mediated by the occupational health nurse can help with this."


1. Lerner D, Amick BC, Rogers WH, et al. The work limitations questionnaire. Med Care 2001; 39:72-85.

2. Kessler RC, Barber C, Beck A, et al. The World Health Organization Health and Work Performance Questionnaire. J Occup Environ Med 2003; 45:156-174.

3. Turpin RS, Ozminkowski RJ, Sharda CE, et al. Reliability and validity of the Stanford Presenteeism Scale. J Occup Environ Med 2004; 46:1,123-1,133.