Creating a road map to better worker health
Leadership, incentives guide UPMC
Creating a safety culture is the holy grail of employee health — an environment in which employees have a heightened awareness of safety and a focus on wellness. But how do you get there?
The University of Pittsburgh Medical Center (UPMC) designed the Employer Health and Productivity Roadmap as a framework for integrating occupational health and safety and health promotion.
About 90% of UPMC's 55,000 employees participate in health risk assessments and healthy lifestyle programs. UPMC leaders are committed to creating a work environment that supports safety and health. Reducing absenteeism and improving productivity is a priority throughout the organization.
"The health care sector has some unique stressors and some unique strengths," says Michael Parkinson, MD, MPH, senior medical director of the UPMC Health Plan and WorkPartners, a health and productivity service geared toward corporate clients. The roadmap creates "a culture of health where we truly care about each other," he says.
At UPMC, the goal of healthier employees is shared by a team that includes disability managers, risk managers, occupational health and LifeSolutions, the employee assistance program. "We view integration as a critical component to our organization," says Stephen Doyle, MS, MBA, director of health promotion operations and account management for the UPMC Health Plan. "We all work together on an ongoing basis."
Focus on work environment
The first step in the roadmap is to optimize the work environment. The organization must be committed to making changes, Parkinson says. "It begins with leadership awareness and leadership buy-in," he says.
UPMC conducts a gap assessment, taking inventory of the attitudes, infrastructure, resources, policies and practices and the health status of employees. "The inventory itself can change as the evidence reveals that some other factor might be contributory," he says.
For example, if you want to encourage employees to maintain a healthy weight, are healthy options highlighted in the cafeteria and vending machines? If you want to improve employees' physical activity, are the stairways well-lit and attractive? Are you reducing ergonomic hazards?
It's important to conduct the assessment periodically and to use different methods of gathering information, Parkinson says. A hospital walk-through can reveal opportunities to boost health and safety. Employee satisfaction surveys, absenteeism, medical claims and injury rates point to problem areas.
UPMC also focuses on health and safety messages. The marketing team targets employees at work and at home, online and in print.
Incentives boost participation
The MyHealth program is the cornerstone of the UPMC efforts to promote a healthy lifestyle. Deep incentives have helped ensure widespread participation.
UPMC began with a modest incentive nine years ago — a $200 credit off of the insurance deductible for employees and $400 for family coverage for those completing a health risk assessment.
"We've gradually increased the value of that deductible credit as the requirements have increased as well," says Doyle. "We converted to a point-based system."
Employees can earn 250 points, or a $250 deductible credit, by participating in a 12-week weight management program. They can earn 15 points, or a $15 credit, by completing an online educational module on high blood pressure. With almost 400 activities that provide points, the maximum credit is $1,000 for an individual employee and $2,000 for families. (Family members participate in the MyHealth program, as well.)
MyHealth uses other motivation strategies. More than 10,000 employees participate in a team-based weight loss competition. The winners receive prizes such as an iPad, in addition to the deductible credits that all participants receive.
The health risk assessment identifies whether employees have low, medium or high health risks. MyHealth's goal is to improve the health status of employees — and maintain the good habits of healthy employees.
Health coaches sometimes walk through units to engage employees and answer questions. They tailor interventions to help employees who have health risks, and they work with employees to manage chronic conditions such as diabetes.
The results speak for themselves. In the past five years, physical activity increased to more than 52%, cholesterol levels improved and 3.7% more employees recorded normal blood pressure. Employees lost more than 30 tons in weight last year.
The UPMC road map also seeks to improve return-to-work after injuries, reduce unnecessary surgeries and minimize avoidable acute care.
"Each year, as an organization we're going to raise the bar on how we can try to improve our health and how we can get more engaged in the right health care decisions," Parkinson says.
[Editor's note: More information about the Employer Health and Productivity Roadmap and other programs to promote Total Worker Health (a program of the National Institute for Occupational Health and Safety) is available in a special December 2013 supplement of the Journal of Occupational and Environmental Medicine. Free access is available at http://journals.lww.com/joem/toc/2013/12001.]