Dallas program slashes presenteeism rates

Losses to musculoskeletal disorders drop 62%

Presenteeism can seem an almost insurmountable cost of doing business, but a two-year study and project by the Federal Reserve Bank of Dallas (FRBD) shows that reducing the direct and indirect costs of a major cause of lost productivity is possible — in a big way. The goal of the study and project, "Managing the Costs of Human Capital — Health and Produc-tivity in the Workplace," was to address the costs of presenteeism and the impact work site disease management programs could have on it. The results were impressive — a 62% reduction in the cost and effects of presenteeism in two departments of the FRBD.

The project was undertaken by the FRBD, Dallas/Fort Worth Business Group on Health, the Institute for Health and Productivity Management, and was sponsored in part by Pharmacia Corp.

"I feel that this project, more than anything, was an effort to determine the impact of presenteeism due to musculoskeletal disorders [MSDs], rather than an effort to demonstrate outcomes due to disease management," says Bob Queyrouze, CEBS, CCP, SPHR, manager of compensation/benefits for the FRBD. "Our initial goals were to identify the economic impact of musculoskeletal disor- ders among employees in two pilot departments, improve health or management of musculoskeletal disorders, and improve employee productivity."

The stated goals of the project were to improve employee understanding of presenteeism, increase healthy behaviors, and improve employee/physician communication, with the underlying message that presenteeism costs employers more than absenteeism.

The study cited national studies that have estimated the cost of absenteeism nationally at 2.5 billion days and $234 billion each year in lost productivity.

Because MSDs top the list of the seven most common conditions impacting work and productivity (the other six are respiratory disorders, migraines, hearing problems, vision problems, diabetes, and depression), the Federal Reserve project chose as its goal to identify the economic impact of musculoskeletal disorders at the FRBD, and to improve the health of its employees with MSDs.

The Federal Reserve is the nation’s central bank, and the Dallas office employs 1,000 people. The FRBD study targeted two of its departments — the cash department, with 49 employees, and the payment services (checks) department, which has 266 employees.

Beginning with calculations of the baseline impact of MSDs on the two departments, the findings were sobering. Lost productivity costs to the two departments amounted to an estimated $532,338 for the year 2000 (not counting direct medical costs), equal to 6% of the departments’ payroll, and a per-employee cost of $2,572 per year. (See Table 1 for a breakdown of costs before the study.)

Source for Tables 1 and 2: Federal Reserve Bank of Dallas.

The study used a questionnaire designed by the Health Institute of the New England Medical Center at Tufts University in Boston. The questionnaire measured employees’ health, how it affected their ability to go to work, and how it affected their job performance. Employees were given the option of registering responses via paper questionnaire, voice response, or on-line; 87% chose the on-line route.

Once the baseline data were in, the second phase of the project aimed to design and implement interventions to address the problems. The interventions included addressing the health needs of both high-risk and low-risk employees; encouraging and facilitating healthy behaviors, educating employees about MSDs, and improving communications between employees and their health care providers.

Phase three consisted of follow-up interview and assessment of the effectiveness of the intervention.

Follow-up assessment of the employees who participated in the program indicate the project had profound effects on loss of productivity due to MSDs. (See Table 2.) The two departments went from a combined productivity loss of 8.3% to a combined productivity loss of 3%; costs of lost productivity went from $532,388 to $201,550.

"I believe we were successful in achieving all three of our goals as a demonstration project to support other disease management efforts we wanted to engage," Queyrouze says. "We clearly had an impact on presenteeism because we reduced its impact by 62%, documented through our resurvey effort at the end of the project.

"While we have no direct measures of improved employee health and management of musculoskeletal disorders, the follow-up presenteeism survey documented increased productivity. This was a three-year project and, unfortunately, during that period of time the largest department — checks — underwent significant changes in structuring and staffing, which has led to difficulty with continuing the work we began."

Some of the behavior modifications employees reported using to improve their musculoskeletal health are exercise, stretching, relaxation, seating and workspace modifications, and improved communications with their medical providers.

"Since the completion of this project, we have engaged three additional chronic diseases through programs in the workplace — weight management, diabetes, and metabolic syndrome," says Queyrouze. "All of these programs are supported through bank subsidies in one way or another — weight management through subsidy of Weight Watchers at Work, diabetes through free diabetic meds and supplies and on-site diabetic educator meetings, metabolic syndrome through a subsidized, on-site, six-week program called the Game of Health.

"All of these programs are performance based. Employees are required to meet specific requirements to qualify for subsidies or meds and supplies."

For more information, contact:

  • Bob Queyrouze, CEBS, CCP, SPHR, Manager, Compensation/Benefits, Federal Reserve Bank of Dallas, P.O. Box 655906, Dallas, TX 75265-5906. Telephone: (214) 922-6374. E-mail: bob.queyrouze@dal.frb.org.