Hospital finds wellness is an EH way of life

New clinic treats non-occ health needs

An employee comes to employee health with blood pressure that’s out of control. Another has diabetes and isn’t good at managing her diet. Another has a headache from a sinus infection. Is that your problem?

It is at the University Health Systems (UHS) of Eastern Carolina. The six-hospital system based in Greenville, NC, has had a wellness center with educational and exercise programs for the past nine years. And this summer, a wellness clinic opened at Pitt County Memorial Hospital, the system’s largest medical center, to provide employees with everything from minor sick visits to comprehensive physical exams.

"You can’t call this a frill," says Pat Dalton, RN, COHN-S, occupational health project specialist and a key player in the establishment of the program. "Sooner or later, you’ve got to say, If we don’t take care of our employees and their health, it’s going to cost us megadollars’" in workers’ compensation claims and medical costs.

Actually, it wasn’t a hard sell to promote wellness among the system’s employees. "It starts from the top," says Mary Chatman, RN, MSN, vice president for specialty services and president of the ViQuest subsidiary, which runs the wellness programs. "Our president is very much wellness-oriented and has been all his life. We have always had support for wellness."

The benefits are both direct and indirect, in lower costs and more productive employees, says Chatman. "We have tried to corral things like absenteeism and presenteeism," she adds, noting that employees now can visit the clinic and immediately return to work.

Managers, too, take more responsibility for their employees’ health. And employees enjoy the perks, which include a wellness incentive program that allows them to earn points for time off, gifts, and bonuses.

Wellness focus evolves over time

A focus on wellness isn’t an instant mindset change. The program has evolved over many years, Dalton points out. "This didn’t happen overnight. We recognized the need for a cultural change that would emphasize the health of our own employee population."

The wellness program began in 1985 with a wellness coordinator who reported to employee health. Initially, the gym in the rehabilitation unit was used for aerobics classes. They offered personal health-related education sessions in available meeting rooms and often took health-related information to the various departments during the work shifts.

Eventually, the health system built a 52,000 square foot, $8.2 million facility at Pitt Memorial. A smaller version serves the system’s regional hospitals. The wellness center has about 5,000 members, half of whom are employees or their family members, who pay a reduced rate, Chatman notes. The center also attracts members from the community.

"We built it on the medical model so there’s a focus on identifying the current health of each participant and assisting them along the continuum to optimal health," she says.

The hospital also maintains an in-house wellness program, offering sessions and activities to employees who don’t belong to the wellness center. The wellness assessment also has been integrated into the occupational health department.

UHS took a big step in its commitment to wellness with the ViQuest Clinic, which opened in July to take care of the ongoing health needs of employees and dependents age 16 and older who are covered on the UHS Medical Plan.

Employees immediately embraced the concept. ViQuest clinic director Debra Thompson, RN, MSN, APRN-BC, CDE, had projected that the clinic would have 45 visits during the first month. There were 142. The top three conditions: upper respiratory complaints, urinary tract infections, and contact dermatitis.

The clinic offers a variety of services, including minor sick visits, annual physicals, sports physicals, comprehensive chronic disease management, pharmacotherapy services, and referrals within the local community and UHS resources. Services are filed to insurance and the employees pay a $20 copay.

The staff include Thompson, who is a nurse practitioner; a receptionist who handles billing and scheduling; and a part-time clinical pharmacist practitioner. The start-up costs were $22,000, and the clinic’s initial budget was $200,000. Within months of opening, Thompson already was hiring another nurse practitioner and planned to add additional staff. The clinic also made plans to expand from three exam rooms to seven.

The clinic doesn’t compete with local physicians but fills in gaps to meet employee health care needs, Thompson says. "We are not here to provide primary care, although many employees have requested us to do that," she says.

For example, if an employee has uncontrolled hypertension, the ViQuest clinic may provide an initial work-up and medication management. The employee then would receive a referral to a private physician. The ViQuest clinic also could provide regular monitoring of the employee’s blood pressure.

"The clinic is not only a benefit to our employees and their dependents, but also can reduce rising health care costs," says Thompson. Some 28% of employees seen by the clinic didn’t have a primary care provider, and if they became sick, they would have visited the hospital’s walk-in emergency department, she adds. "The ViQuest clinic can provide consistent, comprehensive care and follow-up until a local provider can provide ongoing care," she says. ViQuest also has a wellness case management program geared toward high-risk and high avoidable risk clients.

Meanwhile, employees who come to work with nagging symptoms, or who begin to feel sick, can be evaluated at the clinic. They can be quickly treated and sent back to work, or if necessary, sent home to avoid infecting patients and co-workers.

"The cost avoidance is going to make a tremendous difference — reducing absenteeism, increasing productivity, and identifying undiagnosed conditions," Thompson says.

If the success of the clinic continues, the concept will be rolled out to other UHS facilities in the future, Dalton explains.

Employees view the clinic as a new benefit, Thompson adds. But the wellness program offers some tangible perks, as well.

Employees don’t have to be members of the wellness center to participate in ViQuest Rewards. They receive incentive points for varied health activities, including taking a health-risk appraisal, exercising regularly, attending classes, or even eating a balanced diet with five fruits and vegetables a day.

They build up points to earn a variety of awards from a T-shirt or pedometer to a day off with pay. "It’s a motivator for the employee to show them that all of their efforts are paying off," Dalton adds.

ViQuest also has an on-line product employees can use to track their health and get information.

The health system is offering the ViQuest clinic and wellness model to local businesses, but the primary focus remains on its own employees, she says.

"We can’t ignore this [aspect of employee health], because if we ignore this, we’re ignoring our bottom line," Dalton adds. "I really feel that strongly about it."