An award-winning Iowa program has a different view of wellness
An award-winning Iowa program has a different view of wellness
Wellness with a twist: Health is more than diet and exercise
The employees of Mercy Medical Center in Mason City, IA, told employee health coordinators what they wanted in a wellness program, and for young health educator Kelly Putnam, MA, what they described was not the wellness model she knew.
Putnam, health promotion coordinator for Mercy Medical Center-North Iowa and executive director of its wellness program, earned her graduate degree and headed into the field of employee health ready, she says, "to implement a traditional employee wellness program — to do cholesterol screenings, blood pressure checks, and aerobics classes." But when Mercy Medical undertook to learn why more of its 2,800 employees weren’t using the hospital’s traditional wellness and employee assistance (EAP) programs, the employees — 90% of whom are women — said they simply weren’t interested in the traditional menu of wellness offerings that Mercy was offering at the time.
When Putnam and her colleagues at Mercy threw out their old ideas about wellness, they did what other wellness programs around the country are doing — they created a program built on data that told them what their employees needed and would participate in, based not on national benchmarks, but on the needs of their unique employee population.
Traditional wellness model rejected
"What we really are finding is that programs that are able to achieve outcomes are the programs that are looking at their population data, whether that be health risk appraisal [HRA], needs and interest survey data, or whatever, and when they look at that data and design their program based on the needs and interests of their population, then they can really clearly understand where they need to branch out," says Kelly Stobbe, MEd, director of council affairs for the Omaha-based Wellness Councils of America (WELCOA), a nonprofit membership organization that supports and links wellness and health promotion initiatives at U.S. work sites.
Putnam says after 18 months of taking to and polling employees, she learned some surprising truths about the employee population at Mercy.
"The first thing we found was, I think, the most profound," she recalls. "While traditional wellness focuses on fitness and nutrition, we were hearing from employees about stress, depression, exhaustion, relationships at work and at home, and even domestic violence.
"They told us that psychosocial and spiritual issues were their primary concern and were having the most negative impact on their health and productivity in the workplace."
Mercy staff said they wanted to feel valued as people and as workers, and that they wanted their workplace to be fun. And finally, they set some limits on their willingness to participate in any workplace wellness services.
"They said time is their biggest barrier to participation, so if we wanted their participation, it had to be on paid time, when they’re already here," Putnam reports. "They said, We’re not coming back after our shifts; and even if you pay us [to participate], we’re going to have to feel strong support from our immediate supervisors before we’re going to want to participate.’"
Kailo: To be whole’
When Mercy was in the process of evaluating what it was offering and devising a better way to deliver the wellness programs its employees really wanted, Putnam attended a wellness conference where she first heard the term "kailo." The definition of kailo is "to be whole, uninjured," or "of good omen."
"I thought, Wow, if we ever do get this new program off the ground, that would be a wonderful name for it,’" she says. "So we took it back to our marketing department, and they immediately hated it."
But what was initially seen as a drawback to the name — primarily, that no one knew what it meant — eventually became a strength, she says, because it represented "that this was a whole new idea."
Kailo was launched in 1998, and in the first year, Mercy saw a 171% increase in the utilization of its EAP services. Kailo consistently sees 450 to 500 employees each month in its lunch-and-learn programs.
Putnam says the preliminary work that was done before developing Mercy’s award-winning Kailo program taught her not only what Mercy employees wanted, but also what makes wellness programs work for employees and employers.
"They were telling us they wanted psychosocial support, and that depression and stress were problems," she says. "We had an EAP in place, so why weren’t they using it?"The traditional EAP, Putnam says, had some characteristics and stigmas that kept employees away.
"People were not plugging into our former EAP services, and when we went back for find out why, they told us there were three issues: One, people weren’t aware we had an EAP, so there was a marketing opportunity there; two, there was an image problem. People viewed the EAP as something you went to when you had problems interacting with co-workers or problems with substance use; and three, they told us that we had a customer service problem because the program was not available to them during hours that worked for them, and the location was not convenient."
The Kailo for One component of Mercy’s wellness program is built off an EAP model, but because of the way it’s designed and marketed, it enjoys a level of use that the old program did not.
The difference between Kailo and traditional wellness is the holistic approach used in the program. Relationships, not aerobics, top the list of priorities.
(See chart)
| Chart What Employees Can Learn from Kailo
Source: Kelly Putnam, MA, Mercy Medical Center-North Iowa, Mason City. |
"It’s a very positive approach, with a huge focus on assisting with relationships at work, relationships at home," says Putnam. "We focus on bolstering what keeps us well, rather than eliminating the risks. The risks are going to be there, no matter what, so we look at how we can bolster our strengths, to live as well as we can live."
Employee acceptance, while rapid, was not immediate, she notes. Employees were skeptical about the program, and Putnam says creative and thoughtful marketing was critical to bringing employees on board. Applying holistic principles to selling the program to employees, Putnam says, marketing materials were developed that eliminated fear and guilt and replaced those messages with ones of empathy, validation, and humor.
Showing value to the employer
"There are a lot of problems with traditional wellness; it’s generally not well attended. You might be doing well to get 10% to 40% attendance," Putnam points out. "It can be terribly underfunded and understaffed, and may not even be coordinated by people with training in wellness. For those reasons, you don’t get good participation. Also, there’s often not a lot of formal planning or evaluation, so it’s hard to return meaningful data back to the employer."
Stobbe says companies that get the most comprehensive HRA data at the outset are ones that link participation to benefits.
"It needs to be integrated with the company and benefits," she says.
For example, a company in West Virginia told employees that if they complete an HRA, the company would pay their health plan premiums in full; if employees choose not to participate, they would be responsible for paying half their premiums. The company had 97% participation.
"They didn’t make it a mandate, didn’t say employees had to," points out Stobbe. "By putting it into the benefits design, it became part of the system. But more importantly, it allowed them to identify employees who are at risk for diabetes or have asthma or need heart care, and whether or not they qualify for coaching.
"It’s a nice process and it works, and you get them immediately into coaching, and that’s when the changes start happening. [Employees] become proactive, start managing their diseases, start eliminating unnecessary doctor and emergency room visits, and that’s when you see health care costs at least maintaining, and even declining."
Employee response was positive early on, but unexpected recognition came when the Joint Commission for Accreditation of Healthcare Organizations named Kailo a best practice in its first year.
"That really surprised us," says Putnam, but in subsequent years the program received gold and platinum awards from WELCOA, a Trinity Health Excellence and Innovation Award, and the Psycho-logically Healthy Workplace Award from the Iowa Psychological Association.
Further validation has come in the form of duplication; other hospitals so wanted to copy Mercy’s success that the hospital has sold the program for duplication in four other hospitals, and developed Kailo-to-Go, a small, highly customized product line of education/awareness kits and speaking/consulting/training services designed to help work site health promotion practitioners improve their wellness programs.
Putnam says the benefits of Kailo are measurable, and include:
- 171% increase in EAP utilization in the first year, followed by an additional 67% increase in the second year;
- a by-proxy cost savings estimate of more than $200,000 associated with reducing depression among employees;
- 76% of employees agree Kailo is a valuable benefit of working at Mercy;
- 52% of employees say Kailo has had a positive impact on how they view their health.
Besides being popular with the employee population at Mercy, Kailo has proved to be valuable as a cross-referral to and for the hospital’s occupational health department, proving, Putnam says, the importance of a wellness system being integrated into the institution, rather than being a stand-alone program.
"We have a really great collaborative with our occupational health nursing staff," Putnam says. "It’s opening an additional door to get help. Our staff knows they can go to occupational health and they’ll be working in collaboration with us as needed, and when they come to us they know they’ll get occupational health services if they’re needed."
[For more information, contact:
- Kelly Putnam, MA, Health Promotion Coordinator, Mercy Medical Center-North Iowa; Executive Director and Creator of Kailo, 1000 Fourth St. S.W., Mason City, IA 50401. Phone: (800) 433-3883. E-mail: [email protected].
- Kelly Stobbe, MEd, Director, Council Affairs, Wellness Councils of America, 9802 Nicholas St., Suite 315, Omaha, NE 68114. E-mail: kstobbe@ welcoa.org.]
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