Keeping the fire lit: Sustaining employee engagement in wellness

The following pages will give you a look inside those presentations.

Evaluating Wellness Investment

The current economy presents tremendous challenges and difficulties, with corporations attempting to streamline their expenses, including those that relate to employee benefits and workplace wellness programs (WWPs). However, available evidence on the value of WWPs and key trends influencing the labour market dynamics provide a strong rationale for sustaining WWP investments. Here are four arguments favouring the continued investment and delivery of WWPs.

1. It has been demonstrated that the financial resources involved in the implementation and delivery of WWPs are outweighed by savings such as those that relate to decreased reliance on short- and long-term disability leaves. Other, less tangible, benefits also materialize from WWPs such as an increased level of workforce engagement and employee productivity.

2. The deployment of effective and relatively inexpensive WWP lifestyle modification interventions allows employers to address the leading cause of morbidity and mortality and, by extension, permits the reduction of the economic burden of illness on the workplace. For instance, cancer, cardiovascular disease and respiratory illnesses can all be prevented via adequate dietary habits, frequent exercising and smoking abstinence.

3. Employees are beginning to expect WWPs be provided in their workplaces and their availability and quality will, over time, provide a competitive advantage for employers to attract and retain the best talent.

4. The demographic trend over the next few decades will create a context in which there will be fewer and fewer entrants into the workplace as compared to those who will be retiring. Therefore, meeting demand could present a huge challenge in the near future for many industries. This concern can be partially offset through keeping a workforce that is as healthy as possible for as long as possible.

There is a wealth of scientific evidence (and colloquial arguments) that supports the irrefutable value and importance for employers to invest in WWPs. One would argue that other corporate expenses bringing equivocal returns should be examined first so as not to challenge the delivery of WWPs that build more productive and engaged workforces.

Frédéric Lavoie is head of private sector for Pfizer Canada Inc.

Debunking (in some cases) Employee Wellness Myths

Hewitt’s 2009 Best Employers in Canada study incorporated a range of questions designed to investigate the links between employee engagement and health and well-being. Some of the results were as predicted, though now there is data to back them up. Other findings, however, were a complete surprise, challenging long-held assumptions.

A statistically significant 115,000 employees at over 200 participating companies were surveyed and their engagement measured. Organizations were then segmented by engagement score—high (more than 65%), moderate (45% to 65%) and low (under 45%). These same employees answered questions about their personal health and well-being, while employers reported key organizational statistics and incidences of programs related to health and well-being.

The following are some of the myths that were either corroborated or debunked by this research:

1. Overwork leads to low engagement. There is some truth to this myth. High-engagement organizations have fewer employees (15%) who report high work overload. In fact, these employees may be as overworked as their low-engagement counterparts who claim to have high work overload (22%), but they don’t see their workload as a burden—nor are they reporting the same levels of job stress.

2. Younger workforces are healthier. This myth appears to be false. Self-reported personal health was highest among the oldest employees.

3. Men are honest. When asked about the state of their personal health, 59% of men—regardless of their engagement level—stated that they were in good health, while only 47% of women made the same claim about themselves. The veracity of this myth is unclear!

4. Higher engagement leads to increased productivity and lower costs. This myth is absolutely true. The number of days absent per employee per year is much lower at high-engagement organizations (6.38 days) than at those with lower engagement (12.89 days). Moreover, the number of new LTD claims per 1,000 employees is greater at low-engagement organizations than it is at high-engagement ones, and workers’ compensation premiums per employee are almost double.

5. Engaged employees are healthier. The data supports a clear link between high engagement and better personal health. In addition, better personal health seems to be related to positive manager support.

Over the last decade, the Best Employers research has consistently supported the conclusion that high employee engagement produces better business results. The latest findings linking employee engagement and health and well-being provides further support that engaged employees enjoy lower job-related stress and absenteeism, along with better overall health, resulting in lower disability and workers’ compensation costs for their employers and a more productive, motivated and happier workforce.

Tim Clarke is Hewitt Associates’ benefits practice leader in Canada.

Good health equals good business at Johnson & Johnson

From the 1978 inception of the Live for Life Wellness Program to present-day efforts to create and sustain a “Global Culture of Health,” the Johnson & Johnson wellness and prevention initiative has been recognized as a key component of the company’s social responsibility and sustainability. Dr. Fikry Isaac, executive director for global health services at Johnson & Johnson, reviewed the approaches the company used in order to create that corporate culture of health for its employees worldwide.

Johnson & Johnson’s Global Health Program offerings are rooted in the disciplines of wellness and prevention, occupational health and employee assistance. Programs range from hands-on professional care and counselling to self-paced, on-line assessments and coaching tools. Most also have elements of behaviour and lifestyle modifications that include:
• Cancer Awareness and Prevention programs (with a tobacco-free workplace policy);
• Healthy Eating programs;
• Physical activity promotion and fitness centres;
• Comprehensive medical surveillance, occupational health clinics and case management for work-related injuries and illnesses; and
• Stress Management and Resiliency programs along with the availability of 1:1 employee assistance counselling;

Commitment to these programs within the organization is visible from top management down. The company shows this support with wellness centres available to employees, spouses and retirees as well as occupational health clinics and services; through global policies related to tobacco-free workplaces and HIV/AIDS detection and prevention; and through integration of wellness initiatives into employee benefits package designs. These are not just positive steps aimed at fostering the goodwill of employees, but also sound business practices directed toward creating a more productive, health-conscious workforce and thereby reducing health-related costs.

In addition, reviewing the results of the various programs highlights and substantiates the value of these efforts. Because of the substantial benefits realized ($8.55 million annually), there is a philosophical paradigm shift at Johnson & Johnson from health being viewed as a cost, to health being viewed as an investment. All in all, it’s about good health, which translates to good business.

Dr. Fikry Isaac is executive director, global health services at Johnson & Johnson.

Colon Cancer Screening: A workplace rationale

When two large employers in Ontario decided to launch colon cancer screening programs, they knew they were providing an important health service. The question was: Would employees be convinced?

In 2006-2007, Ontario Power Generation (OPG) and the Toronto Transit Commission (TTC) both introduced innovative employee programs with robust communications campaigns to raise awareness of colon cancer screening.

“The main goal of both programs was to empower employees with knowledge about colon cancer screening,” said Dr. Alain Sotto, who spearheaded both programs as chief physician at OPG and the TTC’s occupational medical consultant.

Employees received colonoscopy referral forms to take to their doctors in order to be referred to reputable clinics reviewed in advance by Dr. Sotto. These clinics had to be easily accessible and provide a quality colonoscopy in a timely fashion. Looking at the big picture of employee health and wellness is what helped convince OPG and TTC to promote colon cancer screening. As Kirsten Watson, the senior director of human resources at the TTC said, “We knew that we had to engage our executive leadership team and our unions for this to be a success.”

With this kind of support from senior leadership, OPG and TTC launched a full communications campaign with face-to-face presentations, posters, email messages, internal newsletters and brochures. At OPG, they also emailed all 12,000 employees a short video message by Dr. Sotto stressing the importance of colon cancer screening. The video received over 5,000 hits in the first 3-4 weeks of its release. A similar video is being finalized at the TTC. The colonoscopy referral form and a brief outline on colon cancer screening was also attached to every TTC employee’s pay-stub.

To bring a personal story to the message at OPG, a well-respected vice president became an ambassador for the program. At the presentations, he shared his own colon cancer experience, while Dr. Sotto presented the medical facts and science.

“At the presentations, many employees volunteered their personal stories to become passionate advocates, even getting up in presentations to say how simple the colonoscopy procedure was and how it saved their lives,” Dr. Sotto said.

Colon cancer is the No. 2 cancer killer in Canada. In 2008, over 20,800 Canadians were diagnosed. However, it is over 90 per cent preventable with a screening colonoscopy.

“At OPG and the TTC, we found that combining these facts with personal stories became a very powerful message for employees,” said Dr. Sotto.

Dr. Alain Sotto is chief physician of Ontario Power Generation and occupational medical consultant to the Toronto Transit Commission.

Engaging employees who are off work

Often, when we think of employee engagement we focus on those who are at work as they represent the vast majority of employees. And yet, how we engage people who are off work can greatly influence whether—and how soon—they come back to work, and how well they perform when they do return. While these employees are only a small portion of the workforce, the costs of mismanagement can be high—in human and financial terms.

Health promotion can be an excellent way to build engagement, regardless of where employees fall on the health continuum. A recent Maritz* study found a clear link between participation in health promotion programs and decreased absenteeism.

While programs for employees at work are aimed at, and structured for, groups, interventions for people off work need to focus on the individual and their specific needs. Many absences are quite straightforward and need no more than regular monitoring, but others are not so straightforward—and that’s when a wellness program is really put to the test. The key is to be able to quickly distinguish the complex absences and focus more specialized attention on them. It takes an individualized, holistic management approach that carefully assesses all the factors at play, builds trust, applies the right resources to deliver the right care at the right time and is able to influence the employee to make healthy choices.

Just as important as the approach to the individual, however, is the approach to the workplace culture. If employees who are off work feel that the work environment to which they are returning is positive and healthy, they’ll want to come back.

Changing the health of the workplace culture can sound daunting, but it really comes down to three things:
• Leadership,
• Communication and
• Rewards.

It’s actually pretty simple. It’s just not easy to do. Sometimes, human resources staff is reluctant to engage senior leaders in a conversation about their role as an “authentic champion”—and that’s unfortunate. Leaders may need time to think about it and they may need guidance or coaching, but not having the conversation in the first place is a missed opportunity.

Doug Smeall is assistant vice president, business development, health management services, group benefits for Sun Life Financial.

* Check Up On Workplace Wellness Programs, Maritz 2008.

The Importance of Local Leadership in Workplace Culture

In almost every organization, managers and employees work in a stressful environment—too much to do in too little time with too few resources. The response has been more multitasking and a higher dependence on technology that enables us to work anywhere at any time. We have created a “culture of hours”—when there is a choice between work and the rest of our life, work wins.

These pressured working conditions only increase when private and public organizations cut costs in the name of efficiency. Such actions, however, generate higher, often hidden, costs in employee disengagement. As employees become overloaded with work they cope by psychologically distancing themselves from the source of the stress. Rising rates of absenteeism, overuse of prescription drug benefits and lengthening of disability leaves represent the more obvious forms of disengagement. A more common and subtle form of self-protective disengagement is presenteeism–a “quit-and-stay” behaviour that results in reduced service quality and customer satisfaction.

Given the drive to be externally cost-effective, these negative effects appear to be inevitable and universal. They aren’t. Based on data from Dr. Dalton Kehoe’s own research, his consulting experience and information from key organizational studies, Dr. Kehoe has found that employee engagement can act as a buffer against the worst effects of workplace stressors.

When employees report a positive emotional connection with their work and organization—and take pride in both—they also report lower levels of perceived burnout, have lower rates of absence and use fewer of their benefits. As leaders, you may not be able to do much about the buffeting waves of change in the world around you, but you can do something about increasing the levels of engagement of your employees and their levels of workplace wellness.

Studies in Canada, the U.S. and Britain, as well as a mountain of consulting research, report that the key driver of employee engagement is the relationship between the employees and their local manager or supervisor. Research findings delineate a set of specific behaviours by local leaders that can enhance or inhibit positive emotional connections between employees, their work and the organization.

Essentially, engaging leaders are:
1. Clear about who does what, with what resources and explains the task’s value in the bigger picture;
2. Considerate of individual differences, including individual development needs; and
3. Collaborative in their decision-making style, involving employees in decisions that affect them.

The particular behaviours within each of these categories can be learned and with the commitment of senior management the “local leadership culture” of any organization can be improved and employee engagement and wellness enhanced.

Dalton Kehoe is an organizational change practitioner, a motivational speaker, a professor at York University and a partner in Heart of the Matter Consulting.

Case Report

A Working Case Scenario: What would your ‘dream team’ do?

This year’s Healthy Outcomes Conference included a session that put attendees to work solving a fictitious—yet highly relevant—case study. Formed into groups, delegates raced against the clock (they only had 25 minutes—although the winning team took a bit longer) to formulate the most innovative solution to a corporate wellness problem. With a strong showing of unique ideas from every table, ultimately, the winners were Table #4.

Congratulations go out to Kim MacFarlane of Manulife Financial; Lori Casselman of Buffett & Company Worksite Wellness; Cathy Lockhart of IWK Health Centre; Kathy MacNeil of Capital Health; Janice Strelow of ENMAX Corporation; and Sari Sairanen of the Canadian Auto Workers Union.

The judges were Rochelle Morandini of Hewitt Associates; Frédéric Lavoie of Pfizer Canada; Laura Blair of Roche Canada; Doug Smeall of Sun Life Financial; and Paul Foley of Shoppers Drug Mart.

Following is the session’s case description and Table #4’s solution.

Asteroids Inc. is an aerospace company headquartered in Ottawa with a manufacturing plant located in Winnipeg. Employees range from those who work on the manufacturing line where the space parts are assembled to those who work in the government relations department in the company’s Ottawa office.

Because of the downturn in the economy, the government has withheld its “space funds” to Asteroids Inc., leaving the company with a $1 million shortfall. Budgets have been cut, jobs have been lost. There are now 2,500 people at the plant where there were once 4,500. And, in the offices, there are now 1,000 employees where there were once 1,500. In total, Asteroids Inc. has lost 2,500 of its 6,000 employees. The demographics of those employees “run the gamut” in terms of age, sex, culture, religion and lifestyle choices.

Asteroids Inc. is in a highly competitive market and uses its health and wellness program as a retention/attraction tool. That program currently includes:
• 80% benefits coverage for medical and dental;
• disability benefits (both short- and long-term);
• an Employee Assistance Program;
• a subsidized cafeteria in the Winnipeg plant; and
• a subsidized daycare facility and fitness centre at the Ottawa office.

(It is up to your group to estimate the original allocation of funds to Asteroids Inc.’s health and wellness program, based on your combined knowledge and experiences.)

However, the budget for the entire health and wellness program has now been cut by 40%.

Asteroids Inc. has hired your team as outside consultants to come up with a plan that will reduce costs to the employer by 40% while maintaining employee wellness, job satisfaction and productivity as much as possible. What will your “Dream Team” do?

Table #4 Solution:
Assumption
• 40% reduction in staffing is proportional to 40% reduction in wellness program; and
• Budget not necessarily reduced allocation by person, but the needs of the group have changed so we need to re-assign resources and budget allocation.

Considerations
• Perceived fairness;
• Transparency of decision-making;
• How people feel about people leaving;
• Managing the people leaving effectively and fairly;
• Helping survivors cope with the change and some guilt, fear;
• Morale;
• Loss of productivity (engagement) & focus;
• Management “buy-in” & maintaining that buy-in;
• Business impact on productivity, fear, morale.

Business Case
• Understand current environment and establish baseline metrics through: engagement surveys, absenteeism metrics, productivity and claims metrics;
• Project impact that wellness action plan can have to the baseline; and
• Change in baseline is the measurement for success.

Strategy
1. Assess and evaluate employee perception and perceived value of current program and preferences for future programs (survey and focus groups led by senior and middle management).

2. Strong communication strategy including senior and middle management around business realities. Communicate results of focus groups and surveys at all levels.

3. Review all suggestions/preferences by location to determine key programs of value to keep and modifications to be incorporated.

4. Review/maintain and possibly enhance EAP offering.
• Focus on resilience/stress management;
• Review and potentially revisit benefits;
• Plan design/coverage option/additions of flex model possibly;
• Potentially cut back to enable addition of options such as: web-strategies, challenges, educational information (possibly temporarily); and
• Review value/cost of cafeteria/daycare/fitness centre.

Options
Cafeteria Subsidy
• Eliminate subsidized cafeteria and possibly suggest increased fees for unhealthy options/decreased fees or subsidy for healthy choices only.

Fitness Facility
• Offer fitness membership subsidy to all or reimbursement for equipment/fees for physical activity programs (e.g.; sports leagues, fitness classes, treadmill) vs. fitness facility in 1 location only; and/or
• Introduce fitness/pedometer challenge for all.

Review Daycare Facility
• Potentially offer openings to outside clients for fee or offer subsidized fee to previous employees as a supportive measure (during job search) and communicate to all staff;
• Possibly provide subsidy for external programs offered through other outside facilities rather than maintaining one
on-site facility;
• Re-dedicate funds towards parenting/work/life balance, educational programs.

Other tables also had innovative ideas that included:
• Change the long-term disability from a taxable to a non-taxable benefit;
• Create initiatives such as flexible work options;
• Ask vendors about cost-reduction strategies; and
• Track how employees use their “wellness credits” to reveal what programs should be cut in future.

For a PDF version of this article, click here.

© Copyright 2009 Rogers Publishing Ltd. This article first appeared in the June/July 2009 edition of WORKING WELL magazine.