Employee Health Screening

Health Information Technology can make the entire health care system more effective and efficient by enhancing:

• Documentation (lab and test results, clinic notes, consult recommendations)
• Communication (provider to patient, provider to provider)
• Information input (templates to facilitate data entry)
• Delivery of care (documenting all patient-provider interactions in a single system)
• Chronic disease risk identification (evaluation of risk factors, recommendations for appropriate preventive services and screenings)
• Consistent recording of correct billing codes

But, adapting to Health Information Technology is a challenge.

• Health Information Technology almost always involves a “new system.” Consequently, the entire staff, from health care providers to IM/IT personnel is on a learning curve.
• Existing IT infrastructure may not be adequate, so the Health Information Technology system may be very slow, or may frequently crash.
• The new system may not have all the forms you need already in place. New forms may be needed.

Lessons learned from Health Information Technology implementation

Take advantage of as many training opportunities as possible.
• Learn as much as you can about the Health Information Technology that you need to use. Become an expert.
• Ask questions if you are unsure how to navigate the system.

Keep the big picture in mind.
• Be aware that those keeping the Health Information Technology system up and running may have a very different set of priorities. The IM/IT staff may not see your request as a priority when it is taking all their manpower to trouble shoot the new system each day.
• Other changes to the Health Information Technology system may be in line in front of yours, so be patient.

Think through changes thoroughly.
• Take time to think through a new form thoroughly. Know exactly what you want before talking to the developer.
• Don’t think in a vacuum. If you build a form, make sure it is one your staff will use and find efficient.
• Make a draft version of the form and use it before requesting that it be put into the new system.
• Be prepared to build a good case for why your form should be created. Build a stronger case if your form should be developed ahead of other requests in the queue.
• Be patient and persistent when working with a programmer/developer on a new form. Meet frequently and set up timelines and deadlines.
• Coordinate with IM/IT and the Health Information Technology contractor to see if they can support a new project in the required time frame.

For more information about Health Information Technology implementation, go to the Agency for Healthcare Research and Quality (AHRQ) National Resource Center for Health Information Technology at http://healthit.ahrq.gov.

To effectively manage your Employee Health and Wellness Program resources, first determine the resources you need and the resources you have. Then develop a plan to fill the resource gaps.

What Employee Health and Wellness Program resources do you need?

• Make a list of staff members, materials, equipment, space, and logistical support.
• Be as specific as possible.
• Include partnerships that will be needed to make the Employee Health and Wellness Program happen.

Identify available Employee Health and Wellness Program resources.

• Use materials that exist or are already on hand. Resist the temptation to start from scratch!
• Determine what other departments already have.
• Contact DHPW/HPPI to find out what other installations have done.
• Know where to borrow or get free materials.
• Use local or internal resources whenever possible.
• Look for opportunities to cut and/or share costs.

Develop a strategy to fill Employee Health and Wellness Program resource gaps.

• Partner with as many staff members and companies as you can. Emphasize what’s in it for them.
o Example: use a Physical Therapist to teach a back health class.
• Take advantage of community organizations and coalitions.
• Use volunteers as frequently as possible.
o Red Cross volunteers, medical interns or nursing students can supplement your manpower.

Former Employee Health and Wellness Program participants make good guest speakers.

• Keep a list of subject matter experts who will provide input for free so you can avoid the expense of an outside contractor or consultant.

Look for innovative Employee Health and Wellness Program opportunities.

• Other funding opportunities may exist at your facility.
o Example: if there is a book fair, see if you can apply to receive some of the proceeds.
• Ask the unit to contribute resources to Employee Health and Wellness Programs directly implemented at the unit level.
• Get to know the contracting person at your installation. They frequently know the least expensive places to obtain many different kinds of materials.
• Look for “recycling” possibilities.
o Example: IMD may be able to give you old computer workstations for use with electronic health assessments.

Good communication will help you find more partners and volunteers.

• Get the word out to the community about your Employee Health and Wellness Programs.
• Describe what you are doing and how you are doing it.
• Presentation is everything. Keep information current and use lots of visual aids.

All Employee Health and Wellness Programs require resources. Some resources you will already have. Some resources you will have to find. Sometimes you will have to make something out of very little. Smart strategies can maximize your Wellness resources.

Organization processes are structured activities that achieve a specific result. By way of example, scheduling appointments is a organization process that results in an orderly work flow and timely patient care.

Employee Health and Wellness Program implementation frequently requires changes to established organization processes. These changes may be simple, such as adding prescreening appointments to the scheduling process, or more complicated, like determining how time devoted to a particular Employee Health and Wellness Program will be coded.

Not all change can be affected painlessly. However, developing a plan for achieving change will overcome barriers like:

“But we’ve always done it that way” or “But we’ve never done it that way.”

Each change situation will be different. The path to achieving change may not always be straightforward.

Lesson learned: Making small, incremental changes will be easier than trying to make one big change. It is also easier to modify a current process than to introduce a brand new one.

Develop a road map for change.

Describe the current organization process.
• By way of example: what is the current registration process for the weight management program? Include steps for both participants and staff.

Identify where the new or modified organization process could fit into the current process.
• By way of example, prescreening appointments for the weight management program could be scheduled when participants sign up OR the prescreening could be done at the first class.

Collaborate.
• Consider the change process to be a team effort. Determine everyone who will be affected by the change and get their input.
o By way of example, be sure to ask the personnel that set up the prescreening appointments AND the personnel that would do the prescreening for their ideas.
• Recruit one or more champions for the change. It helps if the champion has some clout.
• Get buy-in from as many staff members as you can – including those that might be most resistant to the change.

Communicate.
• Don’t keep the change a secret. The more staff members know, the more likely they will support a change.
• Anticipate barriers ahead of time. Be ready to articulate concrete benefits that will result from the change – especially advantages such as costs avoided or training time conserved.

Employee Health and Wellness Program evaluation is critical for effective Wellness and will help you get Senior Management support.

Why evaluate your Employee Health and Wellness Program?

Employee Health and Wellness Program evaluation answers these questions:
• What change(s) occurred in the target population?
• ‘What’s in it’ for Senior Management?
• Are the resources that are being used worth the outcomes that are achieved?
• Were Employee Health and Wellness Program outcomes expected? (Unexpected outcomes may have occurred.)
• What Employee Health and Wellness Program areas need improvement?

Employee Health and Wellness Program Fact of Life:

Employee Health and Wellness Program evaluation left to “chance” or until “there is time” will never happen.

• Employee Health and Wellness Program evaluation should be considered as an essential part of the whole plan for Wellness and not as something extra.

Where do you start?

Keep it simple. Employee Health and Wellness Program evaluation does not have to be complicated.
• Get baseline information.
• Baseline information is the health status of the target population at the beginning of the Employee Health and Wellness Program.
• Start by collecting just 3 or 4 primary items as the baseline. You will have better success collecting follow-up information later if you only need to get a few pieces of information.
• Don’t rely only on health indicators that require lab evaluation. Also use self-report information and health indicators that are measurable without lab tests.

• Collect information that relates to readiness.
• You should always be ready to communicate to leadership the ways that your Employee Health and Wellness Program impacts readiness. Plan ahead to collect information that will demonstrate this connection.
• Think like Senior Management: what Employee Health and Wellness Program outcomes will be important from Senior Management point of view?

• It’s never too late to incorporate Employee Health and Wellness Program evaluation into Employee Health and Wellness Programs.
• If your Employee Health and Wellness Program is already up and running and you didn’t plan for information collection ahead of time, start collecting information NOW.
• If you don’t have baseline information, then collect interim information and compare that to end-of-program information.
• Or, you can compare final Employee Health and Wellness Program outcomes to similar initiatives elsewhere.

If you can’t make any comparisons to other information, use resources like The Community Guide (http://www.thecommunityguide.org/ ) that have already evaluated the effectiveness of Employee Health and Wellness Program components. Compare the components of your Employee Health and Wellness Program to those that have been proven effective elsewhere.

Think ahead: what unexpected challenges might come up as you implement your Employee Health and Wellness Program? How could you adapt and change the Employee Health and Wellness Program to meet those challenges?

• Consider the “what if’s?”

• What if your classroom space is suddenly no longer available?
• What if you can’t hold the Wellness Fair in the usual place?
• Have a ‘Plan B’ (or even Plan C or Plan D) in mind for when the “what if’s” happen.

• Build a team that can help with the Employee Health and Wellness Program
• Who else could teach the health education class if the regular instructor cancels at the last minute?
• Know what areas of expertise your staff has besides their ‘main’ job. By way of example, find out who has excercise instructor credentials besides just the physical therapist.
• Don’t wait for a crisis before you build a network of staff members that you can call on.

• Be ready to roll your sleeves up
• Jump in to fill a gap if you need to.
• YOU may have to help restock the milk case in the dining center when the Dairy Month ‘Milk Mustache’ contest results in increased sales during lunch.

• Be willing (and ready) to respond to feedback about the Employee Health and Wellness Program
• Get participant feedback while the Employee Health and Wellness Program is ongoing. Then be ready to adapt to those suggestions.
• By way of example, if kids in a pediatric obesity Employee Health and Wellness Program fight the idea of completing physical excercise logs, then get a verbal summary of their activity for the week instead.

• Simplify Employee Health and Wellness Program
• If part of your Employee Health and Wellness Program is not working, try making that part less complicated.
• By way of example, if getting follow-up information is not going the way you planned, then make the process to get information easier OR decrease the number of pieces of information that you collect.

• Use lemons to make lemonade
• What do you do when the Employee Health and Wellness Program doesn’t turn out exactly as you planned? Look for what did turn out. Often, the ‘unexpected outcomes’ produce positive results.
• By way of example, one installation’s database to collect sick call data was made obsolete by a regional system. However, the installation database was able to be used in a different way to track vaccination information that improved delivery of care to Employees.
• At another installation, world events halted a new physical training program. Instead, Employee Health and Wellness Program materials were made into a excercise guide.

Take the time to plan Employee Health and Wellness Programs before they are implemented.

Strategic planning enables better use of all your resources. Include all the steps below when you plan a Wellness activity.

• Do your homework – Locate the science and research that support your interventions. Look for similar Employee Health and Wellness Programs that already exist.
• Determine the specific health need(s) - Use these needs to target interventions to problems that are an issue for your population.
• Organize a team – A team is a resource multiplier. Network and build as many partnerships as you can.
• Make a plan, but don’t start completely from scratch. Make a written plan for your Employee Health and Wellness Program. Look for every opportunity to take advantage of resources that already exist. Don’t reinvent the wheel.
• Select a focus - Choose one or two main target areas for Employee Health and Wellness Programs. Address all five stages of change in the target areas rather than trying to hit every possible Wellness topic.
• Determine your resources - What assets do you have? What assets will you need? How can you fill the gaps?
• Get Senior Management support – Think like Senior Management. Communicate the value of Wellness from Senior Management’s perspective.
• Start the activity- Be flexible. Be prepared for unexpected challenges.
• Market the activity - Keep your Employee Health and Wellness Program visible for Senior Management, line and medical personnel, Employee Health and Wellness Program participants, and potential partners and volunteers.
• Collect and analyze outcomes - Outcomes indicate Employee Health and Wellness Program impact. Start with just a few outcomes – you don’t have to collect everything. Remember that it’s never too late to start measuring Employee Health and Wellness Program impact.
• Evaluate, improve and re-evaluate – Use participant feedback and Employee Health and Wellness Program outcomes to determine Employee Health and Wellness Program impact. Identify areas in need of improvement. Use outcomes to determine if expended resources were worth the results.

Why use small steps toward health behavior change?

Small steps give participants immediate feedback on the changes they make towards better health. Measuring these small steps is also an excellent way to collect interim Employee Health and Wellness Program effectiveness information.

Employee Health and Wellness Program small steps make a big difference

Small steps for Employee Health and Wellness Program participants
• Walk to work.
• Use fat free milk instead of whole milk.
• Each day think of two things you are grateful for.
• Do sit-ups while you watch TV.
• Drink water before a meal.
• Take 10 deep breaths to relieve tension.
• Eat half your dessert.
• Skip second helpings and buffets.

Measuring small Employee Health and Wellness Program steps
• Use short pre- and mid-point surveys to ask:
• How many glasses of water do you drink a day?
• How frequently you do eat fast food?
• How frequently do you skip a meal?
• How frequently do you engage in physical activity?
• How many servings of fruits and vegetables do you eat each day?

Use the results to show participants how their health behaviors are changing for the better.

• Ask participants to rate their health status and/or stress levels before and after an intervention.
• Add up individual (or team) steps and mark the progress on a map towards a far away destination.
• Be innovative! Do not rely only on weight loss, BMI, or cholesterol tests as health status progress indicators or health behavior change feedback.

Wise words for taking small Employee Health and Wellness Program steps

• The first wealth is health. (Ralph Waldo Emerson)
• We are what we repeatedly do. (Aristotle)
• The victory is not always to the swift, but to those who keep moving. (CDC)
• There are 1440 minutes in every day…schedule 30 of them for physical activity. (CDC)

Why Employee Health and Wellness Program follow up?

Getting feedback from Employee Health and Wellness Program participants serves two purposes: to obtain information that quantifies a Wellness Program’s impact, and to find ways to improve a Employee Health and Wellness Program.

Building follow up into your Employee Health and Wellness Program

Keep it simple
• Keep follow up to information you absolutely require. A three-question survey is more likely to get a response than one with 20 questions.
• Use email or phone for follow-up. Use personal, AKO, and installation email addresses; use cell phone and unit phone numbers.
• Go to the Employees: go to the unit or somewhere else they will all be gathered (like the APFT test location), and get follow up information there.
• Give participants a stamped envelope addressed to you, with a printed form listing the information you will need.

Keep it structured
• Tell participants right from the beginning that you will be doing follow up after the Employee Health and Wellness Program is finished. Be specific about the information you will collect.
• If you need to do hands-on measurements, find out if participants will be coming back to your location for another reason (like another clinic appointment). Ask them to stop by while they are in the building – or, better yet, go to where they will be.
• Ask participants where they will be the next time you will be collecting information. They may already know their next duty station if they will be PCSing soon.
• Plan ahead for follow up and put it on the schedule. Planning to do follow up “when you have time” usually means follow up will never get done.

Keep it catchy
• Give participants something to go along with the request for information. By way of example, if you send an email to ask for information, send along a yummy recipe or a timely excercise tip.
• Schedule a ‘reunion’ day to collect follow up information. Invite participants to come back and share successes and challenges. Have some (healthy) munchies available.
• Have a silly contest – the team with the most follow up information wins something, like having their photos posted on a prominently-placed bulletin board or an eggplant trophy, or some other fun thing.

Why bother to market your Employee Health and Wellness Programs?
Because of the transient nature of the many staff member populations, you must market your Employee Health and Wellness Programs all the time. Your goal should be to keep your Employee Health and Wellness Programs as visible as possible.

Creative marketing can increase awareness of your Employee Health and Wellness Program for:

• Potential Employee Health and Wellness Program participants
• Senior Management
• Line and medical personnel
• Potential partners and volunteers

Creative Employee Health and Wellness Program marketing ideas

Involve Senior Management in your marketing Employee Health and Wellness Program as frequently as possible.
• By way of example: invite Senior Management to judge a Employee Health and Wellness Program logo contest.

Link your Employee Health and Wellness Programs to national advertising campaigns
• …like the Great American Smokeout and the Dairy Council’s Milk Mustache campaign.

Collaborate closely with personnel in the corporate office.
• Submit articles about your Employee Health and Wellness Programs that coincide with National Health Observances. By way of example: highlight your Asthma Program in May, which is National Asthma Awareness Month.
• Let the corporate office know you can always provide an article to them when they run short on material. (Then make sure you always follow through.)
Word of mouth is the most effective advertisement for your Employee Health and Wellness Program
• Use real staff members in your advertising: enlist the help of successful Employee Health and Wellness Program participants or use Employees and other post personnel for your marketing materials, when possible.
• Start “buzz” by incorporating an element of competition: which ‘team’ had the most steps over the past week? Which department engaged most frequently in physical activity?
Take advantage of technology
• Use post television and radio resources.
• Use email whenever you can.
Don’t just market your Employee Health and Wellness Program to potential participants, but market the opportunities for others to be involved, as well.
• By way of example: does the Red Cross know you can always use a volunteer? Do other departments/clinics know that you can always use personnel with some temporary down time?
Don’t be “old news”
• If you put advertising materials up, be sure to take them down in a timely manner.
• Update marketing logos and themes as appropriate.

What is Employee Health and Wellness Program data?

Employee Health and Wellness Program data is information that is collected about your Employee Health and Wellness Program. All Employee Health and Wellness Programs should include data as an integral part of the Employee Health and Wellness Program plan.

Why should you care about Employee Health and Wellness Program data?

Information tells the Wellness story. Information is the tangible proof of a Wellness Program’s impact.

Building data into Employee Health and Wellness Programs

Why bother with Employee Health and Wellness Program Data?

You need Employee Health and Wellness Program data to:
• Evaluate whether or not your Employee Health and Wellness Program is working.
• Answer the ‘so what?’ about the need for a Employee Health and Wellness Program.
• Offer information to Senior Management about the impact of the Employee Health and Wellness Program.
• Write a budget justification so you can secure Employee Health and Wellness Program resources.
• Use Employee Health and Wellness Program resources efficiently and market your Employee Health and Wellness Program more effectively.

Where to begin collecting Employee Health and Wellness Program data:
• MAKE A PLAN to collect the data: decide what, when, and how information will be collected.
• Determine what information is ALREADY BEING COLLECTED.
o By way of example: use dairy sales information in the dining center to measure the impact of a milk marketing/dairy month campaign.
• Start collecting JUST A FEW small pieces of information. Be innovative!
o By way of example: BMI, APFT scores (before & after), tobacco quit rates

IT’S NEVER TO LATE TO START collecting Employee Health and Wellness Program data.

Innovative Employee Health and Wellness Program data strategies
• Use local college/graduate students to help collect, input, and analyze Employee Health and Wellness Program information.
• If your organization has an internship program, get to know the Internship Director. Take advantage of intern resources – including having the Director and/or interns implement the data collection plan for your Employee Health and Wellness Program.
• Use information to let upper management know about the Employee Health and Wellness Programs affect on the workers.

Present this information at their monthly/quarterly meetings.
• Use innovative follow-up strategies to get information. Phone calls can be effective, but also consider email, mailed surveys with return postage provided, and going to the units in person to collect the information.
• Make data collection ‘fun’ for Employee Health and Wellness Program participants.
o By way of example: use a team approach – the team with the ‘best’ overall results gets some sort of award or recognition.
• ALWAYS relate the impact of your Employee Health and Wellness Program to readiness.