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1045 dr chng shih kiat the importance of workforce health as an effective business strategy

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  • 1. Holistic Approachin EmployingOlder StaffDR CHNG SHIH KIATMBBS MMed(FM) MCFP GDOMDeputy Medical DirectorRaffles Medical Group
  • 2. Topics Epidemiology Effects of Aging on Health Work and Health Work Hazards Fitness Examination Workplace Health Promotion Conclusions
  • 3. Epidemiology Aging population  > 65 yo 8.7% in 2008 to 19% in 2030  Aging workforce 2004 22% >50 yo, 2015 29%
  • 4. Epidemiology Chronic diseases  2010 2 in 5 people  2020 3 in 5 people Top 4 causes of death (72% of all deaths)  Cancer  Ischaemic heart disease  Pneumonia  Stroke
  • 5. A Dilemma Experienced Trained Know the company’s culture and values? More health problems ? Increase susceptibility to hazards ? Increase cost ? productivity
  • 6. When It Comes to Work, HowOld Is Too Old? My 92-year-old grandfather cuts hay atop a 5-ton tractor each summer, baling winter feed for more than 800 head of cattle. The rest of the year he herds, corrals, immunizes, and cares for the cattle. A senior scientist at the Centers for Disease Control and Prevention (CDC) reported to work each day well into his 80s, contributing greatly to our understanding of biomarkers, and helping advance laboratory safety measures. An annual laboratory safety award is now given each year in his honor. By L. Casey Chosewood, MD Posted: 05/03/2011 at Medscape
  • 7. How old is too old?Fumi Chinen, 102 years old has been in the same business for morethan 50 years-a tiny Okinawan kimono shopkeeper at Naha PublicMarket. She is often difficult to find since she recently enrolled inEnglish classesAdapted from http://okicent.org/media.html
  • 8. Seikichi Uehara, 96 years old is a karate master, who is also the guardian of a rare karate method, "Mutubu-Udundi." The method was originally created in secret to protect the Royal Family of the Ryukyus. Now that there is no official royal family, anybody can learn it, if they can keep up with the masterAdapted from http://okicent.org/media.html
  • 9. Benefits of work To the doctor, work is medicine as stated by Dr Casey Chosewood Enhances well-being Promotes social interaction Increases variety and quality of life Sense of accomplishment and satisfaction Maintain and extend their physical activity Improve mental health and memory
  • 10. 12 Benefits of older workforce Sept 20, 2006 Entrepreneur  Dedicated  Punctual  Honest  Detail-oriented, focused and attentive  Good listeners  Pride in job well done  Organisation skills  Efficiency and confidence  Maturity  Setting an example  Communication skills  Lower labour cost
  • 11. Changes as We Age Cell  More vulnerable to damages  Less efficient eg in energy release  Declining functions Connective tissue  Stiffness  Vision deterioration eg catarract Immunity  Susceptibility to infection  Less surveillance
  • 12. Common conditions in theolder person Physiological  Decreasing vision  Decreasing hearing  Decreasing energy and concentration  Decreasing strength  Decreasing flexibility  Decreasing stamina  Decrease thermoregulation  Decreasing cognitive functioning and ability to pick up new skills  Decrease response time
  • 13. Common conditions in theolder person Pathological  Chronic diseases  Diabetes  Hypertension  High cholesterol  Heart disease  Neurological diseases eg Parkinsons, dementia, stroke  Infection  Skin problems  Cancer  Musculo-skeletal disorders eg osteoarthritis  Risk of falls
  • 14. Common conditions in theolder person Psycho-Social  Mental health  Social relationship, empty nest  Retirement planning  Caregiver
  • 15. WHO Definition of Health Healthis a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
  • 16. Work Health
  • 17. Work Health Decreased Productivity & Increased Healthcare Cost
  • 18. Health Promotion as theCornerstone for Prevention Healthpromotion comprises efforts to enhance positive health and prevent ill- health, through the overlapping spheres of health education, prevention, and health protection. Downie, R.S., Fyfe, C. & Tannahill, A. (1990), Health promotion. Models and values. Oxford (Oxford University Press), 1990, 59
  • 19. Invest in Prevention “We dedicate resources to prevention because, like any successful investment we’ve made, it yields steady returns….a healthier, more productive, more committed workforce and significantly lower overall healthcare cost. For every dollar we invest in our workers’ health, we see a return of more than $4…..” - William Weldon, Chairman and CEO, Johnson and Johnson (Jan-Feb 2011, Harvard Business Review)
  • 20. Invest in Prevention Inaddition to the health benefits for workers, every Euro invested in WHP leads to a Return on Investment (ROI) of between 2,5 – 4,8 Euros ($4 - $8)due to reduced absenteeism costs. European Agency for Safety and Health at Work (EU-OSHA).
  • 21. European Network forEnterprise for Health Justification for WHP  Reduces costs of ill-health and poor work quality  Drives innovation and productivity  Addresses the challenge of an ageing workforce  Satisfies employees, customers, shareholders and public stakeholders  Aligns with corporate social responsibility, a central pillar for future welfare and economic prosperity (Breucker, 2004, draft executive summary)
  • 22. Where does employee health andwell-being appear on seniormanagement’s list of priorities?  The number one priority 4%  Near the top of the list of priorities 35%  At the middle of the list of priorities 33%  Low on the list of priorities 16%  Not on the list of priorities 12% Canadian Survey (Lowe, 2003 and Bachman, 2002)
  • 23. Benefits of WHPTo the Staff Better working conditions Improved social climate Improved organisational process Greater health awareness Improved state of health: Many chronic diseases can be prevented through adoption of healthy lifestyle Happier
  • 24. Benefits of WHPTo the Company Improve staff health Increase staff morale Increase staff productivity Decrease staff turnover Decrease staff training needs Decrease absenteeism and injuries Decrease presenteeism Decrease healthcare cost Enhanced Company image
  • 25. Not just having a form…The reason for workplace health promotionis that it contributes to the main goals of thecompany. It should be part of thecompany’s culture, integrated and alignedwith companies’ goals and strategy.
  • 26. Interventions that work Empowering Individuals
  • 27. Empowering Individuals Chronic disease prevention/risk factor reduction programs (Family physicians)  Smoking cessation  Healthy eating  Weight gain prevention/weight loss  Physical activity programs  Low impact aerobics: walking, steps counting  Balance/core training: Dancing, tai chi  Strength training  Stress management/depression
  • 28. Empowering Individuals Health portals Health screenings  Lifestyle survey  Company health profiles
  • 29. Supportive Environment Hazards control (Occupation Medicine Physicians) Workplace hygienic factors  Temperature  Noise  Lights  Ergonomic workstations  Non slipped flooring Healthy vending machines Water coolers Financial support for health related initiatives
  • 30. Organisation Policies (mostimportant) Health related policies (periodic screening, no- smoking policy etc) Staff communications (feedback and suggestions)Specifically for re-employment Eliminate age-based discrimination, promote age diversity and age-friendly culture through  Events  Talks  Workshops  Mixed-age work team Flexible job design, flexible working hours
  • 31. Organisation Policies (mostimportant) Trainingand re-training opportunities from employment to retirement Special business unit Leave policies  Extended family care leave Employee assistance programmes  Mental health assistance programmes  Financial/ retirement planning
  • 32. Assistance Workplace Health Promotion Grant  The Workplace Health Promotion (WHP) Grant is a funding scheme offered by the Health Promotion Board (HPB). The Grant provides financial support to help organisations start and sustain their workplace health programmes.  The maximum grant quantum is $10,000. The organisation must co-fund the WHP project by contributing 50% or more of the project cost.Adapted fromhttp://www.hpb.gov.sg/hpb/default.asp?pg_id=2165
  • 33. Assistance Mental Health Top Up Grant  An additional funding option offered by HPB.  Provides financial support to sustain and augment their workplace mental health promotion programmes.  The maximum top up quantum is $2000. No co- funding by the organisation is required. Adapted from http://www.hpb.gov.sg/hpb/default.asp?pg_id=2165
  • 34. Work and Health
  • 35. Workplace Health and Safety Identify work hazards Identify worker’s health issues and match it to the work
  • 36. Identify Work HazardsWorkplace inspection by DWDs/ Hygienists Mechanical factors including physical work Ergonomics  Work stations  Work environment (Temperature, noise, light etc) Chemical/ biological hazards Psychosocial factors Staff interview
  • 37. Control for work hazards Personal protective gears Ventilation eg LEV Mechanical assist for lifting heavy loads Engineering control eg substitution of hazardous material in process
  • 38. Workability Developed by the Finnish Institute for Occupational Health (FIOH)
  • 39. Workability Appropriate match and balance between:  individual resources, including health, functional capacity, knowledge, skills and competencies, values, attitudes, motivation, personal support systems and other individual factors; and  the physical, mental and social demands created by the nature of the individual’s work and their physical and psychosocial work environment.
  • 40. Job WorkabilityCompetency Health
  • 41. Medical Fitness Matching health and work Need to know  Job scope and what exactly is involved  Match physical health, capability to the job task Pre-existing illnesses/ Newly diagnosed illnesses  Does it affect work performance  Will the work aggravate the medical condition
  • 42. Medical Fitness Medical illness ≠ Un-employability Focus is on matching of work and health Implication is possibility of higher medical cost
  • 43. Financing Healthcare Services Agreed medical benefit plan  Capping  Co-payment  Insurance schemes
  • 44. Financing Healthcare Services Managing and controlling of chronic diseases  CDMP programme  Diabetes  Hypertension  Lipid disorders  Stroke  Asthma  Chronic Obstructive Pulmonary Disease (COPD)  Schizophrenia  Major depression  Bipolar depression  Dementia
  • 45. Financing Healthcare Services Primary care partnership scheme  As of 2012 1st quarter  Extended to include patients > 40 yrs old  Cover chronic disease management  Government subsidy of $50 per visit for per capita income of 901-1500 (Annual cap $300)  Government subsidy of $80 per visit for per capita income of < 900 (Annual cap $480)
  • 46. Financing Healthcare Services Important to consider coverage for hospitalisation and surgery
  • 47. Maintenance of Health Routinehealth screening Occupational screening GP coverage for chronic diseases  Important to adopt the concept of one patient, one family doctor
  • 48. What does it all mean? Medical checkups Redesigning of  Work culture  Work-station, work environment  Job scope, job rotation  Work hours, shift pattern Removal of hazards Active staff feedback and actions Monitoring of MC trends Expert assessment of workplace, work stations Discussion with staff on new re-employment package Etc etc etc
  • 49. It’s a Paradigm Shift
  • 50. Planning for re-employment Management Support and HR policies Workplace Re-employment WHP Assessment PEPromote and Promote andencourage encourage Ensure good job fithealthy behaviours healthy workplace Successful engagement of Healthy workforce healthy experience staff
  • 51. Thank You