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The State of the Art in Workplace Audits With Thomas Golaszewski
 

The State of the Art in Workplace Audits With Thomas Golaszewski

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    The State of the Art in Workplace Audits With Thomas Golaszewski The State of the Art in Workplace Audits With Thomas Golaszewski Presentation Transcript

    • HEcheck: A Workplace Health Environment Assessment
    •  Provide a rationale for organizational assessment and intervention Review the Heart Check odyssey Introduce the new organizational assessment: HEcheck Demonstrate HEcheck assessment and reporting capabilities Discuss the future of organizational assessments
    •  Are systems-based models Explain behavior as the interrelationship of organisms and their environments *Salis & Owen, Ecological Models of Health Behavior, In:Glanz et al, Health Behavior & Health Education, 2002.
    • Adapted from: http://www.carbc.ca/HelpingCommunities.aspx
    •  “People will change behavior to reflect their environments. Therefore, if you want healthy people, simply create healthy environments.” Thomas Golaszewski
    •  Grew out of NYS Department of Health’s “Healthy Heart Program” – Mid 1990s Application of Social Ecology principles Research Question: How do you create healthy workplace environments?
    • “You can’t manage IT unless you can measure IT.”Peter Drucker, Ph.D. (?)
    •  Assessment for organizational support for employee heart health (structure): policies, services and facilities; and program administration 226 items scored as a dichotomy: 0 or +1 Contains sections on: organizational foundations, administrative support, tobacco, nutrition, physical activity, stress, screening
    • 200 180 Experimental 160 Control 140 120 100 80 60 40 20 0 -20 Smoking Nutrition Phys Act Screen Adm Sup TotalGolaszewski et al. (1998). An Organization-based Intervention to ImproveSupport for Employee Heart, Am J Health Promotion.
    • Costs Associated with Risks Medical Paid Amount x Age x Risk $7,123 $5,813 $4,530 $4,401 $7,000 $3,216 $6,000 $4,718 $5,000 $2,098 $3,364 $3,069 $4,000 $2,667 $3,894 $2,480 $2,912 High Risk $3,000 $1,550 $2,605 Medium Risk $2,110 $2,200 $2,000 $1,351 $2,941 Non- Participant $2,081 $1,851 Low Risk $1,000 $1,523 $1,641 $1,122 $0 19-34 35-44 45-54 55-64 65-74 75+Edington. AJHP. 15(5):341-349, 2001
    • THE HEART CHECK HEALTH PROMOTION MATRIX December 2004Organizational Foundations: This section describes compensation and human resource management elements that indirectly support employee health. Although veryimportant, they are not usually under the auspices of the health promotion agenda and are therefore listed separately.9.1.1, 9.1.2, 9.1.3, 9.2.1, 9.2.2, 9.2.3, 9.3.1, 9.3.2, 9.4.1, 9.4.2, 9.5.1, 9.6.1, 9.7.1, 9.7.2, 9.7.3, 9.7.4, 9.8.1, 9.8.2Smoking Nutrition Physical Activity Stress Screening Administrative Implementation Level Support 8.1 8.2 8.6.1 8.11.1 1. Start-up: 8.1.1 8.6.3 8.11.2 Structural development, “must do” 8.1.2 8.5 8.6.4 beginning activities, no service 8.1.3 8.5.3 8.6.5 delivery. 8.1.4 8.5.4 8.6.6 8.1.5 8.5.5 8.6.7 8.5.6 8.6.83.1.1a 3.4.1 4.1.1 4.5.1 5.3.1 5.7 6.2.2 6.7.1 8.1.7 2. Policy/Environment3.1.1b 3.5.1 4.1.2 4.5.2 5.3.3 6.7.2 Enhancement:3.1.1c 5.3.4 5.8 6.5 6.7.3 8.9 Easy policy changes or logical3.1.2 4.2.1 5.3.6 6.5.1 continuations of the above. Sets up3.1.3 4.2.2 6.5.2 8.10.13.1.4 4.2.3 6.5.3 service delivery.3.2.1 4.1.3 4.4.1 5.4.1 5.9.1 5.10 6.3.1 6.4 7.1 7.4 8.7.1 3. Beginning Service Delivery:3.3.11 4.4.2 5.4.2 6.3.2 7.1.1 7.4.1 Information and awareness building 4.2.4 4.4.3 5.4.4 5.11 6.3.4 6.8 7.1.3 7.4.4 8.8.1 activities, relatively inexpensive3.3.1 4.4.4 5.4.5 5.11.1 6.3.6 programming. 4.3.1 4.4.6 5.4.9 5.11.2 6.3.10 7.6.1 8.123.3.4 4.3.2 4.4.103.3.6 4.3.4 4.3.6 4.6.1 4.3.103.3.2 3.3.9 4.3.3 4.4.5 5.4.3 5.5 5.6 6.1.1 6.3.3 7.1.2 7.2 7.3 8.3 8.7.2 4. Advanced Service Delivery:3.3.3 3.3.10 4.3.5 4.4.7 5.4.6 5.5.1 5.6.1 6.1.2 6.3.5 7.1.4 7.2.1 7.3.1 8.7.4 More expensive and intrusive than the3.3.5 3.3.12 4.3.7 4.4.8 5.4.7 5.5.2 5.6.2 6.1.3 6.3.7 7.1.5 7.2.2 7.3.2 8.4 above, broadened service delivery.3.3.7 4.3.8 4.4.9 5.4.8 5.5.3 5.6.3 6.1.4 6.3.8 7.2.3 7.3.3 8.4.1 8.8.23.3.8 4.3.9 4.4.11 5.4.10 5.5.4 5.6.4 6.3.9 7.4.2 7.2.4 7.3.4 8.4.2 8.8.33.3.9 4.3.11 5.5.5 5.6.5 6.2.1 6.3.11 7.4.3 7.2.5 7.3.5 8.4.33.3.8 5.6.63.3.9 5.6.73.2.2 5.1 5.2 5.3.2 6.6 7.5 8.1.6 8.7.3 813.1 5. Institutionalization: 5.1.1 5.2.1 5.3.5 6.6.1 7.5.1 8.13.2 Advanced policy development, 5.1.2 5.2.2 6.6.2 7.5.2 8.5.1 8.10.2 8.13.3 relatively expensive, high capital 5.1.3 5.2.3 6.6.3 7.5.3 8.5.2 costs, long term cultural change. 5.1.4 5.2.4 5.9.2 6.6.4 5.2.5 8.6.2 5.2.6
    • THE HEART CHECK HEALTH PROMOTION MATRIX November 2006Organizational Foundations: This section describes compensation and human resource management elements that indirectly support employee health. Although veryimportant, they are not usually under the auspices of the health promotion agenda and are therefore listed separately.9.1.1, 9.1.2, 9.1.3, 9.2.1, 9.2.2, 9.2.3, 9.3.1, 9.3.2, 9.4.1, 9.4.2, 9.5.1, 9.6.1, 9.7.1, 9.7.2, 9.7.3, 9.7.4, 9.8.1, 9.8.2Smoking Nutrition Physical Activity Stress Screening Administrative Implementation Level Support 8.1 8.2 8.6.1 8.11.1 1. Start-up: 8.1.1 8.6.3 8.11.2 Structural development, “must do” 8.1.2 8.5 8.6.4 beginning activities, no service 8.1.3 8.5.3 8.6.5 delivery. 8.1.4 8.5.4 8.6.6 8.1.5 8.5.5 8.6.7 8.5.6 8.6.83.1.1a 3.4.1 4.1.1 4.5.1 5.3.1 5.7 6.2.2 6.7.1 8.1.7 2. Policy/Environment3.1.1b 3.5.1 4.1.2 4.5.2 5.3.3 6.7.2 Enhancement:3.1.1c 5.3.4 5.8 6.5 6.7.3 8.9 Easy policy changes or logical3.1.2 4.2.1 5.3.6 6.5.1 continuations of the above. Sets up3.1.3 4.2.2 6.5.2 8.10.13.1.4 4.2.3 6.5.3 service delivery.3.2.1 3.3.11 4.1.3 4.4.1 5.4.1 5.9.1 5.10 6.3.1 6.4 7.1 7.4 8.7.1 3. Beginning Service Delivery: 4.4.2 5.4.2 6.3.2 7.1.1 7.4.1 Information and awareness building3.3.1 4.2.4 4.4.3 5.4.4 5.11 6.3.4 6.8 7.1.3 7.4.4 8.8.1 activities, relatively inexpensive 4.4.4 5.4.5 5.11.1 6.3.6 programming.3.34 4.3.1 4.4.6 5.4.9 5.11.2 6.3.10 7.6.1 8.123.36 4.3.2 4.4.10 4.3.4 4.3.6 4.6.1 4.3.103.3.2 3.3.9 4.3.3 4.4.5 5.4.3 5.5 5.6 6.1.1 6.3.3 7.1.2 7.2 7.3 8.3 8.7.2 4. Advanced Service Delivery:3.3.3 3.3.10 4.3.5 4.4.7 5.4.6 5.5.1 5.6.1 6.1.2 6.3.5 7.1.4 7.2.1 7.3.1 8.7.4 More expensive and intrusive than the3.3.5 3.3.12 4.3.7 4.4.8 5.4.7 5.5.2 5.6.2 6.1.3 6.3.7 7.1.5 7.2.2 7.3.2 8.4 above, broadened service delivery.3.3.7 4.3.8 4.4.9 5.4.8 5.5.3 5.6.3 6.1.4 6.3.8 7.2.3 7.3.3 8.4.1 8.8.23.3.8 4.3.9 4.4.11 5.4.10 5.5.4 5.6.4 6.3.9 7.4.2 7.2.4 7.3.4 8.4.2 8.8.3 4.3.11 5.5.5 5.6.5 6.2.1 6.3.11 7.4.3 7.2.5 7.3.5 8.4.3 5.6.6 5.6.73.2.2 5.1 5.2 5.3.2 6.6 7.5 8.1.6 8.7.3 813.1 5. Institutionalization: 5.1.1 5.2.1 5.3.5 6.6.1 7.5.1 8.13.2 Advanced policy development, 5.1.2 5.2.2 6.6.2 7.5.2 8.5.1 8.10.2 8.13.3 relatively expensive, high capital 5.1.3 5.2.3 6.6.3 7.5.3 8.5.2 costs, long term cultural change. 5.1.4 5.2.4 5.9.2 6.6.4 5.2.5 8.6.2 5.2.6
    • Risk 2005 2007 DifferenceSafety Belt Use 9.0% 5.4% -3.6%*Medication for Relaxation 27.1% 23.9% -3.2%Physical Inactivity 18.5% 15.9% -2.6%Smoking 9.8% 7.6% -2.2%Illness Days 30.1% 28.3% -1.8%Life Dissatisfaction 25.2% 23.9% -1.3%Perceived Health 17.6% 16.60% -1.0%Health Age Index 1.9% 0.9% -1.0%Disease 13.9% 13.1% -0.8%Alcohol 2.0% 1.3% -0.7%**Also a significant decrease in recorded absenteeism.
    •  Organizational health support (OHS) can be measured reliably and accurately. Relationships exist between OHS measures and employee health risks, health culture, absenteeism, and selected health care costs. OHS can be improved relatively easily and cost effectively. Employee health risk profiles stabilize with organization-focused intervention. Most OHS variables remain following intervention. OHS tools can be integrated within a comprehensive worksite health promotion intervention
    • Contextual Work Features (Organizational Leadership, industry type,) (management style, profitability, etc.) Worksite Worksite Structure CultureGolaszewski et al. (2008). Working Together to Create Supportive Environments in Worksite Health Promotion, The Art of Health Promotion.
    • Recommendations… Develop new tools based on the latest standards of excellence in WHP Consider alternate item construction Add organizational health culture Refine automated systems accessible on the Internet Develop detailed summary reports Golaszewski, in:Pronk (Ed.). 2009. ACSM’s Worksite Health Handbook.
    •  An assessment process of the workplace’s HEALTH ENVIRONMENT that supports employee health. Online capability 3 dimensions, 9 sections, 47 constructs and 227 items (variable weights) Within dimension/section/construct scoring And more…
    • 3. MedicalManagement 2. RiskManagement1. Foundations
    • Medical Management Psychosocial Tobacco Control Nutrition Physical Activity Screening Culture Change CommitmentHuman Resources Management
    •  Assessment Awareness Services Structural Supports Policy Supports
    •  To the online HEcheck…
    •  Expand research activity at the company-level Establish norms for geographic region, health plan groups, industry type, or other company demographic Link organizational rewards to high scoring companies, e.g., provide award recognitions, premium discounts or rate “lock ins”