Learning & Discomfort
“The truth is that our finest moments are most likely to
occur when we are feeling deeply uncomforta...
EVIDENCE BELIEF
Worksite Wellness
At a Crossroads
Evidence vs. Belief
EVIDENCE BELIEF
Worksite Wellness
At a Crossroads
How successful do we want to be ?
How seriously do we want to be taken?
WHAT
IF?
Lots of:
• Questions
• Research
• Resources
What If…
17th Century Science
• Mechanistic
• Reductionist
• Dualistic
• Patriarchal
whole = the sum of its parts
analysis = to bre...
17th Century Science
The Purpose of Science:
“to torture nature’s secrets from her so
she can be forced out of her natural...
17th Century Science
" Man is more courageous, pugnacious,
and energetic than woman,
and has more inventive genius."
Patri...
“Congressional Birth Control Hearing Involves Exactly Zero People
Who Have a Uterus”
17th Century Science: Organizations
• “Scientific Management:” Control the
Machine
―Human nature to “goof off”
―Job tasks ...
Patriarchy Still Alive & Well in Organizations
• Gender Biases
• Success = Masculine Traits:
―Money
―Power
“Stuck”- The Old Paradigm
Worldview — Mechanistic
Science — Reductionist
(Whole = sum of its parts)
Culture — Control orie...
“Stuck”- Worksite Wellness
• Reduce and analyze
• Measure and quantify
• Scare, cajole, pressure, persuade
• Behavior modi...
What If…
Roots of the Biomedical Model
“I consider the body as a machine ...my
thought...compares a sick man and an
ill-made clock ...
" There is nothing included in the
concept of the body that belongs to
the mind; and nothing in that of the
mind that belo...
Traditional Worksite Wellness
“I believe you have to address the things that matter most
– and those core programs will be...
Traditional Worksite Wellness
• Health Risk Assessments
• Biometric Screens
• Weight Loss / Nutrition
• Exercise
• Smoking...
What If…
Why We Do What We Do
Autonomy & Authenticity:
• Actions come from true sense
of self
Control & Alienation:
• Actions come ...
Extrinsic Motivation
• Does not produce long-term behavior change
• Diminishes performance
• Diminishes creativity
• Foste...
Realities of Motivation
1995 2009 20101993
Incentives ??
Curry, Wagner., J.Consult Clin Psych. 1991;59(2):318-323)
Windsor, 1988, J.Behav.Medicine;11:407-21
Matson e...
Trapped 17th-20th Century
“Words are the most
powerful drug used by mankind”
• How do we manage human resources?
• How can...
What If…
Participation & Engagement
• Participation - the act of taking part in something
• Engagement - how employees feel about t...
• Incentives increase participation
• Claim improved engagement
Bribing employees to participate may increase the numbers ...
The Penn State Fiasco (2013)
Fiasco
“a thing that is a complete
failure,
especially in a ludicrous or
humiliating way.”
What If…
The “Safeway Amendment”
“Safeway figured out how to incentivize
people to take better care of themselves, and
they have fl...
“Safeway designed such a plan in 2005 and
has made continuous improvement each
year. The results have been remarkable, our...
The “Safeway Amendment”
“You know, there’s a guy who has
become pretty famous lately, and he’s
the CEO of Safeway… Safeway...
The “Safeway Amendment”
“It’s a program that has helped Safeway cut
health-care spending by 13 percent and workers
save ov...
David S. Hilzenrath, Washington Post
“Misleading claims about Safeway wellness incentives
shape health-care bill”
Washingt...
The “Safeway Fiasco”
The Reality
• Costs declined by 12.5 % in 2006
• Program was not implemented until 2009
—(only 28,000...
What If…
The “Safeway Amendment”
The Reality
“Although it may seem obvious that charging higher premiums for smoking
(body mass ind...
The “Safeway Amendment”
The Reality
“We also have a pretty good idea of what doesn’t work, and
heading the list are strate...
WELLNESS OR ELSE !
By 2016 the % of employers who will punish
employees for not participating in their workplace
wellness ...
WELLNESS OR ELSE !
Health professionals of all persuasions
Punishing employees who don’t comply:
• Something you believe i...
WELLNESS OR ELSE !
CEO’s, managers, HR, benefits professionals
Punishing employees who don’t comply:
• Likely to improve e...
The “New” Sciences
• Quantum Physics
• Chaos and Complexity
• Psychoneuroimmunology
• Neuroscience
Getting “Unstuck”
Quantum Physics
• Key Learning:
- Universe bears little resemblance to a machine
- Vast interconnected living web
- Parts ...
Complex Systems: Nonlinear Causality
• Small changes in a variable can produce huge outcomes
• Everything effects everythi...
Complex Systems: Nonlinear Causality
• Cannot know all initial conditions exactly
• Small errors grow exponentially over t...
Chaos & Complexity
Chaos & Complexity
Psychoneuroimmunology (PNI)
• Matter & spirit are not separate
• Thoughts feelings, and emotions
powerfully influence our ...
Neuroscience
Prefrontal
Cortex Basal
Ganglia
Limbic
System
Nucleus
Accumbens
“Unstuck”- The New Paradigm
Worldview — Organic-Living
Science — Holistic
(Whole > sum of its parts)
Culture — Relationshi...
Organizational Wellbeing
• Organizational Health Defined:
”An organization is healthy when it is whole, consistent, and
co...
Employee Wellbeing
5 Universal, Interconnected Elements:
• Career Wellbeing
• Social Wellbeing
• Financial Wellbeing
• Phy...
The 7 Points of Transformation
TP #1: Survey the Land
• Reality Check of Current State:
―Organizational Wellbeing Data
―Employee Wellbeing Data
• Dynamic...
TP #2: Create the Blueprint
• Beginning the Journey…
―Strategic Thinking > Strategic Planning
―Include EVERYONE!
―Telling ...
TP #3: Pour the Foundation
Framework for Developing Quality Leaders:
1. Enhancing Self-Awareness
2. Building Effective Thi...
TP #4: Frame the House
• Create a Supportive Climate:
―Leaders Intentionally Living Values & Desired
Culture
―Clear Purpos...
TP #5: Wire the House
• Rethinking Change - 2 Types of Challenges:
Technical
Adaptive
Ronald A. Heifetz & Donald L. Laurie...
TP #6: Decorate the House
• Are Your Programs…
―Addressing the issues that have the greatest
impact on employee well-being...
TP #7: Maintain the House
• Continuous Quality Improvement
―Meaningful Evaluation
―Engagement > Participation
―Course Corr...
Final Thoughts…
It’s a JOURNEY, not a destination!
Our Recommendations
1) Read outside of your profession:
• Not just trade journals and vendor research
• PNI, quantum physi...
Our Recommendations
2) Make sure what you are doing is evidence based:
• Can’t do that effectively without spending consid...
Our Recommendations
3) Please keep this in mind:
The only way to achieve the goal of having employees act
like creative, t...
How To Build A Thriving Culture at Work
• Rosie and Jon
• One-Day Workshop
• Tampa, Florida
• February 10th or 11th – 2015...
How To Build a Thriving Culture at Work: What's Science Got To Do With It?
How To Build a Thriving Culture at Work: What's Science Got To Do With It?
How To Build a Thriving Culture at Work: What's Science Got To Do With It?
How To Build a Thriving Culture at Work: What's Science Got To Do With It?
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How To Build a Thriving Culture at Work: What's Science Got To Do With It?

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How To Build a Thriving Culture at Work: What's Science Got To Do With It?

  1. 1. Learning & Discomfort “The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable… For it is only in such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers.” M. Scott Peck
  2. 2. EVIDENCE BELIEF Worksite Wellness At a Crossroads
  3. 3. Evidence vs. Belief
  4. 4. EVIDENCE BELIEF Worksite Wellness At a Crossroads How successful do we want to be ? How seriously do we want to be taken?
  5. 5. WHAT IF? Lots of: • Questions • Research • Resources
  6. 6. What If…
  7. 7. 17th Century Science • Mechanistic • Reductionist • Dualistic • Patriarchal whole = the sum of its parts analysis = to break down matter & spirit separate aggression, competition and control
  8. 8. 17th Century Science The Purpose of Science: “to torture nature’s secrets from her so she can be forced out of her natural state and squeezed and molded.” ~ Sir Francis Bacon Patriarchy
  9. 9. 17th Century Science " Man is more courageous, pugnacious, and energetic than woman, and has more inventive genius." Patriarchy ~ Charles Darwin
  10. 10. “Congressional Birth Control Hearing Involves Exactly Zero People Who Have a Uterus”
  11. 11. 17th Century Science: Organizations • “Scientific Management:” Control the Machine ―Human nature to “goof off” ―Job tasks broken down to component parts ―Pay for production ―Micro-managing
  12. 12. Patriarchy Still Alive & Well in Organizations • Gender Biases • Success = Masculine Traits: ―Money ―Power
  13. 13. “Stuck”- The Old Paradigm Worldview — Mechanistic Science — Reductionist (Whole = sum of its parts) Culture — Control oriented (hierarchy, patriarchal) Health — Biomedical (fix the machine) Traditional Approaches to Change Extrinsic (controlled) Motivation Outdated Outdated
  14. 14. “Stuck”- Worksite Wellness • Reduce and analyze • Measure and quantify • Scare, cajole, pressure, persuade • Behavior modification • “Get” people to change  Fear }Risk Factors }Control
  15. 15. What If…
  16. 16. Roots of the Biomedical Model “I consider the body as a machine ...my thought...compares a sick man and an ill-made clock with my idea of healthy man and a well-made clock " ~Renes Descartes
  17. 17. " There is nothing included in the concept of the body that belongs to the mind; and nothing in that of the mind that belongs to the body " ~ Renes Descartes Roots of the Biomedical Model
  18. 18. Traditional Worksite Wellness “I believe you have to address the things that matter most – and those core programs will be pretty much the same from worksite to worksite. These include physical activity, proper nutrition and preventive screening…” Aaron Hardy, The Power Of Incentive Campaigns, WELCOA Absolute Advantage, 2008
  19. 19. Traditional Worksite Wellness • Health Risk Assessments • Biometric Screens • Weight Loss / Nutrition • Exercise • Smoking Cessation • Stress Management
  20. 20. What If…
  21. 21. Why We Do What We Do Autonomy & Authenticity: • Actions come from true sense of self Control & Alienation: • Actions come from being pressured • Acting without sense of personal endorsement • Behavior isn’t expression of self Source: Deci, E. (1995). Why We Do What We Do: Understanding Self-Motivation
  22. 22. Extrinsic Motivation • Does not produce long-term behavior change • Diminishes performance • Diminishes creativity • Fosters short-term thinking • Encourages cheating, lying, shortcuts, etc. • Becomes habit forming • Reduces or extinguishes intrinsic motivation
  23. 23. Realities of Motivation 1995 2009 20101993
  24. 24. Incentives ?? Curry, Wagner., J.Consult Clin Psych. 1991;59(2):318-323) Windsor, 1988, J.Behav.Medicine;11:407-21 Matson et al., AJHP 1993;7(4):270-80, 295 Koffman DM , et al., AJHP 1998;13:105-111 Redmond et al., Center on Budget and Priority Policies, June 2007 Cochrane Database of Reviews,Cahill & Perera, 2008, Issue 3 Kevin Volpp et al., Randomized Controlled Trial of Financial Incentives, JAMA 2009;360:699-709 Kramer et al., Behavior Therapy 1986:295-301 Obesity Reviews 2007;9, 355-367 Volpp, Financial Incentive-Based Approaches for Weight Loss, JAMA 2008;300, 2631 Geller, Rudd, et. al. Journal of Safety Research 1987;18:1-17. Gingerich SB, et al. Impact of financial incentives on behavior change participation and risk reduction in worksite health promotion, American Journal of Health Promotion 2012;27(2) 25 years of workplace research: Top 13 Reasons Not To Use Incentives Competitions & Incentives for Smoking Cessation, Kate Cahill and Rafael Perera - April, 2011
  25. 25. Trapped 17th-20th Century “Words are the most powerful drug used by mankind” • How do we manage human resources? • How can we “maximize” human capital? • What’s best way to “drive” participation? • How do we “get people” to change? Rudyard Kipling
  26. 26. What If…
  27. 27. Participation & Engagement • Participation - the act of taking part in something • Engagement - how employees feel about their work Engaged employees are committed to and excited about their work and willing to go the extra mile to make a difference
  28. 28. • Incentives increase participation • Claim improved engagement Bribing employees to participate may increase the numbers who do. But it says nothing about how they feel about their work. Participation, Engagement and Incentives
  29. 29. The Penn State Fiasco (2013) Fiasco “a thing that is a complete failure, especially in a ludicrous or humiliating way.”
  30. 30. What If…
  31. 31. The “Safeway Amendment” “Safeway figured out how to incentivize people to take better care of themselves, and they have flat-lined their health care costs for 200,000 employees in the last four years.” The Rhetoric Sen. Thomas R. Carper, Democrat, Delaware, Senate Finance Committee, September, 2009
  32. 32. “Safeway designed such a plan in 2005 and has made continuous improvement each year. The results have been remarkable, our health care costs for four years have been held constant.” The Rhetoric Steven A Burd, Safeway CEO, Wall Street Journal, June 12, 2009 The “Safeway Amendment”
  33. 33. The “Safeway Amendment” “You know, there’s a guy who has become pretty famous lately, and he’s the CEO of Safeway… Safeway’s health- care costs have gone down. Why can’t we adopt that on a national scale.” The Rhetoric Sen. John McCain, Republican, Arizona, Town Hall Meeting, August, 2009
  34. 34. The “Safeway Amendment” “It’s a program that has helped Safeway cut health-care spending by 13 percent and workers save over 20 percent on their premiums... And we’re open to help employers adopt and expand programs like these.” The Rhetoric President Barack Obama – June – American Medical Association speech
  35. 35. David S. Hilzenrath, Washington Post “Misleading claims about Safeway wellness incentives shape health-care bill” Washington Post: Sunday, January 17, 2010
  36. 36. The “Safeway Fiasco” The Reality • Costs declined by 12.5 % in 2006 • Program was not implemented until 2009 —(only 28,000 out of 200,000 employees) • 1st year of the program costs rose steeply • http://ilovebenefits.healthcarebenefitsnetwork.com/?p=3284
  37. 37. What If…
  38. 38. The “Safeway Amendment” The Reality “Although it may seem obvious that charging higher premiums for smoking (body mass index, cholesterol, or blood pressure) would encourage people to modify their habits to lower their premiums, evidence that differential premiums change health-related behavior is scant. Indeed, we’re unaware of any insurance data that convincingly demonstrate such effects.” Volpp, et. Al, Redesigning Employee Health Incentives, NEJM 2011;365:388-390
  39. 39. The “Safeway Amendment” The Reality “We also have a pretty good idea of what doesn’t work, and heading the list are strategies that tie individual employees’ share of health insurance premiums to health-related behaviors and/or meeting benchmarks.” Workplace wellness regulations: First do no harm. The Prevention Institute, The Greenlining Institute, 2013
  40. 40. WELLNESS OR ELSE ! By 2016 the % of employers who will punish employees for not participating in their workplace wellness program is expected to triple. • Now - 22% • End of 2013 - 36% • By 2016 – 61% 2013 Staying @Work Report from Towers Watson & Company ??
  41. 41. WELLNESS OR ELSE ! Health professionals of all persuasions Punishing employees who don’t comply: • Something you believe in? • What you went into your field to do? • Something that will improve their “wellness”? Or have we really lost our way?
  42. 42. WELLNESS OR ELSE ! CEO’s, managers, HR, benefits professionals Punishing employees who don’t comply: • Likely to improve engagement? • Help employees want to bring their best selves to work each day? • Enhance employee “wellness”? Or have we really lost our way?
  43. 43. The “New” Sciences • Quantum Physics • Chaos and Complexity • Psychoneuroimmunology • Neuroscience Getting “Unstuck”
  44. 44. Quantum Physics • Key Learning: - Universe bears little resemblance to a machine - Vast interconnected living web - Parts exist as both matter and energy at the same time - Universe made up of relationship not things - Parts are difficult to quantify without knowing their relationship to each other and the whole - Whole can be misunderstood by focusing on the parts
  45. 45. Complex Systems: Nonlinear Causality • Small changes in a variable can produce huge outcomes • Everything effects everything • “The Butterfly Effect” Chaos & Complexity 0.506 0.506127
  46. 46. Complex Systems: Nonlinear Causality • Cannot know all initial conditions exactly • Small errors grow exponentially over time • Limits ability to predict the future • Most living systems are complex • Includes human behavior Chaos & Complexity 0.506127 0.506
  47. 47. Chaos & Complexity
  48. 48. Chaos & Complexity
  49. 49. Psychoneuroimmunology (PNI) • Matter & spirit are not separate • Thoughts feelings, and emotions powerfully influence our health • Psycho • Neuro • Immuno Mind, Body, Spirit Science
  50. 50. Neuroscience Prefrontal Cortex Basal Ganglia Limbic System Nucleus Accumbens
  51. 51. “Unstuck”- The New Paradigm Worldview — Organic-Living Science — Holistic (Whole > sum of its parts) Culture — Relationship-oriented (equalitarian) Health — Bio-psycho-social-spiritual (holistic, ecological) Re-Thinking Approaches to Change Intrinsic (autonomous) Motivation
  52. 52. Organizational Wellbeing • Organizational Health Defined: ”An organization is healthy when it is whole, consistent, and complete, that is, when its management, operations, strategy and culture fit together and make sense.” ―Minimal Politics ―Minimal Confusion ―High Morale ―High Productivity ―Low Turnover Source: Patrick Lencioni, The Advantage (2012)
  53. 53. Employee Wellbeing 5 Universal, Interconnected Elements: • Career Wellbeing • Social Wellbeing • Financial Wellbeing • Physical Wellbeing ―Emotional Wellbeing • Community Wellbeing
  54. 54. The 7 Points of Transformation
  55. 55. TP #1: Survey the Land • Reality Check of Current State: ―Organizational Wellbeing Data ―Employee Wellbeing Data • Dynamic Complexity / Holistic View
  56. 56. TP #2: Create the Blueprint • Beginning the Journey… ―Strategic Thinking > Strategic Planning ―Include EVERYONE! ―Telling Your Wellbeing Story
  57. 57. TP #3: Pour the Foundation Framework for Developing Quality Leaders: 1. Enhancing Self-Awareness 2. Building Effective Thinking Skills 3. Developing & Fostering Quality Relationships so Others Can Grow 4. Growing the Organization
  58. 58. TP #4: Frame the House • Create a Supportive Climate: ―Leaders Intentionally Living Values & Desired Culture ―Clear Purpose & Direction for Culture Change ―Communication ―Wellbeing = Platform for Employee Experience
  59. 59. TP #5: Wire the House • Rethinking Change - 2 Types of Challenges: Technical Adaptive Ronald A. Heifetz & Donald L. Laurie (December 2001). The Work of Leadership. Harvard Business Review, p. 131-141
  60. 60. TP #6: Decorate the House • Are Your Programs… ―Addressing the issues that have the greatest impact on employee well-being? ―Addressing the issues that have the greatest impact on organizational health? ―Promoting engagement? …or Inhibiting it? ―Evidence and experience based?
  61. 61. TP #7: Maintain the House • Continuous Quality Improvement ―Meaningful Evaluation ―Engagement > Participation ―Course Corrections
  62. 62. Final Thoughts… It’s a JOURNEY, not a destination!
  63. 63. Our Recommendations 1) Read outside of your profession: • Not just trade journals and vendor research • PNI, quantum physics, chaos and complexity, neuroscience, motivation • Leadership and “culture” – not “wellness” culture but real organizational culture. • Research design and statistics
  64. 64. Our Recommendations 2) Make sure what you are doing is evidence based: • Can’t do that effectively without spending considerable time doing #1. • Lack of evidence of efficacy = proceed with great caution. • Evidence of lack of efficacy = don’t proceed at all.
  65. 65. Our Recommendations 3) Please keep this in mind: The only way to achieve the goal of having employees act like creative, thinking, responsible, autonomous adults is to treat them as if that is exactly what they are.
  66. 66. How To Build A Thriving Culture at Work • Rosie and Jon • One-Day Workshop • Tampa, Florida • February 10th or 11th – 2015 • More information to follow – SOON ! Featuring: The 7 Points of Transformation
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