Implementing HealthLead- The CDC Experience with Cpt. Tina Lankford
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CDC will provide an overview of their WorkLife Wellness Office services and describe how they used the HealthLead accreditation process to provide a framework to assess the comprehensiveness of their new office and existing programs and processes. Also, how the scoring of framework identified strengths and weaknesses and how the assessment plan of action is used for future strategic planning to drive new connections, data sources, and programmatic gaps as they strive to achieve HealthLead Silver. CDC will share specific examples of what was required and shared as part of the HealthLead audit during the presentation.
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Implementing HealthLead- The CDC Experience with Cpt. Tina Lankford
- 1. Implementing HealthLead-The CDC Experience November 2015 Tina Lankford, MPH WorkLife Wellness Office Director CDC
- 2. Objectives • Provide CDC overview • Describe the HealthLead domains and example CDC responses • Provide lessons learned and next steps for CDC as a result of the HealthLead process • Invite participants to HealthLead Forum to hear case studies and other experts in the field of workplace wellness!
- 3. CDC Profile • Founded in 1946 • Headquartered in Atlanta, Georgia • Fitness Program began 1978 • Lifestyle program began in 1996 • WorkLife Wellness Office began in 2013 • Over 10,000 employees (19,000 including contractors) in nearly 170 occupations • 62% female • 59% Cauc, 29% AA, 9% Asian, 3% Hispanic • Field staff assigned to all 50 states and more than 50 countries
- 5. Health Promotion/ Awareness Promotion of National Health Observances: Heart month, National Nutrition Month, Fitness month, Smoke- out, Men’s Health Campaigns and Challenges Health Days/Know Your Numbers/ Biometric Screening, (Cholesterol, Glucose, Triglycerides, Blood Pressure) Healthiest CIO Challenge Health Education Seminars and Courses Physical Activity Nutrition and healthy eating Stress Management Clinical Prevention Seminars (Diabetes, Hypertension) Basic Life Support/AED and First Aid Behavioral Health and Resilience Individual and Group Support Employee Assistance Program Deployment Resilience training Support groups and referrals Peer support Coaching and Counseling Campus Supports for Wellness • Active Environments Campus amenities to support active lifestyles through fitness centers, walking routes (indoor and outdoor), and healthy stairwells. • Food Environments Management, direction, and guidance in provision of healthy food offerings in cafeterias, cafes, vending, farmers’ markets, and meetings WorkLife Wellness Office Services Provide health promotion programs and educational seminars to improve health of the CDC workforce. Design and promote health-enhancing campus amenities, policies, systems, and social supports for workplace environments. Provide consultation for behavioral and emotional well-being for workplace relations and pre or post-deployment support.
- 6. WorkLife Wellness Office Staff
- 7. ASSESSMENT AND VISION • Started with a comprehensive view using environmental, individual, and organizational assessment tools. • Create a strategic plan with leadership. • Establish data collection needs and outcomes to monitor. http://www.cdc.gov/nationalhealthyworksite/index.html
- 8. Overview of HeathLead Domains • Organizational Engagement and Alignment • Population Health Management and Well-Being • Outcomes Reporting For more information about HealthLead Accreditation, visit: http://www.ushealthiest.org/
- 9. HealthLead Components of Organizational Engagement and Alignment • Business Alignment • Leadership Support and Alignment • Data Management Alignment • Employee Benefits Alignment • Policy Alignment • Environmental Alignment • Communications Alignment • Administrative and Operations Alignment
- 10. Business Alignment CDC’s OCOO invests in Healthy Organizations • Training and workforce development • Direct support of Wellness Amenities • Management/Leadership Performance Organizational Engagement and Alignment
- 11. Organizational Engagement and Alignment
- 12. Policy Alignment Wellness-supportive policy/protocol examples: • Wellness policy • Workplace Violence Prevention (Anti-bullying inclusion) • Alternative work schedules/Telework policy • Dietary guidelines implementation (cafeteria/vending) • Tobacco-Free Policy • Healthy meetings guidance • Alternative commute options/Fare share • Disability Program and Reasonable Accommodation Organizational Engagement and Alignment
- 13. Leadership/Agency Support CDC Provides Wellness Recognition/Promotion • Agency Award Category “Excellence in Workforce Wellness” • CDC Health Days • Healthiest CIO Challenge and Culture Challenge “I would like us to be not only the greatest health organization in the world, but the healthiest one.” Dr. Frieden. Organizational Engagement and Alignment
- 14. Communications Alignment Organizational Engagement and Alignment
- 15. Liaisons-We Win Together Liaisons bring to co-workers: – Direct information and data on wellness initiatives across CDC – Automatic trust as their communicator is respected and one of their peers. – Instant peer contact and foundation for peer group support structure for buddy systems or group consults. – Connection point between WWO and Center management and Workforce Devpt Committees – Increase in awareness and accessibility to WWO programs (and OSSAM). Wellness Office receives: – Relevance to program staff – Meaningful feedback from program (barriers, needs, achievements, testimonials) – Connection between CIO’s/programs and WWO as well as OSSAM in general (safety, facility, and sustainability issues are typically part of discussion) 15 Organizational Engagement and Alignment
- 16. Challenge yourself to a healthy lifestyle! Be sure to take your health assessment at: https://HealthDayCheck.com Communications- On the Ground Organizational Engagement and Alignment
- 17. HealthLead Components of Population Health Management and Well-Being • Primary Prevention and Health Maintenance • Risk Factor Intervention/Modification • Decision Support and Medical Management • Well-Being Information and Support Services • Community Engagement • Work Safety
- 18. Primary Prevention/Health Maintenance Increase peer support/connectedness • Support groups- eldercare, parenting, • Clubs- weight watchers, walking clubs • Intramural sports- kickball, volleyball, softball, soccer Population Health Management and Well-Being
- 19. Risk Identification/Reduction Onsite biometrics • Increase awareness • Blood Pressure, Cholesterol, Glucose • Interpretation/Feedback • Resources and Referral Population Health Management and Well-Being
- 20. Decision Support/Disease Management Disease management/referral efforts: • Consultation/referral to primary care provider. • Partner with Benefits office to share information on coverages and help increase their visibility in the workplace. • Deliver programs that are available via citgo for teleworkers and potentially families as well as recorded archives. • Peer support groups (ADHD, Eldercare) • Health Coaches Population Health Management and Well-Being
- 21. HealthLead Components of Outcomes Reporting • Process Outcomes • Risk Factor/Clinical Outcomes • Financial Outcomes • Optional Financial Outcomes
- 22. Data Collection Data collection to support wellness: • Health assessments • Participation/Engagement • Biometric data • Employee perspective survey • Environmental audits (core wellness supports) • Process data (hotwashes) • Health data (carriers) • Climate data/Culture • Absenteeism • Medical costs • Worker’s Comp data Outcomes Reporting
- 23. Outcomes Reporting Outcomes on infrastructure program goals: 2012 2013 2014 Change Overall Reach 13,987 14,907 17,557 26% Health Scorecard N/A 217/264 (82%) 267/286 (93%) 11pts Liaisons N/A 66% 10/15 86% 13/15 20pts
- 24. Outcomes Reporting 62% 37% 32% 16% 5% 5% 65% 41% 30% 16% 5% 4% 0% 10% 20% 30% 40% 50% 60% 70% Telework Health/Wellness Programs Alt. Work Schedules Employee Assistance Program Childcare Programs Elder Care Programs Percent EVS 2013 and 2014 Employee Participation in Work/Life Programs CDC 2013 (n=6004-6289) CDC 2014 (n=6238-6562)
- 25. Challenge Participation 48.58% 32.58% 22.08% 10.22% 12.59% 26.32% 43.81% 9.11% 22.10% 21.23% 22.61% 12.68% 7.15% 3.34% 16.35% 59.42% 42.15% 24.01% 26.46% 22.19% 21.92% 15.48% 34.00% 26.18% 32.57% 17.46% 24.97% 23.04% 7.16% 6.67% 22.04% 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% OSTLTS NCHS NCBDDD NCIPC CSELS OD(allexceptOCOO) OPHPR NCCDPHP NCHHSTP NCEH/ATSDR NCIRD NCEZID OCOO CGH NIOSH CDCTotal Small CIO Medium CIO Large CIO Healthiest CIO Challenge Participation % Signed Up (2013) n=23012 % Signed Up (2014) n=19022
- 26. CDC Overall -Biometric Screenings 41% 26% 15% 31% 15% 15% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% High TC >200 High GLU >110 High Ratio >3.0 PercentAboveRecommendedRange Total Cholesterol, Glucose and LDL/HDL Ratio higher than recommended (limits given) 2013 2014
- 27. Next Steps Future action planning: • Data integration • Annual report of health status • Increase connection between employees and health benefits • Business case for productivity/performance • Return-to-work • Continue primary prevention efforts
- 28. Lessons Learned Process was valuable for understanding: • Our degree of comprehensiveness--validating to confirm we are very comprehensive, but also it identified how we can improve for increased impact. • Importance of organizational alignment and business alignment. • Additional related data sources (MISO, HR-hiring, benefits/enrollment, medical). • Program alignment strategy to follow data and organizational goals.
- 29. WorkLife Wellness Office: Road to Silver
- 31. HealthLead Forum January 14th -15th, 2016 Co-Sponsored by USHealthiest and CDC To register visit: https://healthleadforum2016.eventbrite.com • Keynotes by Dee Edington, Ray Fabius, and Doug Stover! • Attendees are Wellness Professionals from all sectors. • Networking Lunch • Meet representatives from AHA, ACSM, ACE, HERO, CEO Cancer Gold, Gallup, NIOSH, and more!
Editor's Notes
- Introduction, looking forward to share with you the CDC experience in going through the Health Lead accreditation. You are familiar with CDC as providing resources and training that occurs out of any of our 15 Centers, Instittues, and Offices My role at CDC is internaly-facing to ensure that we provide resources to our own staff who are very diverse and come from a multitude of backgrounds. In 2013 there was a reorganization in the Office of the Director which created this new WorkLife wellness office. While wellness related services took place in various places across the agency (fitness center contract, eap, health benefits, etc) there was not a central focal point for broader wellness programming and evaluation of internal efforts. As a new office, we used the HealthLead process to give us an idea of where we were in our programming as a sort of baseline. The process provided us two things---1) that CDC did offer a comprehensive set of services to the employees and 2) gaps were identified for us to work on towards drawing a more meaningful conclusion of our efforts.
- Here is a little background on the agency and the demographics and scale. CDC was founded in 1946. Employee sponsored fitness program started in 1978 and was led from Div of Health education, several years later in 1996 the official contracted Lifestyle program who still operates under that name, and early in 2013 we had an internally focused office. We are over 10,000 full time employees/19,000 including contractors. Mostly female and slightly diverse. We have staff in all 50 states and over 50 countries.
- I’m sharing this organizational chart to show where wellness sits within our organization. You’ll see the immediate 8 links around Dr. Frieden and his deputy in the centter—the top left is Sherri Berger-the Chief Operating Officer. Our parent office (Office of Safety, Security and Asset Management) is within the Office of Chief Operating Office (OCOO). The bottom half of the org chart is our various CIO’s (Centers, Institutes, and Offices) that you may be more familiar with.
- Our office plans in a way that we provide the informational support, environmental support, and social support to bring wellness to our employees. You’ll see from the left we manage the fitness facilities and food service environments and will join them as part of our health education and awareness offerings. The last box in purple includes our more direct and personal approach that may be directed to higher risk groups, a more in-depth preventive focus of support, or to build longer-term connections for support.
- Here are a few shots of our WWO staff, we have a fun and energetic group and we are “always in action” and interacting with employees on the ground. If we can’t be excited and bring fun and play into our workplace then I don’t know who can or will? So our first year, we really got attention and broke a few barriers because we had the support of our leadership.
- Assessments and having a vision was a key factor in allowing us to set a strategic path and begin to identify how “success” could be defined. When our office first started we used CDC’s own “toolbox” of public domain resources—on the left is the CDC Health Scorecard and on the far right is the health assessment tool “Capture” which included the climate survey tool “Inputs”. Both of these tools are available on the website linked on the page. In the center is the Federal Employee Viewpoint Survey that all federal agencies complete which provide us with employee interest and climate data. All of these tools provide a good start for strategic planning. So we had all of this data and we really needed to be able to “frame” this data in a comprehensive way and this is when we began looking into the HealthLead accreditation. Poll question: How many of you have used the CDC Scorecard or other tool to “frame” or provide vision to develop your wellness goals?
- US Healthiest is a non-profit organization established in 2008 through funding from the CDC, ASTHO, NACCHO and private sector leaders that believe in our vision to improve America’s health in the workplace and at home. So we will begin to review the sections of the HealthLead tool. These are the three larger sections of the tool and each breakdown into multiple categories. But for simplicity and time’s sake—I will highlight what CDC provided within each of these domains and areas where we still have work to do.
- I like to use colors to organize so I made the title of “Organizational Engagement- green” so you can follow along and notice when I shift to a different domain, I will shift the color for you as we enter the other two domains. So here you have all of the focus areas within this domain. For the assessment tool, there is typically a page of questions dedicated to each of these areas. Points are assigned based on your response to degree of implementation. So it is nice that you get points from “intending to implement-5 pts—and partially implemented, to the full 15 pts in “fully implemented”. So you are provided a score out of the total for each domain. This domain I like to think of as mostly related to the “infrastructure” of your program.
- Business alignment in terms of management’s support of wellness in terms of how it is valued across the agency. We provided examples of our management support of our internal program. Shown here is bullets around our parent office (Office of the Chief Operating Officer)-OCOO which is in the Office of the Director and The business of OCOO is to build a strong workforce. Information gained from our Leadership 360 and Employee Viewpoint surveys are used to build our staff/supervisors both personally and professionally. We define wellness a little broader as well-being to encompass professional and personal growth. Training and workforce development Dedicated CDC University Individual Development Plans and Iindividual Learning Accounts- provide funds for staff to use for professional development. Direct support of Wellness Amenties Establishment of WorkLife Wellness Office with staff of 13 We are financed through a “working capital fund” where we are a core activity and each centers budgets chip in a portion for the business service offices operations. Management/Leadership Support OSSAM Director has performance goals and objective to achieve in the area of wellness
- A product initiated by our OCOO and the lead (Sherri Berger) pictured here is an agency-wide implementation of OCOO’s healthy organizational goals takes place through the Healthy Organization workgroup. CDC’s HOW was created by senior leadership and reps. across CDC’s Centers, Institutes, and Offices address goals and work with the CIO’s to improve our organization across multiple domains. This group is inspiring and has a very forward thinking approach regarding organizational health. In a sense, this is the agency committee for overall organizational health and well-being at work. Wellness is one of the representatives on the workgroup and we stay partnered with them as they evolve on various goals.
- Several of these policies existed previous to the wellness office being institutionalized and occurred through work in various programs with subject matter expertise. Tobacco-free started in 2005 by Office Smoking and Health. Some examples here, we continue to influence such as inclusion of anti-bullying statements and defintions to incorporate them into existing workplace violence prevention policy. Also, we implement the HHS health and sustainability guidelines for food service as we’ve established that within our food service and vending program goals.
- More examples of organizational supports wellness. The first listed is an award and recognition for wellness support “Excellence in Workforce Wellness”-believe it or not our office is not the only competitor or winner in this category. This recognized agency-wide efforts. The next two bullets represent that at least twice per year, the agency is sort of “taken over” as a time to promote staff wellness. Meaning we are in the lobbies, on-the-ground,. Health Days is when CDC staff get their own flu shots and have an opportunity to participate in biometric screenings for free. The last bullet for the healthiest CIO Challenge (across centers, institutes, and offices) is when we do a kick off for healthy goals over summer and it is a 6 week challenge with hundreds of teams that compete and we end it with an awards celebration and recognition of the “Healthiest CIO” .
- Likely the strongest/most impactful part of our office is our ability to market and communicate We need a big presence to “breakthrough” and clear messages. Shown here is our main method to communicate with CDC—it is the home page which provides news, updates, and links to other programs, and administrative tools. In this screenshot, you’ll see a feature story and sub-stories. We always have some sort of wellness focus or story on the page. In the past, we have been a part of the Directors’ corner, the main feature, and snapshots. WE have to “plan” our time and the best time to use it.
- Besides our electronic communications, we need “on-the-ground” resources. Another big part of our infrastructure is our liaisons. Our liaisons are usually passionate volunteers that we provide a formal assignment with their supervisor approval and courtesy copy. We provide wellness training and include them on items related to their center and employee wellness. Listed here are the advantages to both groups. Basically to the employees with a liaison—they have a focal point to receive and provide feedback and for us in the wellness office it helps us offer what is actually needed so we can be more strategic.
- We also have our traditional approaches to communication which I think is most memorable to staff as it is more personal. the top left- the signicades have offered us the best way to reach people who miss our email announcements. Middle-center- we use business cards all the time as a means to greet and remind people of big campaigns going on.. And pocket cards are really liked by people to record their numbers or goals. These other photos represent email signatures, personal touches though a “hearts and cards” campaign which is my favorite, balloons, “this just in” monthly flyer board, etc.
- Now we’ll move on to the next domain- changing gears. On this slide are focus areas underneath the “population health management” domain which is the bulk of what most of us do in health promotion.—it is sort of the “prevention programming” domain.
- We try to keep the healthy “healthy” so we offer things to do and feel connected and bring their colleagues to join in for healthier influences. Pictured here is a walking group, in the middle is a picture was sent to us as part of the Healthiest CIO challenge and it was taken in the Emergency Operatins Center as they elected to do weekly plank contests as part of their challenge. We love it because it shows the things you can do in an office on a short break and if the EOC can do it during Ebola that doesn’t leave the rest of us with much of an excuse. The last is a photo taken during a scavenger hunt that was part of a “green challenge”-so mixing in a little fun has become a need.
- During our annual Health Days as a way to promote awareness, we partner with our occupational health clinic which provides the flu shots. On our side of the room we offer free biometric screening for total cholesterol panel and glucose through a fingerstick. We also provide a blood pressure check. The results are available within 8 minutes and we provide the interpretation and make suggestions on the spot for lifestyle changes or if they should see a physician. We identify several new diabetics and those that may be hypertensive and should start tracking their numbers. We are able to connect them with health carrier offerings for wellness coaching, tobacco cessation and other items. Poll question: How many of you are able to use health assessment data to target programming to specific work units or geographical locations?
- Still part of the 2nd domain is capturing the risk groups and assisting in the management of chronic diseases. It may include connecting the dots between employees and benefits. This is an area that did not exist in a strong pro-active way and was a new piece that our office added.
- Last domain is the toughest one to complete for us—the outcomes reporting. Partly, because of our ability to access to the data we would need as it is more difficult in the government because of how the health benefits is managed at a federal level. But we are working to get better data on what we can to determine outcomes in these areas and if we can have any impact on them.
- Listed here in white are the types of data we were collecting. Those listed in yellow are new and was identified to us as part of the HealthLead process. Some are more difficult to achieve but we are working in the direction. Engagement data is a little difficult and require the ability track on an individual level over time. But, we have just embarked on a contract that will integrate our data from various sources and provide those in a de-identified way where we may be able to watch the level of engagement over time. We are hoping to impact workers’ comp costs with our new return to work –workgroup efforts. We are considering a “culture set” of questions to monitor that may represent “supv support, peer involvement, CIO engagement, and free press*
- For reports to management, some of our higher level “dashboard” type items are total reach, scorecard averages, and infrastructure involvement that includes liaison engagement.
- This is showing from our employee viewpoint, what they participate in—management also sees these numbers. We are glad to report that our numbers are typically favorable and high which is evidence that we are reaching people.
- This is a glimpse of our summer challenge and the tracking of sign-ups for us to see the levels of various CIO engagement. Some when down but overall we went up. Taking it to the CIO level allows us to be strategic in our marketing and recruitment for champions/liaisons.
- We only have two points in time so we are not saying that we have impacted the biometrics this dramatically but we are looking forward to seeing how 2015 data changes this. We also look at this at the CIO level and there are many fluctuations under this bigger average. But we do see that some CIO’s are going in the right direction and others that we need to continue to work on.
- Listed in this slide are a few items that we took to heart to work on over the next 3 years when it comes time for our renewal.
- As part of the process of completing that accreditation, we made several connections across our agency that we didn’t previously have and I think this tool was a good final linchpin of pulling it all together in how we could operationalize a comprehensive plan. And it solidified with leadership that we were on the right track as a credible program.