© Copyright 1999 Maclean Hunter Publishing Ltd. The following article first appeared in the January 1999 edition of BENEFITS CANADA magazine.

The Wellness Package

Want a workplace wellness program that's a gift to any company?
From identifying employee needs to getting top-level buy-in,
here's how to create the whole wellness package

By Dianne Dyck

Pulling together all the components that embody a successful wellness program is a challenge for employers wanting to reap the benefits of a healthier workplace. And as more Canadian companies latch onto the trend towards promoting wellness at work, they need to keep in mind that setting up a single smoking cessation or stress management class just won't cut it these days. To be most effective, wellness should be viewed as a management strategy supported by a business case and measurable outcomes. It's important to integrate all the components of wellness into one package and channel efforts and outcomes to meet business needs.

Although workplace wellness has become a buzzword for organizations these days, some human resources (HR) leaders shy away from the concept because of the vague nature of the topic and the anticipated extra costs. What does this wellness business really mean, many employers ask, and how can it benefit business?

In its simplest form, workplace wellness can be viewed as having two components--organizational wellness and personal wellness. Organizational wellness involves managing both business functions and employee well-being in a manner that allows the organization to be more resilient to environmental pressures. On the other hand, personal wellness involves managing both psychological and physical issues in response to environmental stress, including one's work environment.

WHY WELLNESS AT WORK?

The concept of workplace wellness is relatively new to Canada, but there are some indications that benefits can be realized. Many companies throughout North America are now reporting the outcomes from their workplace wellness programs. The costs of wellness programs per employee per year vary depending on whether a comprehensive approach or a single program is presented. As well, costs vary according to the formula used and variables perceived to be program costs. The key is for an organization to determine what its workplace wellness costs are and what benefits have been realized. Here are some examples of measurable wellness program outcomes:

• Canada Life, based in Toronto, developed a health promotion program in 1978 which was independently evaluated over a 10-year period. The program showed a return of $6.85 on each corporate dollar invested based on reduced employee turnover, greater productivity and decreased medical claims by participating employees.

• A review of worldwide wellness studies by Dr. Ray Shephard for the Canadian government found that workplace wellness programs have a return on investment of between $1.95 to $3.75 per employee, per dollar spent.

• A 1997 Labour Canada study showed that employees who smoke cost companies between $2,308 to $2,613 more per year than non-smoking employees. This is due to increased absenteeism, lost productivity, and increased health and life insurance premiums.

• According to a Government of Ontario report called "The High Cost of a Sedentary Lifestyle," up to half of the burden of medical costs could be prevented by changes in personal lifestyle. Physical activity, in particular, has the potential to reduce both acute and chronic demands on the healthcare system, with a reduction in employee turnover and absence, an increase in productivity, a reduction in absenteeism and a decreased risk of industrial injury.

With such positive outcome possibilities, most employers have indicated an interest in introducing workplace wellness into their organizations and some Canadian companies already have components of workplace wellness in place. In fact, the Conference Board of Canada reports that over 80% of Canadian companies with 500 or more employees have Employee Assistance Programs or Employee and Family Assistance Programs (EAPs/EFAPs). Still, 63% of employees reported having no access to wellness programs at work.

While workplace wellness is undoubtedly still in the introductory phase in Canada, it's a different story in the United States. According to a 1996 Hewitt Associates study, American companies have a wide range of wellness programs in place: 85% of the mid- to large-sized companies surveyed had smoke-free workplaces; 78% produced wellness newsletters; 76% had health risk assessments with blood pressure and cholesterol testing; 50% hosted health fairs; 48% had employer-sponsored sports; 41% had employer-owned fitness facilities; 39% had financial incentive programs for smoking cessation and weight control programs; 33% had discounted fitness facilities; and 25% offered health risk appraisals (HRAs) to their employees.

The irony is that although organizations, both in Canada and the U.S., have some components of workplace wellness, the various programs tend to be disjointed, operating in isolation and focusing solely on their individual goals. The issue is that there is no overall vision with concrete measures and expected targets in place for workplace wellness. The opportunity for a collective synergy and for a tangible return on investment is missed.

DESIGNING A MODEL

Aon Consulting and the City of Calgary jointly produced a workplace wellness model (see "A model for success," above) that graphically displays workplace wellness, what it involves and how it functions.

In this model, organizational wellness, and employee and family wellness, operate side-by-side and are linked through a partnership approach. Methods such as open communication, proactivity, timely interventions and ongoing measurement are used to achieve a comprehensive workplace wellness program focused on employee and organizational well-being.

The outcome measures for both employee and organizational wellness are focused on productivity, effectiveness, efficiency, value-added, and profitability and resource optimization.

Prior to the introduction of a workplace wellness program, baseline data is needed for the outcome measures that are to be used. Targets, based on health promotion research, can then be set for each measure. Achievements should be assessed regularly to determine whether the process is meeting its established objectives. Key to this process is to have the workplace wellness program aligned with, and part of, the existing corporate business strategy. An effective wellness program must have short-term, mid-range and long-term goals to be able to demonstrate sustainable value.

PROACTIVE APPROACH

Companies that focus their business health culture on reactive approaches (such as dealing with attendance and disability, accident, EAP utilization and/or staff turnover rates and costs) tend to focus their resources and energies on controlling "failure costs." Failure costs occur when there's a breakdown in a company's prevention systems, such as workers' compensation claims costs resulting from an injury in the workplace.

Detection and prevention activities, however, can positively impact an organization's business outcomes. Detection activities focus on identifying concerns and issues before they become problematic. Some examples are doing an organizational climate evaluation, health and safety audits, employee health risk appraisals, pre-placement screenings and incident or "near miss" investigations.

Prevention activities, on the other hand, focus on avoiding and/or eliminating the identified concerns and issues so that they don't result in failure costs. Traditionally, fitness programs, nutritional counseling, smoking cessation, stress management, on- and off-the-job safety training, immunization and financial planning have been examples of workplace prevention programs.

Recent studies in the area of work life have shown that high-performance leadership, quality communication, support of a work and personal life balance, meaningful participation, control over one's work and development of effective interpersonal skills can be the best preventative measures for workplace failures.

In essence, organizations should approach health as an investment rather than a cost. In order to significantly reduce failure costs, judicious investment in detection and prevention is required. Research has shown that companies which focus on detection and prevention activities can, and do, realize lower failure costs.

It is possible to develop a business case for a workplace wellness program that demonstrates the positive impact it can have on the bottom line. This means quantifying a number of outcome measures when establishing what return on investment a wellness program can offer. These include:

• attendance rates and costs;

• disability rates/costs;

• amount of staff turnover and costs;

• benefits costs;

• insurance premiums and costs;

• the status of the corporate climate/ culture--level of employee commitment and loyalty, level of employee job satisfaction, and participation in various programs; and

• costs required to implement and operate a workplace wellness program.

The workplace wellness model wasdesigned to encourage a partnership and self-care approach to employee well-being. It is meant to encourage employee responsibility and self-care.

The organization's role is to provide a receptive environment and support for positive health and well-being. The overall organizational goal is to achieve good business results through good health--workplace wellness is a management strategy.

HR personnel are well-positioned to assist management with this business strategy. Frequently, the HR department has the prime responsibility for developing the work-place wellness strategy, architecture, resources and operation. If you are inthis position, here are some stepsthat will lead you in the right direction:

• determine the current status of workplace wellness efforts within a company;

• collect objective outcome data (attendance, staff retention, disability, benefit program and corporate culture data);

• influence policies/procedures to improve employee and organizational health;

• develop a business case for wellness;

• actively participate in the development of a workplace wellness program; and

• evaluate the program outcomes.

HR also has a role to play in reinforcing the idea that workplace wellness is a management issue--one that has cost drivers and expected outcomes.

What does it take to ensure the effectiveness of a workplace wellness program? It must:

• have buy-in from all stakeholders;

• be proactive in its approach;

• meet stakeholder needs;

• be aligned with the business strategy; and

• add value to the organization and employees in terms of effectiveness, efficiency, productivity and profitability.

How companies implement a workplace wellness program will vary to suit the corporate culture, nature of business and needs. But for those innovative and inspired companies willing to go for the whole wellness program package, the pay off can be big.

Dianne Dyck is a senior consultant with Aon Consulting Inc. in Calgary, Alta.

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Making a business case for wellness

According to Danielle Pratt, president of Calgary­based Healthy Business Inc., there are four areas you should cover when preparing a business case for workplace wellness:

• the impact of health, safety and wellness problems/costs on the company's effectiveness;

• the projected impact of "doing nothing" to address those problems and how that would affect both future costs, organizational resilience, employee morale and corporate culture;

• magnitude of the potential improvement which can be achieved by implementing workplace wellness "best practices;" and

• describing the level of excellence that could potentially be achieved regarding employee health, safety and wellness, and organizational performance.

The Romanow Commission has released its final report on the future of healthcare in Canada.

For Commissioner Romanow's recommendations, click here.

Click here for Senator Michael Kirby's report, "The Health of Canadians – The Federal Role: Recommendations for Reform."