Faye Tompkins RN, BS, COHN-S, CWCP Erik Nieuwenhuis MS, PT St. Luke’s Employee Health and Wellness

1. Creating an Organizational Culture of Wellness Faye Tompkins RN, BS, COHN-S, CWCP Erik Nieuwenhuis MS, PT St. Luke’s Employee Health and Wellness Faye Tompkins RN, BS, COHN-S, CWCP Erik Nieuwenhuis MS, PT St. Luke’s Employee Health and Wellness

2. WHY Worksite Wellness? • Control and Reduce Health Care Costs • Reduce Turnover • Reduce Absenteeism and Presenteeism • Improve Recruitment and Retainment of Employee’s • IMPROVE MORALE :) • Reduce OSHA Recordable MSDs (Restricted and Lost time days) • Reduce and Control Short Term Disability Costs • Improve the Health of Your Company’s MOST Precious Resource – YOUR Employee’s!!

3. Healthy Lifestyle Habits =Resilience (LIFE) CDC and Prevention recently found that 87% of Heart disease, 93% of Diabetes, and 37% Cancers can be PREVENTED and REVERSED with 4 Healthy Lifestyle Choices: • BMI less than 30-- Weight Management (Obese > 30 BMI) • Never Smoking • 3.5 hours of Physical Activity per Week • Healthy Nutrition

4. “The doctor of the future will give no medicine but will interest his patients in the care of the human frame (your body), in diet (healthy nutrition), and in the cause and prevention of disease.” By Thomas Edison

5. Physical In-Activity in America Today 70% of adults don’t get the recommended amount of physical activity daily Some 37% of US adults report they are not physically active at all. By Walking 30 to 45 minutes 5 or more days/week, you will delay the onset of disability by 10 to 12 years!!

6. Obesity (BMI) and Workers Compensation

7. Co-Morbidity’s of Overweight/Obesity66% of Adults in the US over 20 years old are Overweight, or Obese Heart Disease Type 2 Diabetes High Blood Pressure High Cholesterol Levels Congestive Heart Failure Angina Pectoris Stroke Asthma Osteoarthritis Musculoskeletal Disorders Cancer (All) Increased fatigue Sleep apnea and respiratory problems Gout Gallbladder disease Bladder control problems Poor self esteem Depression/ Anxiety Poor female reproductive health

8. STRESS in the Workplace • One million workers miss work every day due to stress • More than 25% of workers take time off work for a “mental health day” to deal with stress • Employee’s using mental health counseling lowered the usage of medical insurance by 31% (Corporate Wellness Advisor by Personal Best email 7/28/20) • 80% of Doctor appointments occur due to symptoms of NOT handling stress, or life change well.

9. Why is Your Health Important to YOU?

10. 7 Keys for Creating a “Well Workplace” • Capture Senior Level Support • Create Cohesive Wellness Teams • Collect Data to Drive Health Efforts • Craft An Operating Plan • Choose Appropriate Interventions • Create Supportive Environments • Carefully Evaluate Outcomes WELLness is something we do with and for people, NOT something we do to them.

11. 1. Capture Senior Level Support • 75% of Employer’s health care costs and productivity loses are related to Employee Lifestyle Choices • Companies with Wellness programs: ROI from $3.50 to $1, due to reduced health care costs and $5.82 reduced absenteeism • Combined workplace health enhancement and risk mgt intervention focused on behavior change: ROI of $3 to $6 to $1 invested in 2 to 5 years • Disease Management interventions: $7 to $10 ROI per dollar on Medical Costs /1 year It’s likely that disability linked programs will yield similar ROI

12. Health Care Workers’ MSDs • Health care workers lead the nation in work related MSD’s • Nursing is the ONLY profession where lifting 100 pounds is considered light/ easy, low stress, and an everyday practice. • A typical nurse lifts nearly 2 tons in an 8 hr shift

13. Musculoskeletal Disorders Musculoskeletal work injury claims (MSDs) are crippling our economy and our workers Cost of Work Related MSD injuries to the economy has been estimated to be $127 Billion annually (National Safety Council) $ 81 Billion Annually for Low Back Injury (Assoc Press) Back injuries result in 100 million days away from work each year

14. Ergonomics Importance in 21st Century WorkplaceCreating a Culture of Wellness Webinar by David Hunnicutt PhD Welcoa April 16, 09 • According to OSHA finding solutions to the problems posed by Ergonomics hazards may the Most Significant workplace safety and healthissue of the 21st Century • Lower back and Shoulder injuries, Carpal tunnel syndrome, and various Tendon Disorders (DeQuervains’s, Wrist Tendonitis, Tennis Elbow, and Rotator Cuff) are the Most rapidly growing category of OSHA recordable injury’s and illnesses.

15. St. Luke’s Employee Variance 2001 to 2009

16. St. Luke’s Employee Variance Restricted Duty 2001 to 2009

17. MSD OutcomesSt. Luke’s Nursing Areas 2005 to 2009

18. St. Luke’s Employee Restricted Duty Claims and Days2005 to 2009

19. St. Luke’s & Four Seasons - Partnering For Healthier Employees

20. 2. Create Cohesive Wellness Teams • Human Resources • Employee Health and Wellness • Safety Specialist • Registered Dietician • Physical/ Occupational Therapist • Nurses (Diabetes, Cardiac Rehab) • Physicians • Nutrition Food Service/ Cafeteria Manager • Health Coaches • Other Employee’s, Managers, Supervisors interested in Wellness • Meet Weekly, Monthly, Quarterly, PRN

21. St. Luke’s Live Healthy Iowa Team This St. Luke’s TEAM of 10 led 26 St. Luke’s Teams with an 8.95% Weight Loss average! • 7 of their 10 team members LOST 6% or more of their body weight • 4 of 10 lost more than 10% of their body weight. • 8 of their 10 team members logged over 60 hours of Physical Activity, with 3 being over 100 hours • The highest Physical Activity time logged was 152 hours and 25 minutes Awesome Transformation of Lifestyle Habits!!

22. 3. Collect Data to Drive Health Efforts Create a Data Dashboard (4 parts) • Risk status of Employee Population • Modifiable Health Care Costs • Participation levels of Company health promotion initiatives • Participation Satisfaction Others may include; absenteeism rates, healthcare utilization, employee engagement, health culture audit results, OSHA MSD log, etc.

23. Employee Health and Interest Survey Results Top 5 Wellness Activities Employee’s Would Participate in: • Weight Management Program • Aerobic Exercise Class • Strength Training Class • Pot Luck of Nutritional Foods • Stress Management/ Relaxation

24. ST. LUKE’S HRA JULY 2009 – 2010 PARTICIPATION 48%

25. WELLNESS SCORE BY LIFESTYLE BEHAVIORS

26. CURRENT CHRONIC CONDITIONS

27. BODY METRICS

28. 4. Craft An Operating Plan St. Luke’s Umbrella Model of Integrated “Wellness and Prevention”

29. Early Warning Signs & Symptoms of MSDs • Persistent Fatigue, Discomfort or Pain • Back, Shoulder, or Wrist Pain (any other joint) • Tingling/ Numbness in Arms, Hands or Legs • Shooting or Stabbing Pains • Swelling and/ or Inflammation • Decreased Grip Strength • Decreased Range of Motion • Stiffness and/ or Muscle Cramping • Disrupted Sleep EARLY REPORTING to Supervisor, and EHW

30. “Early Reporting” is a MUST! • DAILY Observe workers and FIND those who complain of Chronic discomfort, and pain while at work • Treat as “First Aid” and Avoid OSHA Recordable MSD Claims • WorkSmart Preventive Coaching (WPC) • Daily Supervisor Oversight of Work • Behavior Based Safety (BBS) Teams • Best way to Significantly reduce COSTS, Increase Productivity, and Improve Morale at Your Company

31. 5. Choose Appropriate Interventions These are taken from the findings of your HRA, Needs and Interest Surveys, OSHA logs • Physical Activity Live Healthy Iowa, 4 Seasons Partnership, Wear Red Day • Healthy Nutrition, Water, and Weight Management Burst Your Thirst, Beat the Holiday Bulge, Live Healthy Iowa, Weight Watchers at Work, Monthly Wellness Challenges • Rest and Sleep • WorkSmart Ergonomics SPHE, Computer Workstations, Dept Mtgs, Net Learning • Stress Management (EAP, Physical Activity) • Tobacco Use (Smoking, Chewing Tobacco) • Alcohol/ Drug Use • Organizational Benefits Health Challenge Payout $240 or $300, 4 Seasons Discount, 401K

32. Regular Moderate Physical Activity(at least 30 min/ day) Reduces the risks of: • Heart Disease by 40 to 50 % • Stroke by 30 to 50 % • Diabetes (Type II) by 30 to 40 % • Breast Cancer by 20 to 30 % • Colon Cancer by 30 to 50 % • Osteoporosis by 40 to 50 % • Premature Death by 30 to 50 % Physical Activity is POWERFUL MEDICINE!!

33. Benefits of Flexibility/WorkSmart Stretching YOUR FLEXIBILITY is the Foundation of Your Physical Health and Vitality!! • Reduces Stress  • Increases Energy!! • Reduces Joint Stiffness and Pain • Reduce MSD Risks • Improves your ability to perform ADL’s at Work, Home, PLAY, Rest

34. Benefits of Drinking 40+ ounces Water Daily • Will help you Lose Weight  • Burn (metabolize) Body Fat!! • Will Reduce Joint pain and Stiffness • Increases Your Energy • Speeds your bodies recovery and the healing process after an injury OR a hard days work How much should I drink each day? • 40 or more ounces working towards half of your body weight in ounces • 40 to 60% Reduction in HBP, Cholesterol, Heart attack and Stroke

35. 6. Creating Supportive Environments KEYS for Behavioral Change: • Direct the Rider (Rational Side) • Motivate the Elephant (Emotional/ Heart Side) • Shape the Path (Environment) • Remove Barriers with Education, Encouragement, and WorkSmart Incentives (Prizes) • Build Habits (When behavioral is habitual—It’s Free) • WorkSmart “Best Practices” • Rally the Herd Behavior is Contagious. Help it Spread.

36. St. Luke’s Wellness • Tobacco Cessation Classes and Support • Physical Activity / 4 Seasons Partnership • Healthy Nutrition/ Water/ Weight Management • Stress Management / Proactive EAP program • WorkSmart Stretching program • Workstation / Ergonomics • Organizational Benefits St. Luke’s Benefits Fair • Health Challenge since 2006

37. WorkSmart Techniques for Computer Workstations • Keep Feet Flat on the Floor or Footrest • Chair Adjusted Properly----KEY • Use Upper Extremity Support When Typing/ Mouse • Keep Elbows Close to Your Sides When Typing/ Mouse • Monitor Directly in Front of You Just Below Eye Level, Lower if You Have Bi/Tri Focals • Use Document Holder to Avoid Forward Head/ Shoulder Posture for Paperwork • AVOID Holding Phone Between Neck and Shoulder • Stand and Stretch or move OFTEN---Your Body is Worth The Effort!

38. WorkSmart Ergonomic Tools/ Equipment

40. Computer Workstation Ergonomic Evaluation

41. 7. Carefully Evaluate Outcomes • Health Risk Assessment • OSHA Log (MSDs, other) • HealthCare Costs and Utilization • Absenteeism

42. “Next Steps” for Creating an Organizational Culture of Wellness at Your Iowa Health affiliation Hospital and Clinics

43. Behavior Change • Awareness and Education • Build Skills and Tools • Policy and Environment • It all Starts with Unhealthy Behaviors : • Employee and Employer Related Health Costs • Health Risks • Chronic Disease • Individual Choices • Family/ Peers • Worksite • Community Influences (Environment)

44. WELCOA Membership A MUST for Your Company/ Organization, for only $1 per day OR $365 per year Powerful Membership Benefits Include the Following; 1) Wellness Training Webinars –Eat Right for Life by Dr Ann Kulze MD 2) Monthly Expert Interviews 3) Reproducible Wellness Bulletins 4) Incentive Campaigns Everybody Everyday 6 week Physical Activity Campaign, and Company Case Studies 5) Quarterly Presentations 6) Absolute Advantage Online and Well-Informed weekly newsletter www.welcoa.org

45. Questions?