Turning Discovery into Healthier Communities Turning Discovery into Healthier Communities
Integrated Health Management at
the Workplace
from a European
Perspective
Dr. WAGNER Norbert L.
MD PhD
Associate Professor
Saw Swee Hock School of Public Health
National University of Singapore
mailto:[email protected]
Turning Discovery into Healthier Communities
Table of Content
1. Integrated Health Management (IHM) at the Workplace: the concept and rationale
2. Major drivers for IHM in Europe
3. Very different models for the organization of IHM
4. Barriers and Challenges
5. Guiding principles: confidentiality and inclusion
Turning Discovery into Healthier Communities
Integrated Health Management at the Workplace
Turning Discovery into Healthier Communities
IHM (or TWSH) means excellence in OHS and HP
Health Protection OHS
Health Promotion HP
Improvements
OHS Management System and KVP
Random activities
Specific & effective interventions
Health management
Time
Effective programs
Turning Discovery into Healthier Communities
Major Reasons for Improving Health Management
1. Aging workforce a) High med leave
b) Shortage of skilled workers
2. Non-monetary reasons a) Attractiveness of employer
b) Demand for work/life balance
c) Demand for values beyond salary
Turning Discovery into Healthier Communities
Major drivers for IHM in Europe
Turning Discovery into Healthier Communities
WHO Europe
http://www.euro.who.int/__data/assets/pdf_file/0007/239902/E57452.pdf 1996
http://www.euro.who.int/__data/assets/pdf_file/0007/239902/E57452.pdfhttp://www.euro.who.int/__data/assets/pdf_file/0007/239902/E57452.pdf
Turning Discovery into Healthier Communities
European Agency for Safety and Health at Work
https://healthy-workplaces.eu/en
https://healthy-workplaces.eu/enhttps://healthy-workplaces.eu/enhttps://healthy-workplaces.eu/en
Turning Discovery into Healthier Communities
European Network for Workplace Health Promotion (ENWHP)
• European WHP Toolbox
• Questionnaires for Self-Assessment
• The Luxembourg Declaration adopted on 28 November 1997
http://www.enwhp.org/
http://www.enwhp.org/http://www.enwhp.org/
Turning Discovery into Healthier Communities
Political Support is needed: Example: Germany’s Prevention Act of 2015
Prevention Act 2015 (Präventionsgesetz, PrävG):
Among many regulations …
• Supports prevention of diseases and disability: early detection of disease, disease management and health promotion in the national health care system and communities
• Subsidizes special HP programs in day-care centers, schools, elder care and workplaces (life cycle)
• Doctors can “prescribe” health promotion activities
• Health promotion activities can be subsidized by health insurances
• Worksite health promotion activities are supported by health insurance companies up to 500 EUR per employee and year.
http://www.bmg.bund.de/themen/praevention/betriebliche-gesundheitsfoerderung/steuerliche-vorteile.html
Turning Discovery into Healthier Communities
Models for the Organisation of Health Management
Turning Discovery into Healthier Communities
Isolated or Integrated? “Managing Health” means integration of “health” into business processes
Most companies just run isolated HP programs. Nothing wrong with this!
Regarding the Integrated Health Management, corporations differ widely in the ways they manage “Health of Employees” and how they integrate it into their everyday business:
• As an opportunity/risk in the enterprise risk management
• As part of OHS Management System
• As an item of quality control
• As a HR process
Turning Discovery into Healthier Communities
Models for the Integrated Health Management
Organizational Form Company Examples Lead Department
Set-up HM as a separate but collaborating management system
Siemens GER Novo Nordisk DEN
EHS and HR HR
Run HM out of the corporate Medical Department
BP UK Unilever NED
Medical Service Medical Service
Integrate HM into existing OSH management system
Deutsche Post/ DHL GER
EHS
Use the Lean Production System for global Ergonomics Prg
Siemens GER Manufacturing Excellence & EHS
Use quality management system Hospital SWE QM (Lean, Kaizen)
Turning Discovery into Healthier Communities
Barriers and Challenges
Turning Discovery into Healthier Communities
EU-OSHA 2012 Survey: Typical Barriers and Challenges
• A negative perception of occupational health requirements and benefits.
• A lack of relevant skills and qualifications.
• Inadequate cooperation between key stakeholders in the process.
• The misperception by employers and organisations that WHP has limited or no benefits for the company, is too time-consuming, and is not their responsibility.
“It is vital to conduct a thorough analysis of the needs and properties of each individual occupational sector (and each organisation within it), and to tailor health promotion policies, practices and initiatives to the identified needs and priorities. “
Source: EU-OSHA 2012. Motivation for employers to carry out workplace health promotion at https://osha.europa.eu/en/tools-
and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotion
https://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotionhttps://osha.europa.eu/en/tools-and-publications/publications/literature_reviews/motivation-for-employers-to-carry-out-workplace-health-promotion
Turning Discovery into Healthier Communities
And misconceptions …
“Surveys have shown that despite recent efforts to redirect attention towards changing environmental and organizational factors aimed at improving and protecting employees’ health, the majority of WHP activities remain focused at the level of the individual. This has been found to be especially true for small and medium-sized enterprises.”
Source: Moore, A., Parahoo, K. & Fleming, P. ‘Workplace health promotion within small and medium-sized enterprises’, Health Education, vol. 110, no. 1, 2010, pp. 61–76 quoted from Guazzi M, Faggiano P, Mureddu GF, Faden 2, Niebauer J, Temporelli PL. Worksite health and wellness in the European union. Prog Cardiovasc Dis. 2014 Mar-Apr;56(5):508-14. doi: 10.1016/j.pcad.2013.11.003. Epub 2013 Nov 19.
Turning Discovery into Healthier Communities
Data Protection and Inclusion
Guiding Principles
Turning Discovery into Healthier Communities
Strong Protection of Privacy
Risks:
• Disclosure of personal information e.g. medical conditions, psychiatric problems, deficiencies
• Consequent discrimination at work, or stigma
• Not getting or loss of work contract
• Loss of health insurance coverage
Principles of Confidentiality
1. Ask only what is absolutely needed!
2. Keep details confidential and exclusively with the medical professional and other authorized departments
=> No medical files are kept at HR!
3. Only conclusions with regard to the work or workplace can reach the employer
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Turning Discovery into Healthier Communities
Keeping People at Work: Inclusion of Chronically Ill Persons
• Protection of chronic ill employees e.g. through
• Anti-Discrimination Laws for equal treatment in hiring and employment
• Penalties for not-employing disabled persons
• Continued health insurance coverage for continuous support in treatment and management of chronic diseases
• Mandatory Return-to-Work processes to support returning and chronically ill employees
Turning Discovery into Healthier Communities
Summary
Turning Discovery into Healthier Communities
Summary
1. Worksite Health Promotion is practiced in Europe with huge differences between companies and, specifically, between large companies and SMEs. There is no ONE model for managing the risks/opportunities of the “health of employees”, they range from isolated HP to Integrated Health Management
2. Worksite HP is strongly encouraged in Europe and facilitated by European-wide networks
3. It is often financially supported by health insurances or gov funds
4. Legislation and politics in some EU countries have clarified the “rules of collaboration” between different players
5. Considering the non-monetary effects of improving health is an important argument in Europe and, maybe, outweighs potentially small monetary gains
Turning Discovery into Healthier Communities
Turning Discovery into Healthier Communities
Thank you!
Dr. WAGNER Norbert L.
MD PhD
Associate Professor
Saw Swee Hock School of Public Health
National University of Singapore
mailto:[email protected]
Turning Discovery into Healthier Communities
Example: Integrating health promotion with quality improvement in a Swedish hospital Sandra Astnell*, Ulrica von Thiele Schwarz, Henna Hasson, Hanna Augustsson, and Terese Stenfors-Hayes, Health Promotion International, 2015, 1–10
Using the existing quality
management system and
Kaizen notes to promote
improvements in health and
safety and wellbeing