Journey to a Healthier Workplace - Canadian Centre for...

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Journey to a Healthier Workplace

Karen Jackson Allan SmofskyTrillium Health Centre Canadian Healthy Workplace Council

Towers Perrin Inc.

Karen Jackson, Trillium Health CentreAllan Smofsky, Canadian Healthy Workplace Council/Towers Perrin Inc.

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Journey to a Healthier WorkplaceOctober 21, 2008

Webinar Presentation

Today’s Agenda

Workplace Health in a business contextDefining workplace healthWorkforce well-being- the next frontierMeasuring workplace health

Trillium Health Centre’s journey to a healthier workplace

The big picture of workplace health in Canada-today and tomorrow


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The Canadian HealthyWorkplace Council

Comprised of a number of leading organizations and practitioners across Canada

Mission-To promote a comprehensive and integrated approach to workplace health in order to improve and sustain the health of Canadian organizations, their work environments and their employees

Main areas of emphasis:Advocates for workplace health, locally and nationallySelects annual Health Work & Wellness ConferencePioneer Award recipientServes as advisory body to various groups on workplace health


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Recent Headlines

Actual work time lost for personal reasons increased from the equivalent of 7.4 days per worker in 1997 to 9.7 days in 2006 – an estimated 102 million work days for all full-time employees – Statistics Canada 2007

Senior management interest in employee well-being is a key driver of employee engagement, a key driver of business performance. Yet, less than one in 10 employees agree that senior leaders in their companies actually treat employees as vital corporate assets; 15% of employees report that their leaders act as if employees don’t matter– Towers Perrin Global Workforce Study, 2007-2008

Close to 50% of employers are committed to building and maintaining a culture of health for employees – Towers Perrin 2008 Canadian Health Care Cost Survey


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Workplace Healthin a Business Context


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Defining a Workplace“Culture of Health”

Safe & healthy work environment

Supp

ortiv

e

Orga

niza

tiona

l /

Wor

k Cu

lture

Personal Health/

Lifestyle

PracticesHealthy, Productive, Successful Workplaces


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Safe & healthy work environment involves:Process Health & Safety• Ergonomics• Physical and chemical hazards• Emergency response• Injury prevention• Disability case management• Harassment prevention• Physical environment• Environmental practices



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Safe & healthy work environment involves:Safety Culture• Assessing cultural contributors to safety

performance• Supervision• Empowerment• Teamwork• Workload



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Personal Health/Lifestyle Practices involve:Health Promotion• Physical activity• Healthy eating• Healthy weights• Tobacco use • Stress• Drug and alcohol use • Immunization• Preconception health• Sun safety



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Personal Health/Lifestyle Practices involve:Health Risk Management• Health Risk Assessments/screening & follow-up• Stress Management• Physical activity campaigns• Nutrition• Group/one-on one counseling (e.g., high risk)



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Supportive Organizational/Work Culture involves:

CommunicationArticulating and living beliefs, values and normsManagement practicesSocial supportWorker attitudes and perceptionsHow work is organized



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Supportive Organizational/Work Culture involves:

Job satisfaction Job control and decision makingLeadership styleWork-life balanceNotion of "fair work conditions"



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Evolution in Workplace Health Planning• All Employers in the

Past• Some (most) employers

today; some tomorrow

• Some Employers Today• Many Employers in Near Term

(1-3 years)

• Few (if any) Employers Today

• Some Employers Tomorrow (3-5 years)

Programmatic Benefit

Management

Integrated BenefitManagement

Integrated Health and Productivity

Management

Medical

Pharmacy

Mental Health

LTD

STD

Incidental Absence

Life, AD&D, Other Benefits

e-health

Wellness and Prevention

Care Management

Occ Health and Safety

Worker's Compensation

Employee Health Management

Total Absence & Disability

Management (TADM)

Life, AD&D and Other Benefits

Integrated Health Management with

Focus on Employee Presenteeism and

Productivity

Employee Well-Being: The Next Frontier


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Top Drivers of Attraction, Retention & Engagagement

Top Attraction Drivers Top Retention Drivers Top Engagement Drivers

1. Competitive base pay

2. Vacation/paid time off

3. Competitive health care benefits

4. Challenging work

5. Career advancement opportunities

6. Flexible schedule

7. Convenient work location

8. Learning and development opportunities

9. Reputation of the organization as a good employer

10. Reasonable workload

1. Senior management sincerely interested in employee well-being

1. Have excellent career advancement opportunities

2. Satisfaction with the organization's people decisions

3. Ability to balance my work/personal life

4. Fairly compensated compared to others doing similar work in my organization

5. Understand potential career track within organization

6. Unit has skills needed to succeed

7. Organization's reputation for social responsibility

8. Positive impact of technology on work/life balance

9. Competitive base salary

2. Organization's reputation for social responsibility

3. Input into decision making in my department

4. Improved my skills and capabilities over the last year

5. Understand potential career track within organization

6. Can impact quality of work/product/service

7. Organization's reputation in community

8. Set high professional standards

9. Organization quickly resolves customer concerns

10. Appropriate amount of decision-making authority to do my job well

10. Unit has skills needed to succeed

Source: Towers Perrin 2007-2008 Global Workforce Study — Canada


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Well-Being: What is it?

Key components of employee wellbeing include:Physical health – overall health, energy/stamina, absence of pain/limitationsPsychological/emotional health – stress/anxiety, intrinsic satisfaction, accomplishment, optimism, confidence, control, empowerment, safetySocial/relational aspects of an employee's work environment – balance in work and personal life, equity, fairness, respect, social connectedness


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The Business Case for Considering Well-Being

Cost controlShift in thinking beyond short term cost management

Continuous discussion of workforce changeUnparalleled diversity of workforceEqually profound levels of workforce stress

Environmental confluencesPhysical health crisesRise in importance of emotional/cultural aspects of workIncreased emphasis on sustainable business practices (corporate social responsibility)

Business performanceRecognition of individuals as key investors of human capital


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Rewards & Performance

Physical Work Environment

Positive Working Relationships

Personal Growth & Aspiration

Competence & Environmental

Mastery

A Framework for Workplace Wellbeing

Physical•Health•Energy

Social/Relational

•Balance•Fairness

•Connectedness

Psychological•Stress

•Accomplishment•Control

•Capability

Leader/ManagerEffectiveness

Wellbeing

Health-Related Metrics

- Absence & disability

- Health care costs

Business Metrics

- HR Metrics- Financial performance

Trillium Health Centre’s Journey to a Healthier Workplace


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Our Mission….Transforming The Health Care Experience


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Trillium Health CentreThe Community We Serve…..

Two LocationsMississauga – InpatientWest Toronto – Ambulatory

Catchment Area >1,000,000 people

Population:

47% foreign born

41.8% of population have a mother tongue other than English or French

Population age of 75 and over will more than double by 2031


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Trillium Health Centre –Mississauga site


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Trillium - West Toronto site


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Trillium Vital Statistics

$400M Budget

761 Beds

708,065 Patient Visits31,875 Inpatient Admissions

283,226 Outpatient Visits206,192 Outpatient Diagnostic Services

81,225 Emergency Visits43,262 Urgent Care Visits

22,288 Surgical Procedures


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Our People

4339 Staff

700 Physicians

1100 Volunteers

Average annual staff growth rate of 4%

http://images.google.ca/imgres?imgurl=http://www.bcs.org/upload/img_200/people-small.jpg&imgrefurl=http://www.bcs.org/server.php%3Fshow%3DConWebDoc.3671&h=140&w=140&sz=8&hl=en&start=13&tbnid=WepJKicBGz8v_M:&tbnh=93&tbnw=93&prev=/images%3Fq%3Dhealthcare%2Bpeople%26svnum%3D10%26hl%3Den%26sa%3DG


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Summary of Trillium Employee Profile

Overall growth in the past two fiscal years was 4%.

Slightly less than half of employees are relatively new (0 to 4 years of service) to the organization.

The average retirement age has slowly increased over the past few years and was 62.9 years of age. This could increase with changes in retirement legislation.

The turnover rate has continued to improve over the last 3 fiscal years


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Summary of Trillium Employee Profile

With 52% internal hiring, Trillium continues to build internal capacity.

The overall nursing (RN and RPN) headcount has increased slightly (1695), with Registered Nursing positions accounting for 90.5% of this number.

The average Registered Nurse age is 44. 18% of RNs are 55 years of age or more (potential retirement age). 43% of RPNs are 50 years of age or more.

77% of Registered Nurses have 7 years or more experience in the profession


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Some of what we are known for…

Largest tertiary care community hospital in Canada

Ranked among the top 3 hospitals in Ontario for volumes in hip & knee replacement surgeries

Largest Day Surgery centre in North America with capacity to perform 30,000 procedures annually

Regional Centre for Advanced Cardiac Services, Neurosurgery, Stroke and Musculoskeletal Services


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Some of what we are known for…

First hospital in Canada to provide comprehensive spine services under one roof with launch of Kingsway Financial Spine Centre (2005)

National leader in beating heart cardiac bypass surgery

Largest provider of mental health services in the region

One of the largest stroke centres in Canada.


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The Trillium Way

Our PurposeIn partnership with many others, we positively impact the health of the individuals, families and communities we serve.


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The Trillium Way

Our Vision

TOGETHER… LEADERS IN HEALTH INNOVATION


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Supporting Cultural Transformation

….Healthy Workplaces

Quality Journey to Excellence

Creating the Right Work Environment that in Turn Creates the Right Approach to Satisfying our Customers


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Our Journey to Creating a Healthy Workplace….a strategic approach

Our Vision & PhilosophyValues Based PhilosophyPhilosophy of Care – Patient Centredness

National Quality Institute CriteriaIntegrated, holistic and progressive approach to quality excellence


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Our Journey to Creating a Healthy Workplace….a strategic approach

Performance Excellence & Healthy WorkplaceContinuous improvement in quality and workplace wellness to achieve and sustain qualityexcellence

Employee Health Safety & WellnessIntegrating ‘wellness’ into OHS

Healthy Workplace CommitteeAdvisory & participative role


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Performance Excellence:Aligning Quality and Healthy Workplace

Being and doing our best;for our patients and

each other.


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Our Culture – Our AnchorInspired by our Vision and Mission

Guided by our Core ValuesServiceExcellenceTeamworkIntegrityLearningDiversity

Clear accountabilities, for results and relationships Engage People FullyContinuously improve and innovateAgile – distributed leadership – just do it!


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Caring – for our patients andour people

Journey towards Patient CenterednessCreating the best patient experienceUnderstanding what we need toimprove upon:• Philosophy of Care

Healthy WorkplaceUnderstand how to improve our staff’s work experience/life• Quality improvement priorities

(Vital Few)• Kailo• Unit level action planning


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Our employees’, physicians’ & volunteers’ perspectives

Healthy Workplace Employee Survey, 2003 - 2008

‘Putting Our Results To Action’

National Quality Institute (NQI) Progressive Excellence Program (PEP) – Leadership Assessment, External Verification process

Self Assessment: Focus Groups, 2004, 2006, 2008

Accreditation 2007


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Outcomes of a Healthy WorkplaceSource: Graham Lowe Group

Population Health ThinkingHealthy, high quality work environments, employee capabilities and health system goals are linked:

Healthy Environment:Challenging but not

overworked

Trust, fairness, commitment

Resources

Autonomy & Input

Effective supervision & communication

Rewards & Recognition

Employee Capabilities:

Healthy

Engaged

Skilled

Adaptable

Results:

Innovation

Performance

Quality


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Excellence and Engagement

Staff

Excellence

Customer Service

Excellence

Engaged

Employees


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Creating Healthy Workplaces

…a Journey

Alignment

Lessons Learned


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Healthy Workplace

Broad Context:

Senior Team: Distributed leadership model, learning organization, ‘Employee of Choice’Leaders: ‘Strategy Map’ – priority area of focusEHS&W: Wellness events/programs & OHSUnit and service staff: ‘HW Survey’Patients: How we act towards each other -‘What they see’


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Integrated Health Strategy…Composite of Measures

Commitment – pride in THC, learning, career/development, support

Satisfaction - work, employee, manager, physical environment

Employee health & well-being - health status & risk


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Integrated Health Strategy…Composite of MeasuresCost and productivity - outcome measures

‘lagging’ indicators: absenteeism, health benefits/costs, workforce stability‘leading’ indicators: work-life balance, workload, engagement, workplace trust/respect, health status

Patient/client satisfaction/fulfillment -quality, competency, value, service


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Integrated Health StrategyNeeds Assessment

Healthy Workplace Survey Rewards & Recognition:• Satisfaction Applause!• Commitment Role/Process Redesign

CommunicationsValues Renewal & Standards For BehaviorLeadership DevelopmentLearning

Health Needs & Interest AssessmentHealth status/Risk Healthy WeightPhysical Environment Stress Management• HEART Mobile Workplace Violence• Survey – EHS&W Due Diligence & OHS• Benefits, EAP, LTD/STD


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Integrated Health Strategy

NQI Assessment/Verification Accreditation 2007Others…

Sustaining PerformanceExcellence through qualityand wellness


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Organizational level: The Vital Few

Internal CommunicationsBuild Communications Capacity

WorkloadQuality ImprovementRole Design

Recognition & RewardSystems & Approaches to Acknowledge Employee Contribution


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Approach to engaging our people…at the unit level

What is ourour good to great news?

What are the opportunities?

What are some of the trends?

What does this information mean for you?

Where are we going from here?


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What are some of the trends?…..the trend is our friend

What are connections? What are disconnects?

Nurse physician relationship score

Volunteers …a highly satisfied group


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Employee Health Safety & ‘Wellness’

OHS Employee Health Safety and Wellness

‘Kailo’ program – Wellness at Trillium(Ky-lo), noun, verb. An Indo-European word meaning to be “whole” or “of good omen.” The name of a non-traditional concept in worksite wellness developed at Mercy Medical Center-North Iowa.In partnership with Halton Health Care


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OUR MISSION


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Trillium Kailo Perks

Free membership/T-shirtBirthday club/Vacation clubMassage MondaysWellness WednesdaysTherapeutic ThursdaysT-Shirt FridaysHealth club discountsWellness LibraryGentle Fitness classes

Nia, YogaBelly dancingCore strengthening classes


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Wellness Wednesdays 2008

Lunch & Learns

April 29 – Enhancing Couple RelationshipsMay 21- Managing Conflict June 3 – Setting and Achieving Your GoalsJune 18 – Effective Communication at WorkSept 10 – Adding Humor to Your LifeOct 8- Understanding Depressive IllnessOct 29 – Living Well With Shift workNov 12 – Getting Restful Sleep Nov 26 – Parenting Teens Dec 17 – Welcoming Change Into Your Life


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Where are we going from here?

Delver deeper as an organization – probe HW Survey results by role, by unit/team, organizationally

Leadership / Management development focus

Measurement – how are we doing?


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What Will Success Look Like…

Stability in sick time statistics

Strengthened Relationships/Partnerships

Work Environment that isSafeHealthySupportive

Success in Recruitment Initiatives


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Outcome of our work…

Leading organization in Healthy Workplace ScoresHigh retention ratesLow vacancy ratesSignificantly below peers for sick timeVery positive employee relations, small number of unionized staffCapacity to meet the needs of our CommunityResilient organization in times of change


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Highest Trillium Scales/Items Compared to HHES

2008 2006 2005 2004

Work Satisfaction +0.2% +10.3% +10.0% +10.4%

Quality Improvement 2.0% +12.3% +12.1% +16.8%

Satisfied With Trillium +6.6% +16.2% +16.5% +19.1%

Treated with respect at Trillium +16.9% +13.9% +13.5% +16.2%

Scale or ItemOverall Report - HHES Benchmark


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Trillium has been consistently below the provincial overall average annual sick days of 10.94 (OHA 2007)

Trillium Sick Time Utilization

10.410

9

9.69.3

9.5 9.59.9

5

6

7

8

9

10

11

12

Apr 00 - Mar 01 Apr 01 - Mar 02 Apr 02 - Mar 03 Apr 03 - Mar 04 Apr 04 - Mar 05 Apr 05 - Mar 06 Apr 06 - Mar 07 Apr 07 - Mar 08

Num

ber

of S

ick

Day

s pe

r Fu

ll-tim

e E

mpl

oyee

THC Sick DaysOHA Average


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labour stability rate shows us the percentage of staff that are at Trillium at the beginning of a fiscal year and were also employed here a full year before.

turnover rate is calculated by comparing the number of employees that have left the organization expressed as a percentage of the average number of employees in a time period.

Labour Stability & Turnover

79.37

84.55

91.292.25

93.46

91.16 90.63

70

75

80

85

90

95

Apr 01 - Mar 02 Apr 02 - Mar 03 Apr 03 - Mar 04 Apr 04 - Mar 05 Apr 05 - Mar 06 Apr 06 - Mar 07 Apr 07 - Mar 08

Labo

ur S

tabi

lity

%

0

2

4

6

8

10

12

Turn

over

%

Labour Stability %

Turnover %


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Key Success Factors

Integrated & Strategic approach to workplace health

Action Plans are completed by Partnership Councils (unit level approach)

Unit level champions resulted in significant increase in completion of surveys

Healthy Workplace objectives are embedded and monitored as part of the annual operating planning process


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Key Success Factors

NQI criteria/Canada Award of Excellence provided necessary support for Healthy Workplace objectives

Ability to see healthy workplace as truly part of what we do each day

Importance of doing multi surveys (staff, physician & volunteers)

Layering for dialogue with groups

Integrating healthy workplace with quality model


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National and International Recognition

Canada Award of Excellence (CAE): Gold -Progressive Excellence Program ® (PEP) Level 4 Award – 2008

National Quality Institute

Innovation Award for Improving Quality and Patient Safety – 2006Ontario Ministry of Health and Long-Term Care

Ontario Environmental Leaders ProgramMinistry of Environment


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National and International Recognition

Canada Top Employer for College and University GraduatesCareer Directory

3-Year Accreditation- 2007Canadian Council on Health Services Accreditation

ISO 14001 Registration - 2004International Association for Standardization

Merit Award for Innovative Patient Information Technology - 2008Showcase Ontario

Workplace Health-The Big Picture


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Workplace Health- The Big Picture

Where we are today:

More organizational leaders accept that traditional approaches have not worked, that employee health/well-being IS important, and that work culture impacts this

Stakeholders from across the workplace health spectrum are beginning to converge (e.g. Forum on the Advancement of Healthy Workplaces, Alberta Premier’s Healthy Workplace Award)


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Workplace Health- The Big Picture

Where is it going?

Corporate Social Responsibility (CSR) is driving greater awareness of employee health / well-being/engagement as vital to organizational success; health indicators increasingly linked to key organizational indicators

Increased multi stakeholder collaboration (public-private)

Greater societal emphasis on improving workplace health: Outcomes (employer and societal metrics)Incentives Legislation


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Who has a stake in Workplace Health?

The Stakeholder The “WIIFM”

•HR • Engagement, Health costs

•Finance • Positive ROI, Profitability

•Occupational Health • Employee health, Absenteeism

•Operations • Productivity

•Sales/ Mktg/ Customer Service • Customer satisfaction/loyalty

•Executive • Attraction/retention, Profitability

•Labour • Member satisfaction

•Each employee • Health/well-being, Stress

•Government • Population health, Productivity


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A Call to Action

Solid evidence indicating that healthy workplaces feature healthier, more engaged & productive employees AND improved organizational performance and reduced costs

Healthy workplaces also contribute to a healthier population and a more prosperous economy

Council believes that the time is right for a coordinated action agenda to create healthy workplaces


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A Call to Action

Federal-provincial-territorial Labour Minister’s March 2006 joint statement called for increased cooperation on healthy and safe workplaces

Fiscal and jurisdictional realities limit the role any one stakeholder can play in realizing healthy workplace change

Healthy workplace change therefore can only be optimized through effective collaboration among all stakeholders


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Questions?

Karen JacksonTel: (905) 848-7580, Ext. [email protected]

Allan SmofskyTel: (416) [email protected]

mailto:[email protected]

mailto:[email protected]


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Thank You

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