Notes from the Road
Working Well has been blazing a trail through South Carolina’s highways and interstates the past few months. The 2011 year ended with a flurry of site visits to Self Regional Healthcare, Oconee Medical Center, Georgetown Memorial and Waccamaw Community of Georgetown Hospital System, Colleton Medical Center, McLeod Health’s McLeod Medical, Dillon, Darlington, and newly acquired Loris, ending in the Lowcountry with Coastal Carolina Hospital.
Administrative leadership and wellness teams shared their insight into implementation strategies, successful outcomes, barriers and opportunities for improvement, and goals for a healthier workforce. They were eager to learn about all the ways Working Well’s resources can help them identify focus areas, prioritize action steps, seamlessly intertwine to enhance their existing employee wellness program, and ultimately achieve their goal of improving population health through a Culture of Wellness.
Working Well visited 34 hospital campuses between April and December 2011, traveling many thousands of miles. We look forward to more travels in 2012, and visits are already scheduled on the calendar. Contact Jen Wright, Working Well Manager to reserve your site visit so you can get on the road to a Culture of Wellness. In the words of Georgetown Hospital System… “Working Well helps you work smarter, not harder” to achieve your employee wellness goals.
Check out the happenings at Self Regional Healthcare, Oconee Medical Center, Georgetown Hospital System, Colleton Medical Center, McLeod Health, and Coastal Carolina Hospital below .
Self Regional Healthcare is located in Greenwood, SC. The strong executive commitment to healthy lifestyles is on display and modeled by President and CEO, Jim Pfeiffer. Mr. Pfeiffer is a cyclist and leads fitness events through the adjacent neighborhoods on a recurring basis, including a Hospital Week bike ride. The population health ideal of Neal Asman, VP of Strategic Development and Community Outreach, is contagious.
Self Cares is the employee wellness program and with its comprehensive structure, onsite Health Coaches, strong benefit/incentive tie in, and executive support, it’s no wonder a very high percentage of employees commit to participate. Participation requires a signed commitment statement to perform 30 minutes of exercise at least twice per week, follow guidance of a Health Coach, and complete an annual exam with a physician. Other required elements of Self Cares to earn the benefit incentives include completing an annual HRA, being tobacco free, and attending at least one wellness/health related education program each quarter. Participation in Self Cares is voluntary, but is a requirement to qualify for the Self Care Medical Plan that comes with reduced healthcare premiums and a chance to earn FSA contributions for completing wellness events throughout the year. Earning additional Paid Time Off (PTO) and other prizes and rewards are also used to incentivize employees to practice healthy behaviors.
Self Regional has a robust tobacco free campus policy that is consistently enforced and openly communicated to all employees. A dress code policy regarding tobacco odor is also in place for the quality of patient care. The campus perimeter is outlined by very visible tobacco free signs at each entrance. Scripting is provided to employees to empower them to speak to policy violators. Open communication between employees, grounds crew, and administration has helped with effective tobacco free sign placement in previously problematic areas. Tobacco users identified by the HRA, attestation, Employee Health, etc are referred to an array of resources to help them quit. Group Quit for Life sessions are available as well as one on one counseling with the Nurse Practitioner for those who prefer that method. A close relationship with the pharmacy results in prescription medications for cessation at no charge when purchased at the Self Team Pharmacy (with a prescription from PCP or Employee Health NP). Discount NRT is also available. This close relationship also allows for more detailed tracking of outcomes and evaluation of the tobacco cessation system.
Wellness Works Health and Fitness Center offers discounted membership rates. They offer Self Cares and Normal Plan rates to anyone over 13 yrs. old. A satellite opportunity is available in Cardiac Rehab with a trainer. Mapped campus and surrounding neighborhood trails are mapped and used for monthly walks and bike rides sponsored by the hospital.
The dietary department is self managed, posting their weekly menus on the intranet denoting Self Cares Selections with a logo. The logo branding matches the cafeteria where Self Cares Selections are identified on the glass at the point of decision in the serving line, even the dressings on the salad bar are marked. Fried items are more expensive and the salad bar price has purposefully avoided pricing increases. Water at the fountain beverage station is available all day at no charge to encourage increased water consumption. Currently a complete database update is happening through dedicated staff so the nutrition labeling can resume soon. The Veranda café in the lobby offers new healthy recipes and will be the first location to rollout the new nutrition labels. To further encourage healthy food choices, Self Cares points are awarded for the purchase of fruits and vegetables at the Uptown Farmers Market.
Oconee Medical Center is “Well Aware” in Seneca, SC with their new comprehensive employee wellness program that rolled out in January 2011. These resources are available to all employees and covered spouses at no charge and are tied to the Well Aware Health Benefit Plan for reduced healthcare premiums and other incentives. To qualify for the reduced premium plan a Know Your NumberTM screening and compliance with the Health Action Plan from an onsite Health Coach is required. The Health Coaches meet one on one with at risk individuals (identified by screening) and are counseled and referred to appropriate resources for tobacco, obesity, and other chronic diseases. Oconee offers an onsite pharmacy and offers free diabetes supplies to employees who maintain compliance with their Health Action Plan. To evaluate the effectiveness of their interventions, they contract with Hays Company to do annual claims analysis which includes chronic conditions.
The tobacco free campus policy is consistently enforced through signage and communication of the policy as well as empowering employees to speak to violators. When security rounds and identifies violators, a report is issued to the department manager of the violator. Tobacco users are self identified on the HRA and referred to a variety of resources. Free NRT is offered and group cessation classes take place quarterly using the American Cancer Society’s Freshstart program. Again, these resources are also available to covered spouses to increase the likelihood of a successful and sustained quit. Employees are also given information on Quit for Keeps, the SC Quitline. Since local ordinances don’t exist for tobacco free restaurants, a Smoke Free Restaurant Guide is distributed that covers Oconee and Anderson Counties.
Oconee’s food environment is in the midst of a complete renovation, which is scheduled for completion in 2012. Along with the new look will come some new offerings, one that might shock you. There will be no fryers installed in the new digs. After thorough discussion it was decided by administration that everything that is currently fried can (and should) be made in a more healthful way. Traditionally fried items like french fries and chicken fingers will make way for healthier versions like baked sweet potato fries. Every serving station will be a certified wellness station and nutrition labeling will be used to identify healthy options. To help educate on "why" and more importantly "how" to make healthy food choices, Weight Watchers at Work is offered with a payroll deduction option and a registered dietitian is dedicated to employee health.
Onsite fitness classes like Yoga and Zumba are made available to employees, and local fitness centers provide discounted memberships. There are opportunities for point of decision prompts for physical activity by drawing attention to the pleasant, and very visible, stairwells located right next to the elevators. One drawback to their beautiful natural surroundings is the presence of bears…that’s right bears. These wild animals have caused them to close the campus walking trail through the back part of their property. Their desire is to develop a walking trail on the large expanse of land toward the front of their property. The proximity to a main road would also be ideal for community use.
Georgetown Hospital System includes Georgetown Memorial and Waccamaw Community Hospitals located in Georgetown and Murrells Inlet, respectively. The employee wellness infrastructure, components, implementation strategies, and outcome evaluation is of the most innovative best practice examples in SC.
The culture of wellness is woven into the fabric of Georgetown Hospital System with total and complete support from their executive team. The wellness health plan has two levels of coverage, both with wellness requirements. An annual HRA, labs, and a fitness assessment including biometrics with required disease management for specific identified chronic issues, are all elements for both employees and covered spouses. Wellness challenges throughout the year also yield points for participants to accrue to help them earn the “wellness master” level and therefore the highest benefit incentive. The required elements of the program are provided by the employee wellness team at no charge to the employee and covered spouse. When the highest level is achieved, the benefit incentive payout covers the employee’s portion of insurance premium the next year. The wellness health plans are optional, however the cost of non-participation adds a 20% increased premium, larger deductable, and larger out of pocket max. Needless to say they have a very high percentage of participation, helping to make wellness the expected norm.
Additional innovative concepts underway include a repackaging of their existing break policy to outline recommended behaviors during break time. A culture of wellness policy is also in the works to encompass all aspects into one comprehensive policy. A culture of wellness module was designed and has been implemented as a required piece of the annual Healthstream competencies for employees, once again tying wellness into the core infrastructure of the system. Physical Agility Testing (PAT) is a part of their new hire process, making sure new team members are physically able to do their job requirements. An addition that will be implemented soon is the same PAT requirement for all current employees prior to returning to work from FMLA. When an existing employee is unable to pass the PAT, a training grace period is granted with references to appropriate resources (i.e. dietitian, exercise physiologist, etc) for assistance getting to the level required to meet the standards. This blends wellness with safety and the reduced risk for worksite injuries.
Sodexo manages the food environment throughout the system, implementing the highest level of Wellness and You criteria. In fact, Georgetown was the alpha pilot site for Sodexo’s Wellness and You program helping to determine the elements that were rolled out nationwide. They offer Sodexo’s Create Your Weight program offering points for participation and partial reimbursement of cost upon successful completion. Weight Watchers is also available with the same opportunity for reimbursement. Medical Nutrition Therapy (MNT) with a dietitian is available at no charge and events like super market tours, lunch and learns, and support groups assist with practical education on healthy eating behaviors. There is a cohesive message between the hospital system’s wellness team and Sodexo. Tiered plates are on display during every food service identifying the healthy (green), moderate (yellow), and unhealthy (red) meals, and cooking for wellness demos take place regularly. Nutrition line IDs are used in the service line at the point of decision, all dietary staff go through mandatory training, and recipes as well as cooking practices are consistently monitored by dietitians for quality assurance in following standards. Product placement is used to promote healthy choices. Healthy items are priced competitively and the salad bar is discounted. Healthy options in beverage vending are priced lower than their alternative and healthy items in food vending are marked by an icon. Many healthy changes in the food environments have come from employee suggestions and the energetic openness of dietary staff to create new healthy recipes.
Georgetown Hospital System is an AHA recognized Platinum Fit Friendly Company. The most popular fitness challenge among employees is the annual 9-week Get Physical Challenge in which over 900 employees participate through teams. Healthpoint is their offsite affiliated fitness facility that offers discounted membership rates and is convenient for both GMH and WCH employees. New hires get 5 free passes to Healthpoint at orientation to promote the importance of physical activity. Space is being considered within the hospital for onsite fitness classes.
The tobacco free campus policy is communicated through strategically placed signage at the property entrances and various forms of communication avenues. Employees are empowered to speak to policy violators, and environmental service and plant ops managers round campus weekly to monitor cigarette butt accumulation. Also, security communicates with administration through regular reporting of offenders. An attestation form is used and a $50 per pay period surcharge, plus ineligibility for the reduced premium health plans is enforced to deter tobacco use. This can be reversed for employees when they can declare tobacco free for 6 months. To support their employees to become tobacco free, their comprehensive system offers free smoking cessation counseling plus NRT patch and Zyban at no charge. Meds and NRT are also available for those who decline to participate in counseling. Resources are available to benefit and non-benefit eligible employees as well as their spouses and are communicated through orientation presentations, mailers, bulletin boards, monthly newsletters, and the intranet.
Colleton Medical Center in Walterboro, SC is an HCA hospital in the early stages of implementing their wellness program. They are off to a running start with an 84% participation rate among employees! Elements of their program include annual labs and an HRA. When health risks are identified, referral to resources takes place. In fact, proof of follow up with a primary care physician is a required piece. Successful participation in this program can result in a $500 wellness credit incentive. Wellness events and education are promoted through their Health to You (H2U) magazine.
Colleton has a tobacco free campus policy and their signs reflect that language. Cessation aids are offered at a discounted rate and employees are referred to cessation counseling and the Quit Now service. No tobacco surcharge is currently in place.
The food environment at Colleton is managed by Sodexo and they look to further implement the Wellness and You criteria very soon. Along with this implementation, they will also look to use product placement and pricing incentives. Menus are on display denoting healthy options using icons and the green, yellow, and red plates are used to help identify the healthy meal options. Vending machines have a skin on the glass creating a window of healthy options. A community health series takes place on campus and employees are encouraged to attend. A four week diabetes series is held twice a year, with great participation.
The FitLife Fitness Center is located conveniently on campus and membership rates are discounted for employees. This expansive fitness center offers an array of cardio and strength training equipment as well as classes. Since it is located on campus, employees are able to incorporate fitness into their breaks and that perk is being utilized as evidenced by individuals working out in scrubs. Between the main hospital building and the fitness center is a lovely walking park. Set back off the roadway, the park is serene and safe with plant lined sidewalks winding through it.
McLeod Health has acute care locations in Florence, Dillon, Darlington, and most recently Loris, Florence being their largest campus. McLeod Health employee wellness is going through some drastic changes moving into 2012, but will maintain some elements of their existing program.
All campus locations are tobacco free with consistent policy language, but some signs reflect “smoke free” language rather than "tobacco Free". Signs are sparsely spaced throughout properties, but very little evidence of cigarette butts indicates their policies are consistently enforced and well communicated. Non-tobacco users, as identified by attestation at open enrollment, are awarded a credit of $10 per pay period.
Sodexo manages main food environments using the Wellness and You program, and outside retailers join the McLeod Innovation Station located in the breezeway of McLeod Medical Center’s campus. Healthy options exist in all environments and would benefit from consistent icon use drawing attention to those choices. A large banner in the main cafeteria in Florence depicts the icon for a healthy choice along with explaining the nutrition criteria that must be met. An expansive salad bar with nutrition labeling for the dressing is positioned as the first option upon entering the cafeteria, while the fried food and pizza is tucked away in the corner. Beverage coolers use product placement with water on the top shelf to promote purchase. Water, baked chips, fruit, Nutrigrain bars, and 100 calorie snack packs are used at impulse buy racks near registers. For those wanting some help in making a change, Weight Watchers is offered with payroll deduction and Lunch and Learns are scheduled on a regular basis. Healthy rewards for healthy behaviors offers incentives to employees for purchasing produce at the monthly farmers market brought to campus by Sodexo. The Loris cafeteria, although smaller in size, still offers a nice salad bar, fruit and healthy snack options strategically placed near the registers, and frozen yogurt as a tasty yet healthy dessert option.
Affiliated Fitness Centers exist in Florence and Loris. Walking trails are mapped and marked on most campuses, and this year, through a Workout Break initiative, posters and handouts with visual depictions of fitness were distributed through departments making their way to hanging in break rooms. The McLeod Health and Fitness Center in Florence is a huge state of the art facility that includes two floors of cardio and strength equipment, a pool, basketball and racquetball courts, etc. Employees can receive a discounted membership to this facility and it is just a short distance away from the main campus. The Center for Health and Fitness at Loris is located on campus, a very convenient walk from the main building. It offers an array of cardio and strength training equipment to employees at a discounted membership rate.
Coastal Carolina Hospital, part of the Tenet Healthcare family, in Hardeeville, SC has a very robust corporate employee wellness program tied to benefits and incentives called Healthy at Tenet. Healthy at Tenet is a comprehensive program including education, disease management through phone and online health coaching, HRA requirement, nutrition, fitness and stress management challenges, healthy recipe sharing, promotion of community events, and encouragement of preventative screening. Employees must successfully accumulate enough wellness credits from the items previously mentioned to earn a significant premium reduction or HSA contribution depending on chosen coverage. Healthy at Tenet has the corporate executive support of Tenet but more importantly the local support of CEO, Bill Masterton. In 2011, they were recognized as a top 5% credit earning facility within the Healthy at Tenet family. The significance of that is Tenet awards their hospitals that meet benchmarks in participation rates with extra funding to be used specifically for employee wellness initiatives on campus. The energetic and motivated team of wellness champions at Coastal can be credited with this achievement for all their hard work in spreading the word and modeling healthy behaviors. Healthy at Tenet is a featured section in the weekly eNews and the Employee Health staff discuss it whenever possible.
Coastal Carolina has a tobacco free campus policy, but like many of our hospitals, struggles with compliance. Areas of heavy cigarette butt evidence was discovered in the campus tour and plans to re-energize communication, enhance enforcement, and strategically place additional signs at the campus perimeter and throughout the parking lot to better communicate the policy are priority for the coming months. Tobacco users are identified through attestation forms that must be signed each year during benefit enrollment. A per pay period surcharge is implemented for tobacco users, but can be stopped at any time once the employee has successfully quit. The cessation assistance system offered through Healthy at Tenet includes telephonic health coaching for cessation counseling, free NRT with enrollment in the program, and discount prescription cessation meds on formulary. The Employee Health Nurse has conversations with all tobacco users during their annual assessment and referral to resources is offered. An onsite cessation program is also available through Pulmonary/Cardiac Rehab.
The dietary department is self managed and has a palpable enthusiasm to make some meaningful change for a healthier environment in 2012. New healthy menu items, rearranging the hot service line to feature the healthier options first and a pricing strategy to make the healthy items more appealing are all in the works. Educational opportunities for staff in healthy cooking practices and portion control will not only provide a healthier food environment for patrons, but will provide personal development that can be carried home. Registered dietitians are accessible for one on one counseling with employees during and after work hours. Assistance with diabetes management is also offered. An incentive based weight management program that includes education sessions, weight ins, and other resource tools is led by the dietitians. Employees pay into the program to show their commitment and reimbursement is possible for successful completion, along with prize incentives for those with top outcomes.
A Healthy at Coastal Carolina Fitness Trail is marked with fitness tips along a ½ mile path around campus. Fitness events are held on the trail and employees are encouraged to use it on their breaks as well. An employee gym with badge access is available in the cardiac and pulmonary rehab area during non-patient care hours. This provides cardio equipment and light strength training. Bill Masterton, CEO, is committed to fitness and an avid cyclist himself. The wellness champions plan to use this example of healthy behavior to alleviate the perception barrier that commonly exists regarding physical activity during the workday.
It has been a privilege to be welcomed by 34 hospital campuses this year to work side by side with executives and wellness teams and my pleasure to share what has been learned so we can move forward together. Working Well is looking forward to another great year. Remember… There are plenty of openings for 2012 site visits. Don’t delay, call or email Jen soon to reserve your spot!
