Promoting a Healthy

Work Environment

1:30 – 2:15 May 22, 2013 Occupational

Federated Press Conference Calgary

Chris Hylton, MA

CG Hylton Inc. 1

Agenda • Overcoming barriers to a

healthy work environment, absenteeism, toxic workplace

• Toxic workplace and lateral violence

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Agenda

Best Practices

– The National Standard of Canada for Psychological Health and Safety in the Workplace

– Overview of the successful Screening, Brief Intervention, and Referral to Treatment (SBIRT) substance abuse model

– Wellness programs that work, at work

– The Aging workforce

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This is Your Show

• What would like to know from today’s session?

• What are your big workplace health issues we can deal with please?

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Overcoming Barriers to Healthy Work Environment

Productivity loss from presenteeism, absenteeism,

and the toxic workplace

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Which City is the healthiest in terms of absence (days lost)

• Vancouver

• Edmonton

• Calgary

• Toronto

• Montreal

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Days lost per worker - 2011

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0 2 4 6 8 10 12

ON

MB

SK

AB

BC

Montréal

Toronto

Calgary

Edmonton

Vancouver

Personal or family resp

Illness / disability

Total

Source: Statistics Canada, Labour Force Survey

Absenteeism

• 8.1% of full-time employees are absent for

all or part of the week for personal reasons:

5.9% due to their own illness or disability

and 2.2% due to personal or family

responsibilities.

• On average, in 2011, full-time employees

lost 3.7% of their work time each week due

to absenteeism

Source Stats Can 2011 Labour Force Data

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Presenteeism

• Absenteeism’s lesser known cousin, is lesser known and stats are more difficult to find.

• US data shows presenteeism is 7 - 9 times the rate of absenteeism (7 x 8.1% = 57%, 9 x 8.1% = 73%)

• Presenteeism occurs when employees who are physically present are, due to a physical or emotional issues, distracted to the point of reduced productivity. Using a sports analogy they are the walking wounded or playing hurt

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Source: Addressing the Presenteeism Issue, Esther Huberman, Benefits

Canada Oct 15, 2012

Why bother deal with absenteeism?

Direct Costs

• Replacement of absent worker

• Loss of productivity

• Sick leave with pay and benefits

Indirect Costs

• Reduced service to clients

• Damage to morale of other employees

• Time spent managing employee and/or claim

Presenteeism

• Performance objectives

• Performance appraisal

• Job description with Performance Objectives built in, signed off, amended annually by ee and er

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Solution:

• Absenteeism or Attendance Management Plan

• Does anyone have one of these?

• Care to share any comments?

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Case Study: CLS’ Absenteeism Management

Program (AMP)

• Implemented May 2005

• Revisions July 2008

• Four Step Program

• Experiencing hi rates of absenteeism

• Target 3.5% absenteeism (9 days/year)

CLS Issues

• People working when sick

• Concern about singling people out

• Concern about Supervisor abuse – “I’ll be watching you”

• Time required to manage program

• Education of staff is key

CLS AMP Steps

• Step 1: Informal Notification, Initial Concern

– Notification package provided to employee

– Contains absence history, AMP process, internal and external support

– Goal is to inform employee and offer education

Step 2

• Formal Discussion, Continued Concern

– Supervisor and employee meet

– Union representation is offered

– Purpose is to determine of there are underlying health issues

– A referral to Occupational Health and Wellness may be made

Step 3

• Formal Discussion, Advance Concern

– Supervisor and employee meet

– Union Representation offered

– Attempt to get at underlying issues

– Mandatory referral to Occupational Health and Wellness

Step 4

• Employment Discussion

– Supervisor and Employee meet

– Union Representation required

– Focus on continued employment relationship in serious jeopardy

– Employee is placed on a 90 day trial period.

Does anyone have any Attendance Programs at their workplace they

wish to share?

Any ideas?

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Breaking the cycle of workplace lateral violence

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Toxic Workplace

• Is anyone here from healthcare?

• Is there a link between a workplace and its toxicity and workplace violence and absenteeism?

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Confucius would be proud

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synonyms

interpersonal abuse, lateral violence, horizontal violence, workplace violence, interpersonal conflict, bullying, anger management

How does lateral violence differ from bullying?

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Causes of Lateral Violence

• Aboriginal Communities

• Healthcare

• What do they have in common?

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What do Healthcare and Aboriginal Communities have in Common?

• Tribal setting

• Close close bonds between workers, families

• Long history with co workers

• Crab in a bucket syndrome

• Feeling of stress, hopelessness, fear

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Causes of Lateral Violence

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• Research finds a clear link between abuse for patients/residents and the workplace environment. There are higher rates of violence in work areas with short staffing, under-staffing, lack of support from management, and poor teamwork among health care disciplines.

Source: Adapted from Central Health presentation: Defining bullying, harassment and disrespectful behaviour, Healthcare

Workplace Safety Conference, April 13, 2011

What employees want

Surveys of Best Practices tell us what employees want in the workplace:

1. Respect

2. Healthy and Safe work environment

3. Trustworthy Leadership

4. Work / Life Balance

5. Sense of Pride and Accomplishment

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If you are an employer where LV is occurring, what do you do, any ideas?

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Policies and Training

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• Policies should have strong opening statements regarding the company’s attitude to harassment in the workplace

• Awareness training among staff is a key strategy in addressing harassment

• Zero tolerance approach

Shunning Cuts Both ways

• Recent Research from University of

Rochester

• Giving someone the cold shoulder is as

painful to you as it is to them

• Shunning someone is just as painful for the

perpetrator as for the victim

• Excluding someone makes a person feel

guilty and shameful

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Source: Hurting You Hurts Me Too: The Psychological Costs

of Complying With Ostracism Psychological

Science 0956797612457951,first published on February 27, 2013

What is the National Standard for Psychological Health & Safety in the Workplace?

• Mental Health Commission

• Supports mental health best practices in the Canadian workplace

• The new standard was developed with the support of health care leaders, government, labour and corporations, including a $250,000 contribution from the Bell Let’s Talk mental health initiative

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Why a Standard?

• According to an Ipsos Reid survey released

fall of 2012,

• seven in 10 (71 per cent) of Canadian

employees surveyed report some degree of

concern with psychological health and

safety in their workplace,

• including 14 per cent who disagreed that

their workplace is psychologically healthy

and safe

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Source: GWL press Release Oct 30, 2012 Ipsos Reid survey results

available at www.workplacestrategiesformentalhealth.com

Why a Standard?

• The survey indicated that more people feel

physically safe (20 per cent concerned)

• than psychologically safe (33 per cent

concerned) in their workplace. This may be

because psychological health and safety

has not historically received the attention,

profile or resources that physical health

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Source: Homewood Human Solutions Jan 16, 2013 Press

Release.

The National Standard is a Voluntary Program

• Not enshrined in Law

• Not a regulation

• Provides guidelines and information

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How the Standard Lines up

• Aligns with the Plan-Do-Check-Act management model found in CAN/CSA Z1000, Occupational Health and Safety Management

• Aligns with other key standards and guidelines, including BNQ 9700-800 on Healthy Enterprises, CSA Z1002 on OHS Hazard Identification and Elimination and Risk Assessment and Control, BSA PAS 1010 Guidance on the Management of Psychosocial Risks in the Workplace, and Guarding Minds @ Work.

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Topics Included in the Standard • Establishing commitment, leadership and

participation

• Understanding diverse ee needs

• Maintaining confidentiality

• Policy and planning process to implement the system

• Identifying psych hazards, assessing risks, and implementing preventive and protective measures

• Infrastructure and resources required

• Providing education and awareness, and ensuring key people are trained and competent

• Collecting data, monitoring and measuring success

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Training by the CSA

• CSA Group Learning Institute has

scheduled web-based training sessions

• Visit CSA.CA training for details

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Bell Let’s Talk

• Bell Let’s Talk is a 5-year, $50-million program to promote Canadian mental health based on 4 action pillars: anti-stigma, care and access, research, and workplace best practices.

• With Bell Let’s Talk Day as its anti-stigma centrepiece, Bell’s initiative is providing significant funding for leading mental health hospitals and grassroots organizations, driving new workplace initiatives across corporate Canada, and supporting new research.

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Let’s Talk Day - Feb 12 • For every text message, long distance call made

by Bell / Bell Aliant customers, and every tweet using #BellLetsTalk, and every Facebook share of our Bell Let's Talk message on February 12

• Bell donated 5 cents more to mental health programs. In 2012, 78 million text messages, long distance calls and retweets by 8 million Canadians on Bell Let's Talk Day resulted in

• $3,926,014 in additional funding for mental health.

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Source: Bell Press Release Jan 16, 2013. Jacqueline Michelis,

Bell Media Relations

Benefits Canada Poll

Has your organization taken steps to improve

psychological health?

• 60% No. We don’t see the need

• 14% Yes. We wanted to address existing

issues

• 26% We are working on this now

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Source: Benefits Canada Polls

http://www.benefitscanada.com/polls#topPoll

Benefits Canada Poll Does your organization offer mental health

services and support for employees?

• 41% Yes, we have a robust program that

includes many services

• 26% Yes, but our program is still in progress

or only offers minimal services

• 15% No, but we plan to offer such services in

the future

• 19% No, we don't offer mental health services

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Benefits Canada Poll

Do you think the new workplace national

standard for psychological health and

safety will improve workplaces?

• 46% Yes

• 54% No

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Overview of the successful Screening, Brief Intervention, and

Referral to Treatment (SBIRT) substance abuse model

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Overview from “35,000

Feet”

Alcohol Screening, Brief Intervention and referral to Treatment (SBIRT) is the leading way to help employees and businesses to

reduce the impact of unhealthy alcohol use.

Screenings

Brief Intervention

Referral to Treatment and Follow-Up

SBIRT

Screening Use a valid, brief (5 minutes or less)

standardized questionnaire about quantity, frequency and consequences of alcohol use.

Referral to Treatment and Follow-up Linking your client to specialized

addiction treatment and staying with the client to support sustained success.

Brief Intervention

A behavior change strategy focused on helping your client reduce or

stop unhealthy drinking.

Four Patterns of Alcohol Use

5%

20%

35%

40%

High Risk

Low Risk

Moderate Risk

No Risk

No Risk: Those who never drink alcohol.

Moderate Risk: Those who regularly exceed one of the recommended daily, weekly or occasion limits for alcohol consumption.

Low Risk: Drinkers who never exceed the recommended daily, weekly and occasion limits for alcohol consumption.

High Risk: Those who regularly exceed 2 or more of the recommended daily, weekly or occasion limits for alcohol consumption.

High Risk

5%

20% Moderate Risk

35% Low Risk

40% No Risk

*Backgrounder | 2008 | The Case for Low-Risk Drinking Guidelines for BC | www.heretohelp.bc.ca

Recommended Low-Risk Drinking

Guidelines

• Men: 2,14,5 (< age 65) (US) No more than 2 drinks per day, 14 drinks per week, 5 drinks per occasion

• 20 or less drinks per week (CA) to avoid health damage*

• Women (and men 65+): 1,7,4 (US) No more than 1 drink per day, 7 drinks per week, 4 drinks per occasion

• 10 or less drinks per week (CA) to avoid health damage*

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Workplace Intervention

• The workplace is a great place to establish education, prevention and brief intervention programs to impact one of the top three avoidable killers today – unhealthy and dependent alcohol use

• Few businesses use the simple, fast, inexpensive and effective workplace programs described in this training.

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Stats

• Nearly 80% of adults who have diagnosable alcohol use disorders are employed.

• 40% of the B.C. population drinks too much at least occasionally (e.g., hazardous use, binge drinking)

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Costs to U.S. Employers

• Unhealthy drinkers are responsible for 60% of alcohol-related missed work, poor work quality and other work limitations.

• Unhealthy drinkers & dependent drinkers may cause up to 40% of industrial fatalities and 47% of industrial injuries.

• 20% of employees report being injured, forced to cover for a co-worker or required to work harder because of a colleague’s drinking.

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SBI IN WELLNESS PROGRAMS

• Alcohol screening can be included in wellness programs.

• Employees can receive a stand-alone screening or screening can be part of a more comprehensive health risk assessment that investigates a range of health concerns including depression, smoking, diabetes, hypertension and obesity.

• When screening indicates that participants may have alcohol problems, they can be encouraged to contact an EAP or counselor.

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SBIRT Materials

• All free, All online

• All can be adapted for your use

• http://bigsbirteducation.webs.com/sbirttraining.htm

• www.rockymountainresearch.us

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Becoming an employer of

choice

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What is an “Employer of Choice”?

• Any employer of any size in the public, private or not-for-profit sector that attracts, optimizes and retains top talent… because the employees choose to be there

• Employees choose to work for your organization… even when presented with other employment opportunities

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Becoming an Employer of Choice

But does it really matter? Yes!

Nearly half of all American workers (49 percent) indicate that their companies' brand, or image, played a key role in their decision to apply for a job at their respective workplace

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• Expectations

• Resources

• Do what I do

best

• Recognition

• Care

• Development

• Opinions count

• Mission

• Co-workers

• Best Friend

• Feedback

• Growth

First Break All the Rules

12 Good Questions Gallup

Buckingham & Coffman

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IPSOS Top 5 reasons for

staying in a job

1. like the work

2. like the co-workers

3. like the company

4. learning a lot

5. salary satisfaction

(Yes, this is in order of

preference)

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Conduct Discovery Interviews

What?

• Informal meetings, separate from

performance reviews.

Why?

• To emphasize each employee’s value.

• To understand his/her top motivators, job

satisfaction and any termination risk—so

that you can proactively address any

issues and focus on what really matters.

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Discovery Interview Questions

Job Satisfaction What makes you want to come to work each day?

Job Content Which particular projects/clients/assignments are

appealing to you?

Recognition How can I make your day?

Manager Relationship How can I be a more effective manager for you?

Retention What is the number one reason you choose to continue

working for us?

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Benefit Plans that Work

• When paying employees it is wise to think

of how to maximize their compensation

• If you give them dollars, it is all taxable

• If you give them a benefit plan it is tax free

• If you are an owner or executive of a

company, you should run all your medical

and dental expenses thru a benefit plan or

health spending account

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Benefit Trends - Flex

• Traditional flex plans are

a pain

• Health Spending

Account gaining favour

• Tax effective

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Flex work schedule costs the

employer nothing

Wellness Programs that Work, at Work

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How will this change with the impact of an aging population, increase in biologic drugs costs and the increase of chronic health conditions?

The Cost of Doing Nothing…..

$3,400

$3,800

$4,200

$4,600

$5,000

2009 2010 2011 2012 2013 2014

$3,701

$3,891

$4,119

$4,345

$4,584

$4,836

Ac

tua

l C

os

ts $

Total Benefit Costs Per Employee - Projected

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Why Wellness

• Costs follow health risks

• Absenteeism, presenteeism & productivity tied to health risks

• It pays to keep healthy people healthy

• Even small increases in physical activity can produce results

• Gains in employee engagement can be tied to wellness programs

• Programs do not have to be expensive

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Costs follow health risks Annual medical

charges for different ages and health risk

groups

19-3435-44

45-5455-64

65-7475+

Low Risk

Non-Part icipant

Medium Risk

High Risk

0

2000

4000

6000

8000

Low Risk

Non-Part icipant

Medium Risk

High Risk

Source: D. Edington. Emerging Research: A View From One Research Centre

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Absenteeism

University of Michigan study

• Workplace health promotion shown to decrease absenteeism:

– 10.5% in first year of implemented program

– 14% in second year

• Translates into $1.22 - $1.63 savings per dollar invested

Rx Drug stats a potential Wellness Tool?

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Any idea how?

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Compare Your Ees Rx Profile

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• to typical usage profile

• Develop programs to educate ees around major Rx uses

Question: are diseases preventable?

Are employers able to educate employees about

Tobacco Use Diet / Obesity Physical Inactivity

Alcohol and Drug Use

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Employer Involvement

• Provide workshops in the four areas

• Link to the Rx profile to provide related workshops and lunch and learns

• Provide wellness counselling for employees on a voluntary basis

• Would this be expensive?

• Would it create change in employee health?

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Health Risks

High Blood

Pressure

Type 2 Diabetes

High Cholesterol

COPD

Lung Cancer

Respiratory Disease Cancer of

Pancreas, Bladder, Kidney

Colon Cancer Breast

Cancer

Prostate Cancer

Cancer of mouth, pharynx, larynx, esophagus, liver

Heart Disease

Mental Disorders

Overweight/ Obesity

Tobacco Smoking

Unhealthy Diet

Physical Inactivity

Alcohol Consumption

Musculoskeletal

Renal Disease

Source: Ontario Ministry of Health and Long-term Care

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Source: Adapted from Sun Life Presentation, Healthy Outcomes Conference, April 2008

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Case Study: Xerox Canada: Bwell

1. Assess ee health risks

2. Develop initiatives throughout the year to reduce and contain health risk in supportive environment

3. Measure success

Make participation easy, non-threatening …and fun!

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Step 1: Health Risk Assessment BWell Cardiovascular Risk Assessment pilot program

– RN screens participants in a 15-minute appointment

– Measures blood pressure, total cholesterol, random glucose, BMI and body fat

– Take away: personal scores and educational info on risk factors

– Participants can be re-assessed each year

LifeWorks / Checkpoint HRA:

– Lifestyle – comprehensive risk assessment

– Can use the numbers received in the BWell assessment

– Access online

– Incentive / contest to get it going

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Step 1: Health Risk Assessment

• Risk factors identified year one (three pilot clinics):

– Smoking (19%)

– Systolic blood pressure (29%)

– Diastolic blood pressure (17%)

– Cholesterol (17%)

– Glucose (9%)

Source: Adapted from Sun Life Presentation, Healthy Outcomes Conference, April 2008

Surprising Stats

• 72% fell into moderate to high risk category for body composition and/or BMI

• Body composition is % of lean mass to fat mass

• BMI is a weight for height ratio to estimate body fat

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Source: Adapted from Sun Life Presentation, Healthy Outcomes Conference, April 2008

Other Assessment Tools

Other risks EAP & OHS Reports

•#1 reason for STD: Psychological

•#1 EAP presenting issue: Stress and work-life balance

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Source: Adapted from Sun Life Presentation, Healthy Outcomes Conference, April 2008

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Activity Outcomes 2006 2007

BWell assessment Cardiovascular risk established

Bwell quarterly newsletter Information for staff and families at their fingertips

Spring fitness challenge Motivation: Create new habits in 30 days

Fall nutrition & wellness chall Motivation: Nutrition Create new habits in 30 days

Weight mgmt nutrition clinics Interactive onsite info session

Stress management lunch & learn

Manage psychological stress, build resilience

Ergonomics in the office Better posture, less strains & pains

Flu shots Flu prevention, reduced absenteeism

Step 2: Develop programs

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3a Measure success Participation rates by ees

– Challenges engaged over 40%

– Cardio Vasc assessment: 25%

– Online assessment: 30%

– Lunch & Learn:s 15%

– Website: 60% (2288 unique users)

Source: Adapted from Sun Life Presentation, Healthy Outcomes Conference, April 2008

3b Measure success

Employee engagement

• 2007 Best 50 Employers Survey (Hewitt): 38th from 49th previously

• Xerox 2007 EES internal survey:

– 83% would recommend Xerox as a good employer

– 86% are proud to work for Xerox

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Source: Adapted from Sun Life Presentation, Healthy Outcomes Conference, April 2008

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3c Measure success • 450 repeat participants

– 152 (38%) improved on four or more risk factors

• Weight loss

– 209 people (53%) improved

– 34 moved into a healthy zone

• 21 stopped smoking

ROI 2:1 after only one year into the program!

Source: Adapted from Sun Life Presentation, Healthy Outcomes Conference, April 2008

http://www.rogers.bwell.com

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The Aging Workforce

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Retirement has changed • Organizations will feel impact of baby boom

retirement wave, just not hit yet

• This Wave is both a benefit and a problem

• Employers need talent, skills, knowledge, experience

• Boomers need engagement, income, flexibility and being valued

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Not your fathers retirement

• 60 or 65 and out

• Full pension or early pension

• With a life expectancy of 2 – 5 years

• WHY

• Another 10, 20, 30 or 40 years of life

• Switch from DB to DC pensions means less income

• Just another stage of life

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Boomer Fears

• Unpredictability of their finances

• Downturn was a wake up call

• Fear outliving their money

• Fear more losses

• RSPs have replaced Defined Benefit plans

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90

Older Workers Need to Work:

Insufficient Savings

0

10

20

30

40

50

1992-93 1996-97 2000 2007

Defined Contribution Defined Benefit

Pe

rce

nta

ge

of

Wo

rke

rs

Source: U.S. Bureau of Labor Statistics CG Hylton

What boomers want

• To be valued, engaged, part of something

• To work for an employer that permits them to create a flex schedule

• Renewed rejuvenated

• Active growing and learning

• Free time, flex time

• Extended time off

• Consulting work

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Phyllis Diller

Whatever you may look like, marry a man your own age - as your beauty fades, so will his eyesight

I’m at an age when my back goes out more than I do

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What boomers offer

• As productive or more productive

• Cost the same

• Superior communication skills

• Less likely to leave the job after short time

• Lower training costs

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Case Studies

• Career Lattice Program

• Ees can dial up, down, across career path

• Flexibility in ways to work

• Custom when, where, how

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CG Hylton Inc. 95 Source: Deloitte MassCareerCustomization_051310.pdf

• Best Companies for Multicultural Women, Working Mother, 2012

• 100 Best Companies to Work For, Fortune, 2010

• Best Places to Work for LGBT Equality, Human Rights Campaign, 2010

• Best Companies to Work for in Texas (Large), Best Companies Group, 2010

• Employees’ Choice -50 Best Places to Work, Glassdoor, 2009

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Adapting the workplace

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• Falls are the leading cause of hospitalization due to injury for Canadians 65+

• one in three expected to experience this life altering moment this year alone

• offices with flexi-floors, when those falls do occur, special new “bouncy floors” could reduce the risk of serious injury

Source: http://www.50plus.com/employment/new-technology-could-help-older-workers/161615/ accessed Aug 11, 2012

Smart Canes

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• Another invention called Smart Canes, will allow real-time feedback on proper gait and alert a worker’s colleagues by text if a fall occurs.

• “It’s a floor that’s compliant enough to prevent injury in case of a fall, but hard enough that you can do normal activities on it,” noted Feldman.

• Initial tests show that it could reduce hip fractures up to 80 per cent.

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The Work Environment

• The spaces where we work affect how we age

• We have control over how workplaces are designed

• Work environment issues are aging issues – Physical demands of work

– Lighting and vision

– Cognitive demands of work

• We can design age friendly workplaces

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Air bags

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• Workers will also have the option of of wearing a belt with built-in

air bags that will deploy when the sensor detects a fall

• Those with balance problems could wear them as part of their regular office wear

Source: http://www.50plus.com/employment/new-technology-could-help-older-workers/161615/ accessed Aug 11, 2012

Thank you!

Questions?

Chris Hylton

403 264 5288 chris@hylton.ca

101 CG Hylton

Chris Hylton, MA

• Chris - benefit and HR consultant

• EAP network with counsellors across Canada

• Volunteer with many organizations including Employee Assistance Society of North America and the Aboriginal Friendship Centre of Calgary

• Patient Engagement Researcher in training thru U of C School of Medicine and Alberta Health

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