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CASE STUDY: University of Texas MD Anderson Cancer Center embeds wellness into its culture

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Conventional wisdom says that successful wellness program design and evaluation begins with a detailed assessment of an employee population's costliest and most chronic health risks.

However, it is possible for employers to achieve a return on their investment in wellness programming even when ostensibly critical health care expense and risk data aren't available. Such is the case at the Houston-based University of Texas MD Anderson Cancer Center, where circumstances forced the organization to take a rather unique approach to its wellness program's design and administration.

“It's been very hard for us to pull some of the data that other companies use to build their wellness programs,” said William Baun, MD Anderson's wellness officer, who was chiefly responsible for the program's design and rollout in 2001. Benefit plans for MD Anderson's approximately 19,000 employees are coordinated by the University of Texas' central administration, which to date has not been able to provide the organization with detailed health care costs and claims data.

Instead, Mr. Baun and his team designed MD Anderson's wellness program to address costs and risk factors that they could evaluate at a statistical level, such as workers compensation and disability claims, lost work time and presenteeism. In 2001, the organization added a workplace injury care unit to its employee health and well-being department, placing an emphasis on expediting recovery times and prevention education.

“I think a lot of companies, because they can't quite get at health care costs or whatever they're being told they should be targeting, they just don't do the programs at all, and that's crazy,” Mr. Baun said. Six years after adding the injury care unit, MD Anderson saw lost work days among its employees drop by 80% and reduced-duty days drop by 64%. The reduction in lost work time saved the cancer center an estimated $1.5 million during that six-year period, while its workers comp insurance premiums declined by 50%, Mr. Baun said.

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Middle-management ownership

“If you take the measures that you do have control of, and use them well to drive support among your employees, your middle management and your senior management, you can still have a great deal of success in wellness,” Mr. Baun said.

He added that the reduction in lost work time factored greatly in driving “ownership” of the program among department managers and supervisors, a crucial element to sustaining wellness participation that programs keyed solely to lowering health care costs often lack.

“When you talk to middle management and try to get them to take an ownership in the program, they're not going to feel costs tied to health care,” Mr. Baun said. “What they do feel is the absenteeism and presenteeism, and the costs associated with those kinds of issues.”

The design of MD Anderson's wellness program also relied heavily on employee surveys and interviews, which Mr. Baun said were used to gauge specific needs and interests among the organization's multitude of individual departments, spread out over 77 buildings within the Texas Medical Center campus in Houston. Early on, Mr. Baun said he and his team were able to identify key wellness infrastructure needs, such as lactation rooms, on-site fitness equipment and stress-relief stations.

“What really drives a wellness program to be successful are the interests and needs of your employees,” Mr. Baun said. “It doesn't really matter what the financial goals of program are. If they don't mix on some level with the interests and needs of your group, it's not going to work.”

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In particular, Mr. Baun said early efforts to build lactation rooms for working mothers of newborns proved to be a critical step in building interest and support for wellness and health management among employees. Mr. Baun said he was able to secure funding for the first lactation room by inserting a female employee directly into the conversation with MD Anderson's senior executives.

“What that did up front was it built a phenomenal momentum among the women at MD Anderson who wanted to understand what workplace wellness was all about,” he said. “That made it easier for us to build out some of the other environmental elements that have become part of the core of our program.”

Today, MD Anderson's environmental wellness offerings include 14 lactation rooms, a 20,000-square-foot on-campus fitness center, a bicycle parking garage and shower facility, and more than a dozen “stress buster” stations. Mr. Baun also successfully lobbied for the creation of three full-time positions specifically in service of the wellness program, including a statistician, physiologist and wellness educator.

The program itself now includes designated “wellness champions,” individualized coaching, nutrition courses, outdoor walking groups, weight-loss support groups, massage therapy, a vegetarian lifestyle club and a peer-based wellness awards program.

“It's been a phenomenal journey to watch MD Anderson go from having nothing to building a first-class foundation of a wellness culture,” Mr. Baun said.