The determinants of workforce wellness approaches for health workers

Going beyond workforce wellness approaches for health workers, 3 strategic workforce well-being levels for healthcare, mental health, and social workers

In health and social services, we are facing a serious workforce shortage complicated by a fatigue in our remaining workforce. Many organizations have 25% unfilled positions with 40% of staff wanting to leave their positions or change careers. Today’s care workforce is faced with new challenges that are taking a toll on their emotional and physical well-being. There has been an increase in the amount of mental health conditions, such as depression and anxiety, among care professionals. This is largely due to the fact that we are now facing a whole new set of challenges such as working in an increasingly complex environment with more demanding work schedules. As a result, the care workforce is becoming less resilient and more at risk for burnout. How can providers attract new staff, and retain and support existing staff so that they can provide high-quality services?

Why are Care Workers Burning Out?

COVID-19 has placed extraordinary pressure on care workers in health care, social welfare and mental health. These professions have a history of direct contact with patients and clients who seek help during times of need. A recently published study (Prasad et. al., 2021) surveyed over 20,000 health workers across 42 organizations around occupational stress. The study found that a majority of workers feared exposure to COVID-19 and transmission to family members. Over one third reported anxiety and depression. Nearly half reported work overload and burnout. The study reports it found that “stress is higher among nursing assistants, medical assistants, social workers, inpatient workers, women and persons of color, is related to workload and mental health, and is lower when feeling valued.”

Why care workers don’t feel valued.

Health care workers are burning out because they have too much work to do, and they feel like the work that they do get done is not valued. Care workers may feel like they are not able to provide the level of care that is needed in settings because there are not enough staff members and resources available. This leads to frustration. When care workers do not receive the respect and appreciation, this can lead to emotional and physical exhaustion. Some care workers feel that they are not appreciated by their managers and supervisors. Some feel that they are not appreciated by their co-workers. Some feel that they are not appreciated by the people they care for. Some feel that they are not appreciated by all three groups. Programs that are effective at improving employee health and reducing chronic diseases can reduce costs for both employees and employers.

What happens when care workers are overloaded?

In addition to feeling undervalued, care workers can experience occupational stress related to their duties. Care workers can feel physical danger because of the risks they take when treating people, which can lead to emotional and mental exhaustion. Some care workers, for example, work too hard without getting enough sleep or taking a break from their job. Some care workers don’t have enough time to spend on themselves because they are too busy working over time to take care of other people. This can lead them to being too stressed out, which can cause them to have more negative feelings and thoughts about their job.

What Can We Do to Build Resiliency in Our Workforce?

In order to address this problem, we need to expand our current approach. We have been focusing on implementing wellness programs, employee assistance programs (EAP), and rolling out subscriptions to mental health apps to help workers outside of work. While these are important supports for workers, more needs to be done to identify if these wellness benefits are effective in relationship to the internal company culture and staff duties within an organization. True workforce well-being relies on three pillars: 1. Work Culture, 2. Position Fit, & 3. Employee Health and Wellness. At the intersection of these three determinants of workforce well-being lies the healthiest and most productive care workers.

Employee Well-Being Survey

What is a workplace wellness program?

A workplace wellness program is a part of an overall initiative to create a healthier workforce that will improve employee productivity, lower healthcare costs, and reduce sick days. It focuses on wellness behaviors that improve health.

A typical workplace wellness program includes the following key components:

– Encouraging healthy lifestyle choices through education and resources.

– Promoting healthy eating and physical activity through onsite resources, policies, and programs.

– Helping employees make good decisions about their health and mental health with the help of online tools.

– Providing access to resources through Employee Assistance Programs (EAPs).

How Do We Know if our Employee Health & Wellness Programs are Helping?

Workforce wellness approaches for care workers can be effective at improving employee health and reducing chronic diseases. Programs that improve the physical, emotional, intellectual and social well-being of employees help to reduce costs both for employers (by reducing absenteeism or increasing productivity) as well as providing better care to patients. However, providers may not see the rewards of their invest in these resources if they do not track the use and effectiveness of each component. Employee resources that are not promoted, not used, or not well matched to staff needs, can result in high costs to providers without positive outcomes. While providers can track absenteeism before and after implementation of a wellness program, those gross measures are not sensitive enough to identify adjustments to wellness program components which could lead to increased positive impact on workforce.

For example, messaging around wellness programs to help staff feel safe in using the resources, improving its use and effectiveness.

“‘There still seems to be a pervasive sense among employees that EAPs are for very specific and discrete problems like substance abuse or management issues,’ said Helen Darling, president and CEO of the Washington-based National Business Group on Health. ‘The message that EAPs really need to get across is that they’re a one-stop shop where employees can seek out help no matter what challenge they’re facing.’ For employers of all sizes, an employee assistance program can be a low cost, high return benefit, if implemented and communicated effectively. An easy way to say, ‘We care.'” (Reynolds, K, 2021).

Once messaging is established, increase communication and awareness of the wellness programs.

Lisa McKeown of Nonprofit HR writes, “increasing awareness for your organization’s EAP is good for business. Why is it beneficial for an employer to provide an EAP for their staff? Facing life’s everyday stressors can take a personal toll on individuals, even impacting work attendance and performance levels. We all face stress and manage it differently; in fact, a little stress is normal. But when it becomes apparent that an employee’s stressors are negatively impacting their presence and productivity, it may indicate the need for additional support. Emphasizing your organization’s EAP keeps you a step ahead.”

How do you measure the effects of workforce wellness programs?

Online solutions, such as Opeeka’s Person-Centered Intelligence Solution (P-CIS) provide HIPAA compliant, HITRUST environments to allow confidential monitoring of wellness programs. Providers can access reports of program usage, wellness improvement indicators, and worker satisfaction with programs. This level of feedback supports providers in adjusting offerings that meet the needs of the workforce. Programs with low usage can be re-messaged or swapped out for new programs to try. Mental health apps that are not moving the needle on indicators of well-being, such as health skills for wellness, can be discontinued and replaced with alternatives. Continuous monitoring of health & wellness programs leads to continuous improvements in quality of offerings. This in turn, leads to increased employee health, less absenteeism and improved productivity. But the impacts from improved employee health and wellness outside of an organization will never be realized by the employer if that employer is not also considering internal drivers of workforce well-being, such as company culture and employee to position fit.

Employee Health & Wellness

What is Positive Work Culture?

Workforce resilience begins with the culture of the organization. A positive corporate culture is one that makes employees feel valued. Even the healthiest of employees outside of work need a positive corporate culture in order to be productive at work.

One way to support a positive work culture is to establish organizational core values.

Establishing and monitoring core values is a powerful way to establish and maintain core culture. For example, Opeeka’s core values listed above were established through focus groups and surveys of employees. Capturing employee voice builds strong company culture. Here are some suggested steps to establish employee driven core values. By making employees voices central to the values of the organization, the organization will build resilience in its workforce. For example, Opeeka’s P-CIS can capture and monitor employee opinions on organizational core values by quickly and easily capture employee voice through questionnaires, surveys, and short pulse surveys through text/email. Employees can click on the pulse survey link and quickly and securely respond without login or passwords.

Employee Well-being App

What are four steps to establishing core values for an organization?

  1. Review lists of potential core values (search online), and identify 20 that you think that the organization does well today; Identify another 5 that you want to strive to do well in the future.
  2. Survey all employees on the 20 core values for how well they think you are doing today. Survey employees on the importance to them for the additional five areas.
  3. Of the 20 surveyed, identify the top rated core values (<10). These become the organizations core values today. Of the 5 surveyed, identify the top 1-2 areas of importance to strive to build strength in.
  4. Schedule regular short pulse surveys (less than 10 questions) to ask about core values, at least quarterly.

Core Values

A positive work culture means providing good support for good work and ensuring that there is a good process.

A company with a positive company culture will also provide the resources for workers to do good work, like good equipment, good training, and the opportunity to advance. Organizations should review processes to make sure the employees have all of the support they need through every action of their day. When work does not get done or done well, organizations should ensure that there is not a nee for process improvement over performance improvement plans (PIP). When process fails, no employee can perform well, regardless of workforce wellness. When work is not done or done well, ask staff their opinions on how to improve the process so that they can perform good work. Workers who are respected for their contributions will be more likely to give back in return. With this type of culture, employees feel like they belong at work and are happy to be there. That’s the key to a positive company culture: happier, more productive workers who want to continue working for you.

A positive work culture uses positive language. Change your organization’s language on annual performance to be resilience-focused.

There is nothing more fear invoking for an employee than to wait an entire year to endure a negative performance review on a document with judgmental phrasing. One way to earn trust is to create human resource and personnel policies that reflect that an organization values its workforce. Organizations that write policies with a resilience framework and focus on building strengths within personnel build stronger relationships with their employees.

Corporate culture begins with the language that the organization uses. Annual performance review templates, for example, often contain autocratic phrases. Organizations looking to change culture can rewrite policies and processes with success-focused wording aligned with organizational core values. For example, consider taking a strength-based approach to responses. In this case, the employee is rated on a Likert scale of strength from “skill needs development” to “centerpiece skill” as seen in the figure below.

How do you create language for success-focused performance?

  • Espouse a resilience framework.
  • Focus on skills and strengths.
  • Identify employee professional goals.
  • Communicate organizational goals.
  • Be solution focused.
  • Use compassionate wording.
  • Ask for feedback.
  • Identify ways to support.
  • Consider secondary trauma.
  • Reflect organizational core values.
  • Elicit ideas to improve process.
  • Don’t blame the people if you can fix the process.

Employee Well-being Tracking

How can an organization improve culture by continuously checking in with employees?

During this time of constant change to adapt to an evolving COVID-19 pandemic, it is more important than ever to take a pulse of workforce well-being at regular intervals. An efficient way to measure workforce resilience is through a pulse survey.

What Is a Pulse Survey?

A pulse survey is a simple and efficient mechanism for “taking the pulse” of staff on just a few topics at a time. Unlike a traditional survey, which is often bound to measuring specific topics or content, pulse surveys’ content should be adjusted to meet real-time organizational goals. Pulse surveys should measure recent status over the last week or up to 90 days.

The 3 Important Pulse Survey Elements:

Effective pulse surveys often have overarching elements which fall into the following 3 large categories or buckets:

  1. ‘Real-Time’ Responses. Since pulse surveys only have a few questions, they ensure you get quick, accurate, and a lot of responses. Remember: A ‘good survey response rate’ ensures larger and better data. Unlike traditional surveys, you do not have to wait one full year for pulse surveys. This helps in addressing concern as and when they arise, making organizations more agile.
  2. Tracking Actionable Data. Since pulse surveys focus on one aspect, you get clear and concise feedback that you can act on right away. It makes it easy to devise new action plans and initiatives. These surveys can be instrumental in learning how staff sentiment about one thing or aspect changes over a period. They are short and hence easy to deploy frequently.
  3. ‘Real Understanding’ Through Engagement. Since you have frequent and current information from employees themselves, you can act to improve upon your organizational processes connected to employees. Organizations should know how employees feel on a regular basis, not just a ‘one and done’ annual work review. Using staff pulse studies, organization administrators’ can investigate and understand the basics and ‘day-to-day’ aspects of their organization which affect both employee experiences and workplace culture. Increased ‘employee voice’ translates into better staff productivity, morale, satisfaction, and retention.

Workforce Pulse Survey

How do you design a pulse survey around a topic?

Pulse surveys should focus on a specific topic that you feel impacts the performance of employees in the organization. The topic should be actionable, meaning that you plan to address the needs raised through the responses to the survey. An organization that asks about challenges of its staff but does not address those challenges risks further frustrating and demoralizing the staff.

  1. Outcome Questions. These are designed to measure trends or the impact of an initiative over time. It’s a good idea to use a scale for these questions so you can gauge the strength of feeling.
  2. Driving Questions. These types of questions help you determine the key drivers for the issues you are trying to measure. It could be agency practices, culture, or behaviors-the aim here is to identify actions and solutions.
  3. Open-Answer Questions. These questions invite employees to write their own responses. It’s an opportunity to gain deeper and more valuable insights. However, open-text questions can be hard to analyze, so keep them to a minimum.

The following example shows a pulse survey designed around teamwork. This survey can then be calibrated in P-CIS and scheduled to be texted/emailed to all employees before and after an intervention to improve teamwork.

Employee Mental Health Software

How can you easily and quickly implement a pulse survey once it is designed?

Opeeka’s Person-Centered Intelligence Solution (P-CIS) has several advantages to quickly and easily implement workforce surveys.

  • Opeeka provides several templates to start from for your workforce well-being survey, as a suggestion. You can use your own surveys more modify one of these as a starting point.
  • Automated insights use Success-Focused Artificial Intelligence (SF-AI) to pinpoint areas of focus that will have the most impact on workforce well-being.
  • Longitudinal changes are tracked so that you can see if your workforce well-being interventions are working, and for whom.
  • Quick and easy mobile-friendly email or text links allow staff completion in seconds.

What are 5 Factors of Pulse Survey Effectiveness?

  1. Purpose. It is crucial to have a plan to respond to the results. If the data show low satisfaction, what will you do? Don’t ask questions about topics that you are not prepared to act on.
  2. Frequency. You must take into consideration things such as what aspects are being measured and how they will be affected over time. You may conduct a few surveys and then figure out the right survey cadence for your organization.
  3. Spot-On Questions. This is imperative to solicit appropriate employee feedback. The questions must be applicable to your organization. Don’t include questions or responses that don’t relate to your employees. Use the templates, customize what you must to get actionable insights.
  4. Right-Size. Pulse surveys, by nature, are meant to be short and simple. You need to be mindful of that and not prepare long surveys such as your annual or bi-annual employee satisfaction surveys. Another reason to keep them short is to encourage employee participation.
  5. Understand & Use Data. Use of analytics on your data to uncover gap areas, discover trends, and figure out patterns. Your feedback data is of no use if you do not make use of it to bring about necessary changes.

How Can Organizations Achieve the Best Employee to Position Fit?

You will never have more of an employees attention and willingness to provide information than at the time of hiring. It is important at the time of hiring to listen and ask. Skills can be learned, and an organization can optimize retention by matching applicant values to organizational culture. It is important to first establish core values of the organization before hiring to meet those values. If you currently have or want to implement pre-hiring assessment of core value and skills, P-CIS can help understand which responses are most important for success in your organization. P-CIS machine learning and success-focused artificial intelligence (SF-AI) engines identify which combination of skills and values perform well in which types of positions. For example, care workers with medically fragile family at home may need to switch into less patient/client facing roles to reduce anxiety for a period of time or longer. Understanding the needs of staff as they relate to the duties of the job is essential to ensuring ongoing employee to position fit. This fit should be evaluated annually, and more often in highly changing environments.

Skill Markers

Track goals annually to ensure ongoing fit to position.

When an organization hires, it is common to ask applicants about professional goals. This question should be repeated each year to ensure that the employee’s professional goals continue to align with that of their position and advancement path. Consider the organization processes and procedures. Are staff overwhelmed with burdensome documentation? Can the organization diagram workflow and create efficiencies within processes for staff? It is a good time annually to re-evaluate the efficiency of processes. Ask staff where processes could be improved. Using P-CIS for documentation, for example, can reduce time spent filling out forms because P-CIS automates form completion from existing information.

Depression and Anxiety Tracking Software

What are the Benefits of Investing in Tracking Workforce Well-Being?

When employees are healthy, they have better performance in their job which leads top five organizational priorities influenced by employee’s wellness being.

  1. Increased productivity.
  2. Higher quality performance.
  3. More employee engagement and morale.
  4. Reduced benefit costs.
  5. Increased safety.

Summary of Steps to Build a Resilient Workforce

Workforce well-being is important to the success of an organization. Employees are the most valuable asset, and they are hard to find and keep in this environment. There are several ways an organization can build and retain a resilient workforce, as summarized above.

Opeeka has created a Person-Centered Intelligence Solution (P-CIS) that can reduce time spent on documentation, increase efficiency of structured communication with staff, monitor workforce well-being outcomes in real-time, direct efforts to improve workforce well-being, and measure the impact of intervention efforts.

  1. Identify organizational core values.
  2. Hire staff with values that match organization and position.
  3. Find creative ways to compensate staff.
  4. Rewrite policies with a resilience framework.
  5. Evaluate processes and workload that burden staff.
  6. Establish success-focused performance evaluations.
  7. Engage workforce regularly with pulse surveys.
  8. Monitor changes in workforce well-being over time.
  9. Improve workforce well-being through purposeful interventions.
  10. Take a person-centered approach and identify what works for whom.

Email [email protected] for more information or visit opeeka.com/workforce for more information.

References

Prasad, K., McLoughlin, C., Stillman, M., Poplau, S., Goelz, E., Taylor, S., Nankivil, N., Brown, R., Linzer, M., Cappelucci, K., Barbouche, M., & Sinsky, C. A. (2021). Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID-19 pandemic: A national cross-sectional survey study. EClinicalMedicine, 35. https://doi.org/10.1016/j.eclinm.2021.100879

Reynolds, K. Employee Assistance Programs – Underlying Message, We Care. https://www.thinkinnovative.net/blog/employee-assistance-programs-underlying-message-we-care/. Accessed 10/3/2021.

McKeown, L. Jumpstart a Conversation about Your Organization’s Employee Assistance Program. https://www.nonprofithr.com/reintroducing-employee-assistance-program/. Accessed on 10/3/2021.

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