Impacts of Workplace Health Promotion and Wellness Programs on Health Care Utilization and Costs: Results From an Academic Workplace.

OBJECTIVE: This study evaluated the impacts of a long-standing workplace health promotion (HP) program on health care utilization and costs and estimated return on investment (ROI). METHODS: Analyses used a retrospective, observational cohort design based on 7 years (2005 to 2011) of health claims and HP program participation data for 3829 HP participants and 6617 controls. Inverse propensity score-weighted mixed-model regression methods were used to balance employee demographics and comorbidities by study arm. RESULTS: Mean monthly health care costs were $35 less for HP participants compared with controls, and results were robust based on sensitivity analyses. ROI was estimated to be $2.53 for every dollar spent on the HP program. CONCLUSIONS: Results support a positive impact of HP program participation with regard to reduced health care utilization and costs and a positive ROI.

The steps to health employee weight management randomized control trial: rationale, design and baseline characteristics.

BACKGROUND: The workplace can be an important setting for addressing obesity. An increasing number of employers offer weight management programs. PURPOSE: Present the design, rationale and baseline characteristics of the Steps to Health study (STH), a randomized trial to evaluate the effectiveness of two preexisting employee weight management programs offered at Duke University and Medical Center. METHODS: 550 obese (BMI ≥30) employee volunteers were randomized 1:1 to two programs. Baseline data, collected between January 2011 and July 2012, included height/weight, accelerometry, workplace injuries, health care utilization, and questionnaires querying socio-cognitive factors, perceptions of health climate, physical activity, and dietary intake. In secondary analyses participants in the two programs will also be compared to a non-randomized observational control group of obese employees. RESULTS: At baseline, the mean age was 45 years, 83% were female, 41% white, and 53% black. Mean BMI was 37.2. Participants consumed a mean of 2.37 servings of fruits and vegetables per day (in the past week), participated in 11.5 min of moderate-to-vigorous physical activity, and spent 620 min being sedentary. CONCLUSION: STH addresses the need for evaluation of worksite interventions to promote healthy weight. In addition to having direct positive effects on workers' health, worksite programs have the potential to increase productivity and reduce health care costs.

A multidisciplinary team approach to reducing medication variance.

BACKGROUND: In March 2000 a multidisciplinary team was formed at Williamsburg Community Hospital (Williamsburg, Virginia) to address medication-related patient safety initiatives. MEDICATION SAFETY TEAM: The team focused on promoting a nonpunitive reporting environment, developing a collaborative medication administration policy, and designing an education and communication plan that promoted safe medication practices. In creating a nonpunitive environment, the first step was to revise the medication variance reporting policy. The team focused on process improvement and removed all references to corrective action from the policy. It launched an extensive educational effort throughout the hospital to raise awareness of the change in policy and to increase the focus on patient safety initiatives. The team also oversaw development of a comprehensive medication administration policy, which consolidated nursing, physician, and pharmacy practices. The team implemented a number of quick fixes that generated momentum and provided some immediate successes. RESULTS: Within a 9-month period (May 2001-January 2002), the number of reports doubled. As the number of variance reports increased, a subcommittee formed, with the specific responsibility of reviewing the reports on a weekly basis. DISCUSSION: The team sought to change the environment and attitudes related to medication variances and reporting. This was an organization wide change that required employees to change their perceptions regarding the purpose of reporting. Implementing the changes in small bites to realize immediate successes helped provide the impetus to keep the team focused and energized in tackling this huge endeavor. The team provided the ability to solve problems and recommend changes quickly and effectively from a variety of perspectives.