Promising and Best Practices in Total Worker Health Workshop Summary (2014) / Chapter Skim
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2 Total Worker Health in the Real World
2 Total Worker Health in the Real World
Pages 7-14
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-- Robert McLellan Robert McLellan, Medical Director of the Live Well/Work Well program1 at Dartmouth-Hitchcock Medical Center, began the workshop by talking about how to build a sustainable foundation for integrating safety and health protection activities with health promotion activities from lessons learned at Dartmouth-Hitchcock. In particular, he noted the development of SafeWell Practice Guidelines2 that "provide organizations with a framework for implementing a comprehensive worker health program, along with specific strategies pertaining to the details of implementation" (McLellan et al., 2012a)
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9. Integrate with primary care.
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McLellan said that in the most recent Dartmouth-Hitchcock engagement survey, employees gave their highest scores -- 86 percent support -- for the center's health promotion and safety efforts. PROGRAM ELEMENTS AND TEAMS At Dartmouth-Hitchcock, occupational medicine, safety and industrial hygiene, disability prevention and treatment, health promotion, and employee assistance services are augmented by primary care services.
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Even for employees who seek primary care outside DartmouthHitchcock, the institution provides care coordination and behavioral health services. The initiative compiles care registries, built through health and wellness assessments and claims data, and staff members ask injured or ill employees whether they have a primary care physician and, if not, help them obtain one, if they desire.
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While the injury reports prompt treatment referrals, they also can stimulate an integrated, comprehensive investigation of the work environment and the personal and organizational factors that may be influencing workgroup health. Similarly, in the occupational medicine clinic, clinicians not only manage illnesses or injuries that result from work-related exposures, they
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From page 12... ...
, triggered not just by units that are work safety outliers, he said, but also by other evidence of problems: critical or clustered events, plus some combination of poor participation in some of the employer-sponsored health promotion activities or indicators of lowerquality care provided by the unit, for example. SWAT interventions begin with an open-ended, integrated work environment assessment intended to prompt discussion, as well as a "culture of health" survey.
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and some approaches used in more traditional health care quality effectiveness assessments, so far have not been applied to integrated health protection and health promotion services.
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Workers' compensation and disability data, for example, may be hard to integrate with the organization's own information; employee surveys may not be online or may be externally managed. As primary care providers move toward an accountable care organization model, under which they assume responsibility for managing the health of a population, they will be increasingly interested in how employer-based health promotion and protection can synergize with community-based health services to improve population health, McLellan said.
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