Working Well
Working Well | Worksite Wellness, Vanderbilt, Health Plus, Dr. Lori Rolando, Go for the Gold, Employee Health

Vanderbilt’s international reputation as an elite university and renowned center for healthcare and research is well deserved.

However, the leadership of the academic behemoth readily recognizes that any institutional accolades are a direct result of the hard work and dedication of its more than 20,000 employees. The best way to keep Vanderbilt working well is to ensure staff members are well at work.

To that end, Vanderbilt has adopted a comprehensive worksite wellness program based on the four components outlined by the World Health Organization (WHO). To achieve optimal health, the WHO takes the broader viewpoint of health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." The public health organization encourages employers to focus on the psychosocial aspects of well being along with wellness in the workplace, at home and in the community.

Mirroring those goals, Vanderbilt’s employee health and wellness program has four components — 1) Health Plus, the organization’s health promotion arm; 2) Occupational Health, which protects faculty and staff through a number of initiatives ranging from immunization programs to population health surveillance to injury prevention; 3) Work/Life Connections-EAP offering complete psychological support services; and 4) Child and Family Center, which offers early childhood education, child care, elder care consultations, and a host of other family support resources.

Lori Rolando, MD, MPH, is the medical director for Health Plus and assistant medical director for Vanderbilt Occupational Health Clinic. In her dual roles, the board-certified occupational medicine specialist spends her days promoting healthy life practices. “We know that increasing health and well being can increase productivity,” noted Rolando. However, she added, the real impetus for Vanderbilt’s integrated approach to caring for employees has more to do with the university’s lifeblood than its bottom line. Quite simply, she said, “Our faculty and staff are our most valued asset.”

Besides, as Rolando pointed out, worksite wellness initiatives are actually a win/win benefiting both the employee and the employer. Vanderbilt’s benefits-rich program aids in staff retention and offers many opportunities to improve an employee’s quality of life. In turn, healthy employees not only boost revenues through increased productivity but also help control healthcare costs.

She added employers should look at worksite wellness programs as long-term investments in employees. Ultimately, research shows the average return on investment for employee wellness ranges from 1.5-3 to 1. Rolando said part of that return was in the form of indirect benefits including less absenteeism and less presenteeism (when employees are at work but not functioning at full capacity).

Ironically, Vanderbilt’s healthcare professionals are sometimes the toughest audience to reach. “Their main focus is that they’re caring for others. It’s sometimes easy to put yourself on the back burner,” noted Rolando, “but it really is important to remember to take care of yourself first.”

To make the journey to optimal health as straightforward as possible, Rolando said Vanderbilt is working hard to foster an environment where the healthy choices are the easy choices. There is a 17,000 square-foot fitness facility on site to make it easy to get physical activity. And the worksite wellness team offers a host of events throughout the year from awareness and risk reduction programs to ‘know your numbers’ events to healthy cooking demonstrations.

One of the most popular events, now in its third year, is a farmer’s market in the Medical Center Plaza every Thursday from June-October sponsored by the Nashville Farmer’s Market, Monroe Carell Jr. Children’s Hospital at Vanderbilt, and Health Plus. “It’s open to the public,” said Rolando. “We encourage people in the surrounding community to take advantage of the market.” She added a satellite market has also been set up at the 100 Oaks campus this year.

At the center of the Health Plus component is the Go for the Gold program. “That’s a three-pronged program that allows individuals to identify their health risk through the Health Risk Assessment; the Wellness Actions Log, which is a web-based program that allows people to take action to reduce the risks they’ve identified; and the Game Plan for your Health video, an informational video produced in-house that addresses important health topics,” Rolando explained. She noted there are multiple programs available for the key modifiable risks — weight, physical activity, stress, nutrition and tobacco cessation.

She added Go for the Gold is an incentive program, which encourages broader participation. “So people paying for Vanderbilt health plan benefits can get up to $240 a year to put into a health plan account that will help offset deductible and co-insurance costs.” Rolando noted there is approximately 80 percent participation annually in the voluntary program.

While all information gathered in the risk assessments is confidential, she noted the de-identified information is used in aggregate “to determine where we, as an institution, are in terms of risk.” Vanderbilt is able to get a good sense of how programming is working through a cohort of approximately 3,300 employees who have participated in Go for the Gold since its inception in 2003. The group’s de-identified information can be extracted from the annually tracked aggregate data to get a baseline comparison in terms of overall wellness scores.

“By the metrics we look at, we can see an improvement year-to-year in both the overall Vanderbilt population, as well as in the cohort of 3,300 individuals who have participated every year,” said Rolando. “We’ve seen a decrease in the number of smokers, an increase in physical activity and we’ve seen a flattening in terms of the curve of people maintaining their weight.”

She continued, “In the U.S. in general, over the years, the obesity levels are increasing, and Tennessee’s obesity rate is higher than the national average. One of the things we’ve seen in the Vanderbilt cohort is that the number of individuals in our Vanderbilt community whose body mass index is 30 or above has leveled off. Considering the trends in the U.S. in general and Tennessee in particular, we think flattening of the curve is a very important first step.”

While it is crucial to help those struggling with modifiable behaviors to lower risks, Rolando said it is equally important to keep those considered ‘low risk’ in that category. Based on the health risk assessment, nearly 82 percent of Vanderbilt employees are categorized as being low risk, which means they only have one or two risk factors. “Keeping the low risk individual low is one of the most important things you can do … especially from a healthcare cost standpoint. Once someone moves to a higher risk level, even if you bring them back down, their healthcare costs will never be as low as they would have been if they had stayed low risk.”

Vanderbilt’s comprehensive programming has garnered national attention. In mid-May it was announced that Vanderbilt has been recognized for the fourth consecutive year at the highest level of the American Heart Association Start! Fit-Friendly Companies Award, which is presented to employers demonstrating progressive leadership toward making health and wellness a priority for their employees. The academic institution and medical center will be recognized next month in Fortune Magazine for its accomplishments in promoting a healthy workforce.