Archive for June, 2006

Wellness Programming for the Time-Challenged

June 29th, 2006 by Melanie Matthews

Are there too many demands on my time? Do I have a short attention span? And, am I a typical wellness program participant? If so, worksite wellness programs are in trouble.

Having recently participated in a workplace wellness program in our office, which challenged our staff to walk 10,000 steps a day and eat five servings of fruits and vegetables each day, these are some of the questions that I'm asking myself at the program conclusion.

Not to provide too many lame excuses for my failure to finish, but I am a full-time working Mom with two young children and a spouse who works rotating shifts. I am active in my daughter's PTA and do publicity efforts for a local breast cancer foundation. On top of those everyday demands, during the eight-week period, my Mom was hospitalized for five days, I had a three-day business trip and my daughter finished school with end of the year activities consuming some of my time. Throw in an obligatory shower, a cousin's wedding and a few birthday parties for my kid's friends, suddenly those 56 days of the challenge become a struggle to accomplish all that needed to be accomplished.

Is this what wellness programs are up against? I try to exercise a little bit every single day, but sometimes, there simply isn't enough time in the day. You don't have to educate me on the importance of exercise and eating right. You just have to help me find the time to do it!!

Maybe there is a need for time management education and programs in workplace wellness programs!

Emergency Rooms Ill-Prepared to Handle Patient Needs

June 22nd, 2006 by Melanie Matthews

Unfortunately, I've had plenty of experience with emergency room (ER) visits in my lifetime. Known as the family “klutz,” I probably can't list the number of broken bones and stitches that led me to visit the emergency room at the local hospital.

Residing in a beach town, it was especially traumatic (pun intended) to have to make this journey in the summertime. In fact, it became a family joke when my Dad would call around to see what the “wait times” were at the ERs at local hospitals.

It's not a laughing matter anymore. Despite the lifesaving feats performed every day by emergency departments and ambulance services, the nation's emergency medical system as a whole is overburdened, underfunded and highly fragmented, according to a new report by the Institute of Medicine (IOM) “Hospital-Based Emergency Care: At the Breaking Point.”

The IOM report found that ambulances are turned away from emergency departments (ED) once every minute on average and patients in many areas may wait hours or even days for a hospital bed. Moreover, the system is ill-prepared to handle surges from disasters such as hurricanes, terrorist attacks or disease outbreaks.

This should come as no surprise to anyone who's visited an ED within the last few years. Understaffed and overcrowded, EDs are serving not only the trauma needs of area residents, but oftentimes the primary care needs of the uninsured.

There are groups at work to change this. Back in 2002, the Robert Wood Johnson Foundation created a $6.4 million national initiative called Urgent Matters to “help hospitals eliminate emergency department crowding and help communities understand the challenges facing the healthcare safety net.”

Urgent Matters engaged 10 communities in a safety net assessment and community education process in conjunction with identified hospitals and other community partners, to raise awareness about the state of the local safety net. It also established a Learning Network comprised of 10 hospitals (all public or non-profit, with Level I or II trauma centers) in those same communities. This Learning Network has developed and implemented best practice strategies to maximize ED patient flow and relieve overcrowding. Four of the hospitals also received $250,000 in grant funding for special demonstration projects.

A number of case studies and strategies for addressing this issue are available on the Urgent Matters web site, covering such topics as the admissions process, triage, serving the needs of mental health patients in the ER and bed placement.

In the 30-some odd years that it took me to more or less outgrow my clumsiness (knock on wood), things have not changed much at our local ER. On Memorial Day weekend, relatives of mine spent four hours in the local ER without being seen…left there to see if they would have better luck at an urgent care center a few towns away. Thankfully, the urgent care center had sufficient staff to meet the healthcare needs of this relative (who was later admitted to the same system with the crowded ER).

Can You Guess the Average Price of a 4-Day Inpatient Hospital Stay?

June 13th, 2006 by Melanie Matthews

Changing consumer behavior is perhaps one of the biggest challenges that consumer-driven healthcare plans face. Consumers need a lot of education to help build their confidence and skills in managing their money, Joan McCarthy, vice president and communication consultant at AON Consulting, told participants in Health Plan Open Enrollment: Strategies to Improve Results, a May 24, 2006 audio conference hosted by the Healthcare Intelligence Network.

The challenge is to get healthcare consumers to be true consumers and use their healthcare funding vehicles appropriately. Consumers have to understand that these are funding vehicles and that they are expected to talk to their doctor and ask a question, for instance, about a brand drug versus a generic drug, Paul Harris senior consultant with Hewitt Associates added.

McCarthy referenced a 2005 Harris survey for Great West Life Insurance Company that found that consumers can guess the price of a Honda Accord within $300, a round-trip plane ticket within $37 but they are off by more than $8,000 for an average four-day hospital stay. After 25 years of HMOs and PPO co-payment plan designs, consumers have really lost touch with the real cost of many healthcare services.

Employers and health plans are offering a variety of educational tools to raise the level of consciousness among their healthcare consumers. In our June survey of the Month on Consumer-Driven Healthcare Education, employers and health plans alike are sharing the strategies and challenges of educating consumers on selecting and using consumer-driven healthcare plans.

Preliminary results show that plan features and services education is the most popular educational component for both employers and health plans. Other ways that organizations are educating members and employees include online calculators, decision support tools, senior management messages, provider quality and cost information and comparison and consumer tips, such as choosing a PCP and evaluating quality information.

One health plan respondent noted that developing the multiple ways to reach members is one of the greatest challenges they face. “Different people learn in different ways, and we need to fully understand that.”

Participants in Health Plan Open Enrollment: Strategies to Improve Results learned from McCarthy, Harris and Hilary Mitchell, director, voluntary benefits programs with Pitney Bowes a number of innovative ways that health plans and employers are meeting this challenge, such as providing “People Like Me" examples to help employees evaluate which options make sense for their personal circumstances and a list of common medical scenarios to compare employee costs under different health plans.

These innovative approaches are yielding better informed consumers who are now able to put a more realistic price tag on the cost of a four-day inpatient hospital stay, which by the way is $14,500, according to the Harris Interactive study.

Words from a Workplace Wellness Slacker: Don’t Count Us Out

June 1st, 2006 by Melanie Matthews

We're midway through a workplace wellness challenge here, and I have a confession to make. While I've worn my pedometer in the hopes of achieving 10,000 steps a day and retooled my family's eating habits to aim for five daily servings of fruits and vegetables, I haven't once recorded my progress at our wellness web site. (This is the only requirement of the program.)

And what's more, I do not have a valid reason for this behavior, other than procrastination. I attended the program kickoff meeting, read the promotional materials, noted my login and password in my Palm and jotted down my first week's efforts on the tracking sheet. I shared pedometer successes and mishaps with my workplace wellness buddies. But somehow, that first weekly login deadline came and went without an entry from me.

The reason I'm coming clean is to give wellness program coordinators some hope. Even though my unreported efforts can't count toward the program's success, and my non-documentation renders me ineligible for the prizes my employer has generously donated, the program has made a huge impact on my life.

Before I strapped on that pedometer, I considered myself an active person. I am a team player. I am competitive. I am educated. Heck, I write about this wellness stuff daily! But I naively assumed that the program goal of 10,000 daily steps was aimed at an overweight couch potato and therefore easily attainable during my average day. However, barely a week into the program I discovered that on days when I didn't schedule a run or a trip to the gym, I was lucky to log 3,000 steps. So I have tried to schedule 30 to 60 minutes of added daily activity to meet this requirement. Because of this, the family dog is treated to an extra-long evening walk. (Note to self: adjust walking route to avoid the Dairy Queen.)

As my colleague commented in an earlier post, I also discovered that when not brown-bagging it for work and school, my family's daily fruit and vegetable consumption slipped precariously. So come the weekend, we're making more of an effort in this area. And slowly but surely, these adjustments are becoming habits.

Emphasizing healthy choices over weight loss, our wellness initiative has all the ingredients for success: participation from top management on down, fun and simple goals, web-based tools and tracking, incentives for participation. While encouraging healthy competition, it fosters a sense of office camaraderie.

I just didn't get around to logging in.

So wellness program coordinators, take heart. I got the message. I've made some changes. Even though there's no evidence of it in our program database, my lifestyle and my family are the healthier for it, and hopefully our healthcare costs (and yours) will reflect this. Maybe there are some healthier slackers in your population, too.