Emergence: Workplace Health Management from Complexity to Order

Post #3 in this series:

Early Planning for a Win-Win Health Management Initiative

Contents and Takeaways

  • Beware of the barriers from the past.
  • Prerequisite to building win-win-corporate health management wellness initiatives.
  • Building on the knowledge and successes of past years.
  • Potential barriers going forward.
  • Commitment to the Initiative.
  • Beginnings of the win-win philosophy.


My mission for this series of five posts is to create a framework for employers and employees to engage in a serious health management initiative. The framework is needed to empower employees and the companies to create an unprecedented collaborative win-win philosophy. Whether you are new to Corporate Health Management (Corporate Wellness) or an experienced professional you should find this as a valuable process.

The objective of this current post is to invite you to think about a solution for the issues many wellness practitioners identified specifically: participation, true engagement, meaningful programs, outcomes, and appropriate questions, methods, analyses, and thoughtful evaluation.  How can you convert this complex set of challenges and opportunities into a framework for a win-win solution? I do not mean to imply that there is only one solution; however, all solutions should result in respective wins for employers and employees.

Beware of the barriers from the past

Below are some of the issues viewed as barriers over the course of the past 40 years. Many of the earlier barriers were corrected although some are still with us.  It is entirely possible that your organization has not encountered these issues, so celebrate.

  • Workplace health management has been a relatively unregulated field driven primarily by providers and a very few research centers. These organizations each have interests related to their own financial potential, conflicting interests, or other competing values influencing the direction the organization takes.
  • Many consultants or providers sell a favorite set of interventions, the same intervention or the same outcome measures or solutions for all organizations. What is the compelling rationale about their recommendation being the right action for your company?
  • Why do consultants, vendors, and providers jump from one glittering solution to another, looking for a savior thought and a single silver bullet?
  • Many of the measurement metrics were oriented towards management’s objectives. What mattered to employees was not part of the solution or evaluation.
  • Sometimes initiatives implemented by providers violate the assumptions that impacts your efforts to formulate an appropriate solution for your employer and employees. You need to remember “not everything matters” but what you want is what matters!
  • Some companies feel they do not know enough to define and implement a wellness initiative for their organization. As a result, they engage benefit consultants or a third party to write a RFP, collect the responses, and offer one to three provider options to the organization’s representative or wellness committee. However, after reviewing many RFP it is apparent that near identical RFPs were used for several companies and often the same provider was recommended for approval.

Prerequisite to building a win-win health management wellness initiative

First, no one should pretend to know all the answers but even more importantly, we should not pretend to know the right questions. Below are some frequently heard comments from individuals leading the initiatives, questions, and challenges, including some of my own questions, in somewhat of a random order:

  • Does your program follow an overall organized framework to allow you to know where you are in your initiative to get to a win-win outcome?
  • Does everyone in your organization understand the rationale for a win-win workplace health management initiative?
  • Are your objectives and programs consistent with the rationale of your initiative and with the values of management and employees?
  • Are you thinking and planning for what the employees want or are you following what the vendors or consultants, or what the third-party health and wellness people want?
  • Are you planning to evaluate only the main effects of the outcomes in relation to the interventions?
  • Some outcomes are too far downstream to be impacted by interventions. Do you have intermediate objectives or are directly or indirectly impacted by your interventions?
  • Are you thinking about the outcome measures that matter or are you thinking of “what can be conveniently measured?”

Building on the knowledge and successes of past years

We need to acknowledge that “living healthy” messages were encouraged by philosophers beginning over 3,000 years ago. Our current teachings are closely related to these but more directly to the work done in the latter half of the 20th and early 21st centuries.

  • Philosophers throughout the ages acknowledged good health as a lasting value.
  • Risk factors and behaviors were
    • identified for cardiovascular and diabetes.
    • converted to contributing to a healthy life style.
    • connected to health care costs and eventually to absenteeism, presenteeism, disability, worker compensation, productivity, and other issues related to individual quality of life and corporate success.
    • shown to be impacted by the environment, culture and climate of the organization, family and community.
    • shown to be related to both physical and mental health and performance.
    • Shown to be involved in initial stages of impacting deeper elements of physical and mental health on quality of life.
  • Companies continue to use workplace health management as a strategy to increase revenue as well as to decrease costs and improve the company working reputation.
  • We have systematically expanded the types of interventions and outcome measures for individuals and organizations by taking advantage of new knowledge beyond the cost of healthcare, while advancing the knowledge of wellness, by including social determinates and incorporating existing and new knowledge into workplace health management.
  • A considerable amount of this expansive thinking was adapted from the abundant work in positive psychology (Seligman, Peterson, and many others) and positive organizational scholarship (Cameron, Dutton, Quinn, Spitzer, and many others).

Potential barriers going forward

It is important to know the successes and potential facilitating forces but just as important to know the possible barriers to a successful initiative, perhaps even more.

  • We have used organizational research findings to make positive applications to work without thoughtful modification and adaptation due to our core values, beliefs, strategies and results. Before we unconditionally accept these applications, we need to pause and evaluate any unintended and complex consequences.
  • While the above are positive elements in driving success, they at the same time could be barriers to success if applied within an organization where management and employees do not share values and results or an organization that does not follow strategic, systematic, systemic and sustainable considerations.
  • We engage in groupthink and become blind to other ways of thinking and blind to what is happening around us. Groupthink typically occurs with people who think alike and don’t stay aware of the needs and wants of the wide variety of people.
  • We tend to embrace the philosophy that anything new is better than the what we are currently doing or any change is too hard or will meet with severe disapproval
  • Some companies have an environment, climate, or culture that throttles individuals who think and believe independently. Some are not allowed to express their opinions, strong cultures have a way to suppress creativity and autonomy. We need to find ways to hear more than the company voice and listen and talk as if wellness is a mutual value.
  • An even more serious set of questions arise when we think about the confusion we are presenting to organizations and employees. For example, which of the seemingly unlimited options or approaches is the correct direction for them? Developing communication among all stakeholders will grow a shared point of view.
  • Are we into too many new and inviting options to allow us to stay focused on our vision and mission? We will need to find a way to simplify our options to achieve our positive organizational and individual health management objectives.
  • Many of our outcomes are focused on business results, such as lower costs, higher revenues, higher productivity, decreased time away from work and return on investment. By itself this indicates we are not listening to employees. What happened to the hourly, lower paid employees, spouses, and families.
  • We rushed to add psychosocial programs typically focused on salaried or exempt employees and in selected organizational environments? There is no question there is a need for programs addressing the psychosocial needs of the population.  The current delivery method of these psychosocial single-focused programs is such that many may not be effective, efficient, or sustainable over a longer period. We need to evaluate this silo thinking by health management vendors especially when they are offered without collaboration with existing Human Resources initiatives.
  • Each provider of the psychosocial interventions believes that they have the silver bullet when they get positive results for a single or an additional outcome measure. However, the positive results are often the same positive results obtained by others using a different intervention. These same results from different interventions could be an indication that the interventions are tapping into the same human response and we are counting the benefits two or more times.

Commitment to the Initiative

It is important that management and employees demonstrate their commitment to each other and to the basic organizational guiding principles such as: will participation be on work-time or non-work-time; will it be costs or no-cost to the participants; what are the measures for evaluation and overall success; what are the historical measures that are in concert with the environment, climate, and, culture of the organization.

  • Prior to sending out a RFP, (large to medium organizations) management and the employees need to include their respective business and personal values, expected results, and the vision for the wellness program.
  • The RFP or agreement should be written to demonstrate to the consultant or vendor that they will be held accountable, in conjunction with the organization, for participation, engagement and results from the initiative.
  • Another item to agree upon is the range of results expected from the initiative as checkpoints along the way. Benchmarks should be agreed upon to allow all to evaluate progress toward the eventual goal and should be written into the contract with appropriate consequences identified when the benchmarks are achieved or not.
  • Prior to signing a contractual agreement, clear outcome and process metrics should be clearly stated. The results should be made available to management and employees as often as needed, including steps to facilitate the win-win strategy, including outcome and process measures via quantitative and qualitative methods.

Beginnings of the win-win philosophy

This will not be a 2-, 3-, or 5-step approach to build a framework for a workplace health management win-win solution. There certainly are enough of those pre-packaged plans in the literature and we don’t need another one.  What will be offered are the building blocks for leaders to follow through on suggestions or to create their own solutions.  The assumption is that everyone has their unique thoughts and visions and will assume their influence within the organization.

Management and employees must have their respective voices in the design of the initiative.  This is a change in protocol since wellness programs are pitched to management and the evaluation and cost reductions are baked into the reasons for the programs.  This could be the first indication management is willing to listen to employees.  Both management and employee interests should be communicated to the vendor or consultant.

  • The purpose of clarifying to managers and all employees is to inform them of the commitment of the company to the initiative as a serious business strategy.
  • The details of the initiative need to be transparent about the values, processes, interventions, and the expected level of the results.
  • The details of the initiative are to be transparent about the appropriate questions, measures, metrics, interpretation, and the level of acceptance.
  • The advantage of this detail in preparing The Beginnings of a Win-Win Solution is to:
    • Demonstrate the solution and advantages to management and to the employees.
    • Get to Shared Values-Shared Results which will increase commitment of management and the commitment of the employees.
    • The early involvement of management and the employees will build interest and commitment to participate and further engagement.


This Post is an example of a process to be completed before any commitment to a consultant or vendor and obtain their commitment to the initiative.  Early engagement by management and employees in planning, designing and measuring an initiative is necessary to obtain the desired results.

The remaining Posts (#4 and #5) in this series will be in late January and February. These will present the elements of an initiative that can be used, in part or in whole, to create Positive Organizational Health as a Win-Win Philosophy. The elements will be drawn from the first three Posts in this series and from Zero Trends: Health Management as a Serious Economic Strategy and Shared Values-Shared Results: Positive Organizational Health as a Win-Win Philosophy books as well as other known knowledge.