Emergence: Workplace Health Management from Complexity to Order

Post #4 in this series:

Growth of the workplace health management initiative. There is no question in my mind we have been remarkedly successful over these past 40-years, all in the name of understanding and impacting the complexity of health. Wellness, Medicine, Lifestyle Medicine, and other applied health professions face the same complex problem, human health. We have come a long way in unwinding some of the complexity of health by discovering simple relationships between a few of the variables and some small percentage of the main effects of the interventions. However, wellness now seems stuck in rediscovering what we already knew.

Complexity means outcomes are not direct or simplistic input-output problems. Even if we control for all that we know about health there are relationships we do not know now. Our 40 years of experience reinforces a well-known principle: The more we know the more we know we do not know. However, in many areas we now seem to be stuck in rediscovering what we already knew. We acknowledge this and accept it: in the meantime, we celebrate what we know and need to move on to what we do not know.

Any new field, or an individual entering a new field, begins with an enthusiastic sense of optimism and energy. This mindset leads one to underestimate the complication or complexity of the problem and to overestimate the potential of the available and practical workable solutions.

In the case of workplace wellness and other health or performance issues:

We underestimated the

  • complexity of health and wellness…and change;
  • challenges to the individual and to the workplace; and,
  • importance of sharing values, results, mission, and vision.

We overestimated the

  • interest of the employees and company;
  • effectiveness of simplistic single-focused interventions; and,
  • degree of our ability to measure and communicate sustainable results.

We need not to be discouraged, but we need to ask better questions and to focus on intermediate outcomes. We need to find better methods and metrics. Finally, we need to seek better solutions.

Take advantage of shared values and shared results. It seems reasonable for management and employees to examine their respective values and to come to some common values. At the same time management and employees can evaluate the strengths and weaknesses of their current environment and culture at work and come to an agreement on shared results. Only after a thorough examination of these beliefs can they formulate a comprehensive design for the health initiative to generate a win-win outcome.

Companies are facing an overwhelming number of options to focus their resource decisions.  We currently are at multiple forks-in-the-road where wrong decisions will be a threat to the integrity and success of the workplace health initiative. The options for the company are somewhere among the following:

  • wellness initiatives;
  • outcome measures;
  • training opportunities;
  • single-focused programs;
  • cultures and environments;
  • stakeholders and shareholders;
  • types and sizes of the organizations; and,
  • other programs related to local conditions.

Consequently, companies are faced with tens or even hundreds of options for implementation. This overwhelming number of options forces a company to focus their resources on only specific options consistent with their agreed upon win-win framework.

A crucial decision. An early fork-in-the-road decision requires a focus on the available and relevant interventions for the expected and desired outcomes:

  • related to healthcare costs, productivity, time away from work and performance;
  • related to mental health, relationships, and performance; and,
  • when there are other outcomes desired by management and employees, the relative mix will depend on the health initiative team.

The difference is artificial, but if there is a limit to the total resources available, the company will need to prioritize on the core mission and vision of the initiative.  The difference in the types of programs should not be 100% vs 0% but more moderate distributions something like 80% vs 20% or 60% vs 40%. This decision will impact participation and the success or failure of the initiative related to the outcomes and metrics.

Awaking to the potential of the mission and vision. One of the first opportunities for a team preparing to lead or to restart a workplace health initiative is to set the parameters for the initiative. The parameters include those developed by management and employees early in the design process such as:

  • values and desired results of management and employees;
  • statements of the mission and vision of the initiative;
  • extensive and on-going communication to management and employees; and,
  • responses from some of the employees participating in the early programs.

Early participation feedback is KEY to the style and content of the communications encouraging continuing participation, continuous improvement and movement towards the mission and vision.

Eight crucial issues and workable solutions.

The following issues and workable solutions are not necessarily unique or universal, but each comes up frequently during discussions among workplace health management directors and staff.  Also, not all organizations or providers are missing or are misusing the issues and workable solutions. To the contrary, many organizations are doing what might be consider best practices, some beyond and even into advanced next practices.

Issue #1. Employees lack of awareness of the existence and mission of the workplace health initiative. One of the observations is the amazing number of employees who do not know of the existence of the initiative at their location.  There could be several reasons for this:

  • little or no participation in the development of the initiative;
  • missed seeing the announcements;
  • not marketed enough or correctly;
  • too busy to participate;
  • other commitments;
  • not interested; and
  • any of the above.

The most obvious answer is “Any of the above.” Many times, this is because programs were offered too early: there was not enough time for preparation of the staff and a lack of communication with management and all employees. The staff could also have been overly convinced of the value of the programs, but they overestimated the basic interest level of the employees.

Workable Solutions #1. The employees would like to know in advance and be involved in the design of the program.

  • Interview employees and management to provide their opinions of the relative strengths of the five pillars of the organization. Attention to the existing strengths and areas needing improvement would reinforce the position that health status of the organization is as important as the health status of the employees.
  • Survey employees and management prior to any implementation to identify workplace values and expected results related the health of the individuals and the organization.
  • By knowing the values and the expected results, the staff and managers of the health initiative can design the programs and cycle of implementation to address the various shared values and the results in an informed way.

Issue #2.  Complexity of Health.  Most of the staff in the health management initiative believe in the multiple dimensions of health.  However, the general employee population has doubts about adding programs to the wellness agenda other than physical activity, body weight, stress, smoking, and other risk reduction programs related to heart disease, diabetes and cancer.

Workable Solutions #2. This issue is an education and communication challenge but not a one-time discussion. People need to hear it, see it, discuss it, and practice it over time.  Even a common discussion like, “… consider three words or phrases about activities that impact your health without referring to physical activity, body weight, or stress” then share the responses. This experience and seeing all the answers together will represent most of the dimensions of health and open the eyes of the employees and management to a broader view of health.

Issue #3. Lack of a guiding model for positive individual health. Each employee will have their own view of health and what impacts their health. Few will have a comprehensive view of health. A 30-minute discussion of a comprehensive model of health will help to understand how health is viewed in the company.

Workable Solutions #3. There have been models for individual wellness, health, vitality, morbidity, and mortality for decades. Each of the models fit into a general model of positive individual health and all are necessary, but few, if any, are sufficient to define a healthy person. A common model will encourage employees to try different experiences and introduce them to multiple areas of health. A common model to guide decision support related to the health initiative gives structure to the process. When this common model for positive individual health is used in parallel to the model for positive organization health (see Issue and Workable Solutions #4) the benefits are exponentially increased.

Issue #4. Many company reorganizations are conducted without attention to context.  This is especially true when companies reorganize the human and physical structure in consideration of the impact on productivity. However, the health of the employees is most often not considered.

Workable Solutions #4. Lack of a model for positive organizational health.  Positive organizational health is more complex than positive individual health. Recently, news about harassment and bullying have raised these two issues impacting environment, culture, climate, and, the health of individuals at the workplace. A positive organizational health model will open-up the minds of employees and management to where harassment and bullying issues fit within the model just as it does for positive individual health. Within an organization, it is important to have a model to guide arising decisions related to new challenges.

Issue #5. A wellness initiative that offers programs with little consultation with others in the organization will likely be short-lived. This relatively common style of an independent director often results in a third-party weight control or physical activity programs initiated without any consultation with other individuals or management.

Workable Solutions #5. Create a senior leadership team (management and employees). First assess their personal commitment to organizational health. Second, assess their view of the readiness of the organization and employees to engage in this initiative. With this highly respected team to provide oversight, mistaken offerings can be avoided or at least minimized by:

  • offering experiences from those with a thorough knowledge of the will of the employees and management eventually leads to overall interest in the initiative and higher levels of participation;
  • offering the right match of focused programs, it quickly enriches the credibility and support in the eyes of the employees; and,
  • being sure the employee-management leadership team understands their commitment, the need for them to remain active throughout the initiative, and the need to provide continuous and strategic, systematic, systematic, and sustainable attention and leadership.

Issue #6.  Many Workplace Health Management leaders underestimate the timeline to integrate the initiative into the culture of the organization.  Underestimating the timeline to achieve such a major change and the desired outcomes results in frustration and decreased enthusiasm and motivation of management and employees.

Workable Solutions #6. The various culture integration strategies being applied range from (a) simply adding more programs to the offerings to (b) engaging and partnering with Human Resources, Organizational Development, and other units within the company to spread the appropriate initiatives throughout the organization. Depending upon the definition of integration, a + b is a reasonable objective and one that was recommended in Zero Trends. Bringing workplace health into the culture, climate, and environment is part of the five-year maturity model or process in each of the five pillars of the organization.

The next two Issues and Workable Solutions are derived from the organizational structure used in Zero Trends: Health as a Serious Economic Model. They are the five pillars for promoting and sustaining the health management initiative.

Issue #7.  Senior Leadership (Engaged and Committed Leadership). We often see leadership support during the formative stage of a workplace health initiative, but then they go off to other important priorities. Wellness directors and staff often feel disappointed and disillusioned from a:

  • lack of support at the senior level;
  • lack of support at the operations level; and
  • lack of a clear and agreed mission and vision.

Workable Solutions #7. The Director of the initiative needs to understand that the role of senior leadership is to support the formation of an initiative, help with implementation, and when it becomes operational, step out of the role and move on to other priorities.  However, the leadership typically appoints one of their members to remain with the initiative to demonstrate their continuing commitment and believing in the shared mission and vision of the initiative. All the senior leaders need to continue to speak about the importance of the initiative as part of their regular communications. By participating in the following, senior leadership will gain the confidence of the director, staff and all employees and thus encourage participation in:

  • designing the initiative;
  • demonstrating their belief in health as a value;
  • speaking about the importance of the initiative; and
  • demonstrating their belief in health and wellness as a value to the future state of the company and employee success.

Issue #8. Operations Leadership (Positive Environment, Culture, and Climate). Success of the health initiative is undermined when operations leadership lacks understanding and support of the initiative, especially when employees who are participating in the initiative feel a:

  • lack of support from their direct supervisor;
  • incomplete or, worse yet, very little communications;
  • lack of a supportive culture, climate, and environment; and
  • lack of support from anywhere in the leadership-management chain.

Workable Solutions #8. Operations leadership must develop a supportive culture, climate and environment in collaboration with the wellness leadership and staff.  There must be training specifically for senior leadership and line leadership such as: directors, managers, supervisors, and if applicable, union leadership. The training includes:

  • employee and organization values and desired results and other local issues;
  • discussions about bullying and harassment and other systemic issues;
  • understand respect, value and trust of all employees;
  • the content of individual and organizational health;
  • other local issues; and
  • how to get involved.


This Post (#4 of 5) is directed towards the crucial preparation and early implementation of a positive organizational health initiative. The objective of the initiative is to improve and maintain the positive health of the individuals and the overall positive health of the organization, including financial objectives.  The first step is to awaken management and all employees to the human potential and to the company potential. The integration of individual and organizational health into the company are valuable contributors to overall health of the organization and are key objectives in arriving at human and company potential.

Prepare Hard: Win Easy. Most of the discussion in this post follows the lesson in this slogan (prepare hard and win easy). Preparations for workplace health initiatives are focused on early thoughtful and inclusive planning, careful implemention of the initiative, and recognition that the long-term success depends upon a successful launch and a sustainable collaborative effort.

As stated before, each of the issues and workable solutions are not necessarily unique or universal, but each comes up frequently during discussions among workplace health management directors and staff.  Also, not all organizations or providers are missing or are misusing the issues and workable solutions. To the contrary, many companies or providers are doing what might be considered best practices, and some are achieving beyond best practices and even creating next practices.

Awaking Phase.  Awaking is the first part of the initiative and involves awaking individuals and the company to the comprehensive nature of health and the human and company potentials. Awaking is for everyone regardless of how long the company has been offering wellness and how experienced is the staff. Awaking is recognizing the value of each individual and of each of the five pillars of the company.

Early Implementation Phase. The initial focus is a discussion of the issues that will be faced during the comprehensive design and early implementation phases. The discussions require that we discover the values and desired results of the employees and of management. In addition, we can address what are the shared values, desired results, and shared mission and vison.  The shared values are critical to how employees and management work together. Shared results help keep all eyes on the shared objectives and shared vision. During this phase the employees and management get involved in discovering what is possible as humans and what is possible together.

Post #5. Post #5 will follow by the end of March.  The focus will be continuing and sustaining the initiative, measurement, communication, and conclude with Final Words and Implications for individuals, organizations, and Public Policy.