Emergence: Workplace Health Management from Complexity to Order

A Personal and High Level View.

This set of 5 posts is the result of my self-imposed sabbatical from January 1 to August 31, 2017.  During this time my primary strategy was to limit my travel and dedicate that time to a review of health and poor health within its complexity; review the learnings from practical experiences of workplace health management initiatives; and review publications in this and other fields over past 40 years.

My first objective for this set of five posts was to search from a high level point-of-view and to address the question, “What is the state of Workplace Health Management in 2017?”  My review was guided by the following statement.

“It is nearly impossible to see a vision of the future if you
do not have an understanding of the simplicity, complication or complexity of the issues;
do not know where have you been;
do not know where are you now; and,
do not recognize that you do not know what you do not know.”

Obviously, my thoughts are biased by my previous research in exercise biochemistry and electron microscopy and the 30-years of research in the workplace health management field with the capstone publication Zero Trends: Health as a Serious Economic Strategy™. The follow-up prospective book Shared Values-Shared Results: Positive Organizational Health as a Win-Win Philosophy™ (co-authored with Jennifer Pitts) incorporates an additional seven-years of research in the field plus findings and experience from several other fields. These books, especially the latter, address many of the issues discussed in this blog series.

Part of the reason for this short sabbatical was to address my long-standing concern about progress from “…our initial simplistic view of poor health; to a realization of the complications and eventually the complexity of poor health; and, how to see order emerge out of complexity and eventually to true simplicity.”  Solving complicated issues of poor health is achieved by extensive examination of the specific situation and finding the correct intervention to address the issues. With this situational view in mind, solving complexity issues of poor organizational and human health most likely will need some combination of physical, sociological, psychological, genetic, environmental, intellectual interventions. The effectiveness of interventions using this diverse view will require qualitative as well as quantitative methods to discover the root causative pathways (why and how) to the outcomes. Typical quantitative statistical tools looking for main effects have not been successful in discovering the why and how the interventions work or do not work.

Until a few years ago I assumed that the various Workplace Health Management initiatives were built on a philosophy or framework (vision, mission, strategies, objectives, and tactics) to guide the implementation of the initiative.  However, after listening to many providers and end-users, I now come away with the impression that my previous assumption is not totally the case. Many of the consultants, vendors, and providers, in contrast to promoting well thought-out initiatives, recommend more routine and simplistic program-centric and theme-centric initiatives. The resulting initiatives are based on the assumption that each individual program contributes equally to the overall level of participation, not to mention positive personal or organizational engagement, and with little or no consideration given to program weighting and the independent value-added results of the initiative.

Typically there is little or no additional value accrued by adding more programs after participation rates from the existing programs are flat. It is difficult to see any direct or even indirect additive positive organizational effect and often there is a negative impact when adding yet another intervention (single-focused program) to the initiative. Often the addition of another single-focus program cannibalizes the participation and outcomes of the already existing programs. In addition, many of the same outcomes are being claimed by two or even more of the interventions. Therefore the primary result only adds costs to the overall initiative.   Is the rate of current and diverse program additions such that we are losing our strategic direction as a field or is the field expanding and we now know what we did not know several years ago?  It appears to me we are uncovering the historical and holistic approach (Eastern and Western approaches) to the human health condition. How do we unite the field, and become a major and realistic marker in the success of individuals and organizations?

I recognize a competing view exists in that additional programs could be an advantage by giving employers and employees a wide range of choices to meet their individual needs.  However, we also know too many choices, lacking a strategic direction, often leads to a lack of action on the part of an individual.  It is the responsibility of the leadership of the initiative or even the organization to carefully select the appropriate options consistent with the objectives of the employees and the organization.

After these eight-months I feel the good news is the increased growth in the number workplace health management initiatives in the U.S. continues at a rapid rate.  My questions now are, “…how can we ensure that this growth rate is not a bubble that will soon burst?” Complexity is most often used to describe total confusion which I feel is the state we are approaching, given the lack of an overall strategic direction for the field.  In general any set of issues will remain in complexity until the strategic direction arises.  When that happens, order emerges out of complexity and will give the field its deserved growth and quality opportunity.

We cannot solve our problems
with the same level of thinking that created them.

                                                   —Albert Einstein

I am not proposing we solve all the more basic issues discussed above but we all need to be aware of the fragile way we approach Workplace Health Management. Also I am not proposing a strategic direction for the field but, lacking an overall strategic direction, I feel the field will flounder and not reach its lofty potential without such a direction.  At this stage in the development workplace health management I feel the most effective way for an individual company initiative to survive will be to build its own effective strategic direction and learn to succeed in the face of the increasing overall lack of a cohesive direction of the field.

Postscript.

As noted in the title, this first post is written at a high level but focused on very fundamental issues seldom addressed by the workplace health management community. These fundamental issues are part of the reason single-focused programs do not work for complex issues: solutions to complicated issues can be programed but solutions to complex issues have to evolve and we all know that health is a complex issue.

The next post in this five-post series is titled: “Where have we been and where are we now.”