Mitigating Hospital Costs:

Providing Wellness Benefits

for Employees to Improve
Patient Outcomes
Samantha Cress, Amy Galindez, Kierstin
Olpinski, and Katherine Tison
 Plan: Define the problem and the Goals
“In these challenging times, health care leaders struggle with work compression, doing the same
amount of work in fewer hours. Often torn between the needs of administration and those of their
staff, nurse leaders are experiencing stress, burnout, and health issues at rates equal to those they
manage. They expect their staff to deliver comprehensive, compassionate patient care to improve
outcomes, satisfaction and engagement scores, and reimbursements. Yet, wise nurse leaders know
that caregivers cannot meet those expectations if they are physically, mentally, or spiritually
exhausted.” (Thieman, 2018)

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 Plan: Defining the Problem
Health care workers, especially nurses, have increased risk of non communicable
diseases: CVD, DM, Depression, and GI issues
(Priano, Hong, & Chen, 2018)

One study associated burnout with these adverse health outcomes,lower patient
satisfaction, lower productivity, and less satisfaction with life work balance
(Salvagioni, Melanda, Mesas, Gonzalez, Gabani, & Andrade, 2017)

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 Plan: Defining the Problem
● Healthier workforce = Increase in productivity, less absenteeism, less health care
costs

● Unhealthy lifestyles and inadequate work life balance linked to less quality care,
poor patient safety, and medical errors, lower patient satisfaction

● Nurses in less than optimal physical and mental health= 26% higher likelihood
of having a medical errors (Melynk et al., 2018)

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Panagioti et al. (2017), found that individual targeted interventions, like yoga, meditation, cognitive
behavioral therapy, and mindfulness classes, reduced burnout scores by three points amongst physicians

Another study found that employees that engaged in physical activity had higher resilience to workplace
stress (Gerber, Joinsdottir, Lindwall, & Ahlborg, 2014)

In a 2010 and 2015 comparative survey of hospitals that provided wellness programs to their employees,
motivating employees to improve health was identified as the number one barrier. Hospitals that
increased the number of resources available and provided a $500 incentive had higher rates of
participation (American Hospital Association, 2016)

In another study, incentive wellness programs correlated to a reduction in BMI, blood pressure, glucose,
and cholesterol levels in participants. Moreover the incentivized wellness program reduced health care
expenditure for employers (Einav, Lee, & Levin, 2018)
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 Plan: Unique Approach to Health Care Workers
● Use National Academy of
Medicine Model

● All encompassing model,

accounts for needs and
complexities of health care workers

(Brigham et al., 2018)

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 Plan: Objectives and predictions
● Objectives:
○ Decrease long-term hospital costs by mitigating the overall cost of
employee healthcare with incentive-based wellness programs
● Predictions:
○ By providing employees with resources that promote mental and
physical well being, the hospital ultimately reduces the likelihood of
costly medical errors and the likelihood of employee illness.

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 Plan: Prep to carry out the cycle and collect data
● Plan to carry out the cycle
○ Who: Through Employee Health and designated representatives as part of clinical
ladder
○ What: Positive reinforcement has proven more effective than punishment in wellness
benefits (Greene, 2011)
○ When: Beginning in January, ending in October, data finalized in December
○ Where: VA Healthcare System
● Plan for data collection: Before, during, and after, as explained in “Do”

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Plan: What cont’d

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 Plan: What cont’d
● Offer more than one option for client to achieve similar goals
● Different programs may work better for different employees
● One study compared the effectiveness of an Internet-mediated
pedometer-based walking program and an in-person weight-loss
program. Both interventions saved the hospital money within the first
year, but neither was more effective than the other.
○ “Comparable cost reductions in both programs suggest that
employers may want to offer more than one choice of incentivized
wellness program with monitoring to meet the diverse needs of
employees.” (Zivin et al., 2017)

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 ● Collect data on the current practice(s)
○ Obtaining a “Base-Line” for current employees
including but not limited to:
■ Gender
■ Race
Do: ■
■
Weight/BMI
Labs (CBC, Cap BG, HgbA1c)

“Before” ■
■
Hours/Shifts worked
Past Medical History

data ■
■
Stress Survey
Mental Health
○ Employee Screening
■ Stress Survey
■ Mental Health Survey
■ Current physical activity regimen
■ Nutritional intake diary
■ Spiritual Assessment 11
 ● Establish and Implement Plan
○ Physical: Institute health initiatives
○ Emotional: Group therapy/journaling sessions
○ Spiritual: Collaboration with Chaplain department for
counseling services/spiritual mentorship
Do: Carry out ○ Cognitive: Providing weekly scholarly journal articles for
employee health
the plan ○ Relaxation: Aromatherapy, guided imagery, massage,
and quiet areas for reflection and personal debrief
○ Team Building: Activities on and off campus
● Document Observations
○ Trained professionals leading groups collect data and
reflection of all group sessions
○ Staff evaluations and surveys prior and post services 12
 ● Evaluations
○ Systematic in approach
○ Useful, feasible, ethical, and accurate
○ Essential to prove workplace interventions are effective

Do: ○
and should be continued
Provides data for correction where needed
“After” data ○ Defines the value of the programs
● Outcomes of Interest
○ Worker productivity
○ Health care costs
○ Health outcomes
○ Organizational change (CDC, 2019)

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 Study
● Analyze data over a one year period
○ Document and record all medical errors
○ Assess the provider satisfaction
○ Assess patient’s perspective of care: HCAHPS
● Compare results to predictions
● Summarize what was learned, and how we can
improve, or change.
 ● Implement an educational and supportive
program to promote nurses health and well-
being
● Programs that were previously implemented
Act & Next elsewhere and shown to increase quality care
Cycle in patients
● Improving
○ Collaborate with staff interdisciplinary
staff members and other institutions
○ Implement feedback for changes or
improvements 15
 ● American Hospital Association. (2016). Health and wellness programs for hospital employee:
Results from a 2015 American Hospital Survey. Retrieved from http://www.hpoe.org/Reports-
HPOE/2016/ 2016-Health-and-Wellness-Brief-FINAL-10-12-16.pdf
● Brigham, T., Barden, C., Dopp, A.L., Hengerer, A.,. Kaplan,J., Malone, B., … Nora, L.M. (2018). A
journey to construct an all-encompassing conceptual model of factors affecting clinician well-
being and resilience. NAM Perspectives. doi: 10.31478/201801b
● Center for Disease Control and Prevention. (2015). Workplace health promotion. Retrieved from
https://cdc.gov/workplacehealthpromotion/model/evaluation
● Einav, l., Lee, S., & Levin. J. (2018). The impact of financial incentives on health and health care:

References ●
Evidence from a large wellness program. Health Economics, 28(2). https://doi-
org.ezproxy.lib.usf.edu/10.1002/hec.3840
Gerber, M., Jonsdottir I.H., Lindwall, M., & Ahlborg G. (2014). Physical activity in employees
with differing occupational stress and mental health profiles: A latent profile analysis.
Psychology of Sport and Exercise, 15, 649–58.
https://doi.org/10.1016/j.psychsport.2014.07.012
● Greene, J. (2011). Employee wellness proves its worth: new hospital programs reduce costs
and energize staff. H&HN Hospitals & Health Networks, (3), 41. Retrieved from
http://ezproxy.lib.usf.edu/login?url=http://search.
ebscohost.com/login.aspx?direct=true&db=edsgao&AN=edsgcl.253534834&site=eds-live

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 ● Ginoux, C., Isoard-Gautheur, S., & Sarrazin, P. (2019). Workplace physical activity program
study protocol: a four arm randomized controlled trial on preventing burnout and promoting
vigor. BMC Public Health, 19, 289. https://doi.org/10.1186.s12889-019-6598-3
● Priano, S. M., Hong, O. S., & Chen, J.L. (2018). Lifestyles and health-related outcomes of U.S.
hospital nurses: A systematic review. Nursing Outlook, 66(1), 66–76. https://doi-org.ezproxy.
hsc.usf.edu/10.1016/j.outlook.2017.08.01
● Panagioti, M., Panagopoulou, E., Bower, P. Lewith, G.,Kontopantelis, E., Chew-Graham,
C.,...Esmail, A. (2017). Controlled interventions to reduce burnout in physicians: A systematic
review and meta-analysis . JAMA Internal Medicine, 177(2).
doi:10.1001/jamainternmed.2016.7674

References ● Salvagioni, D.A.J., Melanda, F.N., Mesas, A.E., González, A.D., Gabani, F.L., & Andrade, S. M.
(2017). Physical, psychological and occupational consequences of job burnout: A systematic
review of prospective studies. PLOS ONE, 12(10).
https://doi.org/10.1371/journal.pone.0185781
● TGH Employee Health & Wellness. (n.d.). Retrieved from https://www.tgh.org/careers/why-
work-tgh/tgh-employee-health-wellness
● Thieman, L. (2018). Selfcare for healthcare: The best way to care for patients Is to care for
ourselves. Nurse Leader, 16, 393–397. https://doi.org/10.1016/j.mnl.2018.07.014
● Zivin, K., Sen, A., Plegue, M. A., Maciejewski, M. L., Segar, M. L., AuYoung, M., … Richardson, C.
R. (2017). Comparative effectiveness of wellness programs: Impact of incentives on healthcare
costs for obese enrollees. American Journal of Preventive Medicine, 52, 347–352.
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