Vanderbilt University Corporate Health Achievement Award American - - PowerPoint PPT Presentation

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Vanderbilt University Corporate Health Achievement Award American - - PowerPoint PPT Presentation

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Vanderbilt University Corporate Health Achievement Award American Occupational Health Conference April 17, 2002 Mary Yarbrough MD MPH, Director Vanderbilt Health and Wellness Objectives Introduce Vanderbilt University and its Health and

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Vanderbilt University

Corporate Health Achievement Award

American Occupational Health Conference April 17, 2002 Mary Yarbrough MD MPH, Director Vanderbilt Health and Wellness

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Objectives

  • Introduce Vanderbilt University and its Health

and Wellness Programs, including Occupational Health

  • Discuss the Health and Wellness Programs

evaluation process

  • Review selected evaluation projects
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SLIDE 3

Mission

  • Education
  • Research
  • Patient Care
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SLIDE 4

Vanderbilt “Demographics”

  • People

– 3,700 faculty – 12,600 staff – 10,000 students

  • Campus

– 323 acres – National Arboretum – Peabody National Historic Landmark

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SLIDE 5

Vanderbilt University

  • 10 Schools
  • Medical Center
  • Public Policy

Institute

  • Freedom Forum

First Amendment Center

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SLIDE 6

Vanderbilt University Medical Center

  • Hospital
  • Children’s

Hospital

  • The Vanderbilt

Clinics

  • School of

Medicine

  • School of Nursing
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SLIDE 7

Mission To protect and support Vanderbilt’s most valuable asset, its faculty and staff

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SLIDE 8
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SLIDE 9

Organizational Structure*

Chancellor

Division of Administration Human Resource Services Health and Wellness Occupational Health Clinic Employee Assistance and Physician Wellness Program HEALTH Plus Child Care Centers

Provost Health Affairs/ Medical Center General Counsel Information Systems Financial and Benefits Employment Practices Campus Planning Environmental Health & Safety Plant Operations Administrative Compliance Risk & Insurance Management Plant Services Infection Control Center for Health Services Research Student Life

* Partial VU Org Structure

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SLIDE 10

Evaluation Conflicts

  • Administrators expect prompt problem

resolution

  • Academic leaders expect scientific

assessment

– Not funded for research – Operational value of data collection for publication limited

  • Employee Confidentiality
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Integrate CQI and Scientific Method

State the Aim Define Change Select Intervention Plan Do Study Act State the problem Formulate null hypothesis Design the study Collect the data Interpret the data Draw conclusions

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Evaluation Process

  • Identify problem

– Review and discuss current process

  • Propose change

– Chart revised process

  • Select metric to guide

– State null hypothesis and study design

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Evaluation Process

  • Implement

– Educate stakeholders

  • Monitor metric continuously

– i.e., graph-on-the-wall or “watch the dashboard”

  • Judge value

– Interpret results – Draw conclusions

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SLIDE 15
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Creating “Enthusiasm” for Evaluation

  • State it is important
  • Include in personal and program goals
  • Provide time and resources, incl. technology and

statistical support

  • Just do it !
  • Share the findings along the way
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SLIDE 17

Vanderbilt Occupational Health Information System

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SLIDE 18

Employee Assistance Program Evaluation Projects

  • Physician Wellness Program Utilization
  • Stress Reduction
  • Satisfaction with the Employee Assistance

Program

  • Internationals Program
  • Physician Stress Reduction Program
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SLIDE 19

Occupational Health Evaluation Projects

  • TB Skin Test Compliance Rates
  • Compliance with OSHA Medical Surveillance
  • Blood and Body Fluid Exposure Injury Reduction
  • Ergonomic Assessment Satisfaction
  • Patient Satisfaction
  • Knowledge of Services
  • Return to Work Program ROI
  • FMLA Utilization
  • Influenza Vaccination Rates
  • Health Indicator Tracking
  • Non-Work Related Employee Mortality Analysis
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SLIDE 20

HEALTH Plus Evaluation Projects

  • Health Risk Assessment (HRA) Participation
  • Fitness Facility Utilization
  • Fruit and Vegetable Consumption
  • Smoking Cessation Program Evaluation
  • The 5-Year Health Change Evaluation
  • Aerobic Program Satisfaction
  • Swim School Program Satisfaction
  • Housestaff Health Status at Baseline and During Residency
  • Weight Management Program Evaluation
  • Longitudinal Analysis of a High Risk Subgroup
  • Self-Reported v. Measured Biometric Data on an HRA
  • Analysis of Employees Completing an HRA
  • Diabetes Prevention Project
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Example Evaluation Project #1

Physician Wellness Program Utilization

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Physician Wellness Program Utilization

  • Problem

– Limited physician utilization of EAP

  • Change

– Physician Wellness Committee – Physician Wellness Program within EAP

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Physician Wellness Program Utilization

  • Metric

– Physician utilization (and physician loss) – Null hypothesis: No significant change in physician utilization after 18 months

  • Implement

– Educate physicians and staff

  • Monitor
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Utilization Before and After

Introduction of

Physician Wellness Program

6 7 1 8 4 5 14 25 5 10 15 20 25 30 35 40 45 50 55 60 65 70 92-3 93-4 94-5 95-6 96-7 97-8 98-9 99-00 MD PWP

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Physician Wellness Utilization

  • Judge value

– No unexpected physician loss – Significant increase in utilization

  • chi-square, p < 0.05

– Program funded

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Utilization Before and After

Introduction of

Physician Wellness Program

1 8 4 5 14 25 47 64 6 7

10 20 30 40 50 60 70

92-93 93-94 94-95 95-96 96-97 97-98 98-99 99-00 00-01 01-02

Year

Participants (No.)

PWP

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SLIDE 27

Example Evaluation Project #2

TB Skin Test Compliance

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TB Skin Test Compliance

  • Problem

– TB skin test compliance ~70%

  • Change

– RN reminder call at 48-72 hrs

  • Metric

– Compliance rate – Null hypothesis: No change in compliance

  • Implement
  • Monitor
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TB Compliance Related to Percent Called

76 80 83 73 41 39 12

10 20 30 40 50 60 70 80 90 100

1 2 3 4 Month Percent Percent Compliant Percent Called

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TB Skin Test Compliance

  • Judge value

– 1 in 4 responded to call – Cost intensive with RN – Continue calls by clerical staff

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Example Evaluation Project #3

Compliance with Non-Infectious Regulatory Programs

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Compliance with Non-Infectious Regulatory Programs

  • Problem

– Non-infectious programs compliance ~80%

  • Change

– Email supervisors

  • medical surveillance information
  • compliance rates for all departments
  • Metric

– Compliance rates

  • Implement
  • Monitor
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Compliance with Regulatory Programs

96.3% 94.1% 83.8% 75 80 85 90 95 100 98-99 99-00 00-01 Fiscal Year Percent Compliant

p<0.05 p<0.05

emails begin site visits and new administrative controls begin

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Example Evaluation Project #4

Injuries Related to Sharps Disposal

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Injuries Related to Sharps Disposal

  • Problem

– Sharps disposal significant cause of work-related injury

  • Change

– Straight-drop box replaced with letter-drop box

  • Metric

– Number of disposal-related sharps injuries

  • Implement
  • Monitor
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Average Disposal-Related Sharps Injuries per Month

1.6 2.8

0.5 1 1.5 2 2.5 3 3.5

Straight-Drop Box 1/97 - 1/99 Letter-Drop Box 3/99 - 1/01

Change

Number of Injuries

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Injuries Related to Sharps Disposal

  • Judge value of change to letter-drop boxes

– Financial Impact

  • Cost $10,000 greater per year
  • Savings of $8,800 per year, not considering cost of

infectious disease conversion

– Compliance with BBP Standard – Decreased stress

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SLIDE 38

Example Evaluation Project #5

Satisfaction with Ergonomic Workstation Assessments

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Satisfaction with Ergonomic Workstation Assessments

  • Problem

– Value of ergonomic assessments unknown

  • Change

– Annual satisfaction survey

  • Metric

– Faculty and staff satisfaction

  • Implement
  • Monitor
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Ergonomic Assessment Satisfaction

10 20 30 40 50 60 70 80 Extremely Useful Somewhat Useful Not at All Useful Year 1 Year 2

Percent

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Satisfaction with Work Environment After Changes

10 20 30 40 50 60 Greatly Improved Somewhat Improved Somewhat Worse No Change No Changes Made Year 1 Year 2

Percent

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Example Evaluation Project #6

Health Risk Assessments Completed

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Health Risk Assessments (HRAs) Completed

  • Problem

– Incomplete health risk data

  • Change

– Offer HRAs at Medical Center New Staff Orientation

  • Metric

– Number of HRAs completed

  • Implement
  • Monitor
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Completion of HRAs

HRAs first offered

500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Total # Initial HRAs Completed Per Year

Med Ctr Orientation University Orientation

Number

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Added Value: Exercise Facility Utilization Increase

500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Total Facility Attendance Total # Initial HRAs Completed

Med Ctr Orientation University Orientation

Number

HRAs first offered

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Example Evaluation Project #7

Fruit and Vegetable Consumption

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Fruit and Vegetable Consumption

  • Problem

– Inadequate consumption of fruits and vegetables

  • Change

– Nutrition education campaign

  • Metric

– Consumption reported on Health Risk Assessments

  • Implement
  • Monitor
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SLIDE 48

Fruit and Vegetable Consumption

10 20 30 40 50 60 70 80 10 20 30 40 50 60 70 80

VU Year 1 VU Year 2

US Ave. 1997 2010 Goal

Percent > 2 fruit servings/day > 3 vegetable servings/day

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SLIDE 49
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Health and Wellness Project Leaders

  • Mary Yarbrough
  • Paula McGown
  • Patricia Kinman
  • Alice Warren
  • Sharon Sulkin
  • Susan Harris
  • Helen Scott
  • Judy Woods
  • Ellen Trice
  • James Kendall
  • Paul Ragan
  • Marilyn Holmes
  • Lisa Connor
  • Cindy Dorminy
  • Susan Walker
  • Brad Awalt
  • June MacNeil

Center for Health Services Research

  • Daniel Byrne
  • Robert Dittus
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Contributors

  • HEALTH Plus

– Lori Cowan – Cassandra McClain-Evans – Kelly McClain

  • Physician Wellness Committee

– Anderson Spickard, Jr.

  • Plant Services

– Ken Browning

  • Environmental Health and Safety

– Robert Wheaton – Susan Johnson – Alex LeHocky – Andrea George – LouAnn Burnette

  • Infection Control

– Vicki Brinsko

  • Health and Wellness

– Chantelle Stoxstill – Leah Cannon

  • Occupational Health Clinic

– Melanie Swift – Cindy Harrison – Willow Price – Aimee Paschall

  • Child Care Centers

– Diane Neighbors

  • Employee Assistance and Physician

Wellness Programs – Ellen Clark – Susan Lescher – Helena Guo

  • Center for Occupational and

Environmental Medicine – Roy DeHart

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Contributors

  • TN Physician Health Program

– David Dodd

  • Environmental Health and Safety

– Carl Gerholdt – Melanie Byer – Tammy Jimison – David Kirby – Danny Anglin – Melissa Kennedy

  • Opportunity Development Center

– Sara Ezell

  • Physical Therapy

– Scott Reynolds – Jim Lassiter – Cheryl Hughes

  • Dayani Health Promotion Center

– Jay Groves – Barbara Forbes

  • Graduate Medical Education

– Fred Kirchner, MD – Jane Shoun

  • Human Resource Services

– Karen Rolling – Lana Clay – Lynn Capps – Donna Thomas – Jane Bruce – Lisa Ponton – Veronica Burns

  • Center for Clinical Improvement

– Doris Quinn – Ted Sperhoff

  • InfoWorks

– Misty Leopper – John Mason – Rick Pineda

  • Risk Management

– Tracy Hamilton – John MacCauley

  • General Counsel

– Sheree Wright – Julia Morris

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www.vanderbilt.edu/HRS/wellness/wellness.htm Visit us at the Vanderbilt Health and Wellness Website