Post on 01-Oct-2020
Healthier Supervision
L. Casey Chosewood, MD MPH
Chia-Chia Chang, MPH, MBA
NIOSH Office for Total Worker Health
A TOTAL WORKER HEALTH® Workshopfor the VALLEY HEALTH ALLIANCE
May 5, 2016Pitkin County Health and Human Services
The findings and conclusions in this presentation have not been formally disseminated by the National Institute for Occupational Safety and Health, and should not be construed to represent any agency determination or policy.
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• Introductions and Icebreaker
• Total Worker Health®: Why is it More Important than Ever?
• Characteristics & Benefits of Healthier Supervision
• Healthier Supervision and Total Worker Health
• Tools for Healthier Supervision
• Group Activity
• Resources
• Wrap Up
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Healthier Supervision
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http://www.ilo.org/global/about-the-ilo/decent-work-agenda/lang--en/index.htm
“Work is central to people's well-being.”
“Decent work sums up the aspirations of people in
their working lives.”
--International Labour Organization (ILO)
Decent Work
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“Well-Being”?
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6Underwriters Laboratories (UL). State Reports on Health Determinants and Workplace Safety Conditions, 2016.
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Underwriters Laboratories (UL) , State Reports on Health Determinants and Workplace Safety Conditions., 2016.
• Little job security• Minimal advancement• Hazardous work• Health insurance• Responsibility• Representation• Vulnerable populations
Changing Employment PatternsPrecarious work, dual employers, etc
“My father had one job in his life,
I’ve had six in mine,
my kids will have
six at the same time”
“The future of work: Five ways work will change in the tuture,”
The Guardian, Nov 29, 2015
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Shift working men:Less likely to eat vegetables & fruits
Shift working women:More energy intake from saturated fat
Hemiö K, et. al. Food and nutrient intake among workers with different shift systems. Occup Environ Med 2015; 0: 1–8
Low-Wage Workers
• Increased risk of job stress— Decisional latitude,
control, respect• Job insecurity• Forced overtime• Discrimination
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Winston, P. Office of Human Services Policy/ASPE, U.S. Dept. of Health and Human Services. Work-family supports for lower income families: Key research findings and policy trends. January 19, 2016 NIOSH Total Worker Health® Webinar
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Policies, programs, and practices that integrate Protection from work-related safety and health hazardswith promotion ofInjury and illness prevention efforts to advance Worker well-being
Total Worker Health®
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November 2015
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American Heart Association News March 1, 2016, http://news.heart.org/study-older-workers-in-sales-have-great-heart-risks/
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Example of Integrated ApproachMusculoskeletal Disease
Reorganizing
workErgonomic
consultations
Arthritis self-management
strategies
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Increase Program Participation and Effectiveness
Integrated interventions
Single intervention
Smoking quit rates:
11.8%
5.9%Sorensen G and Barbeau E. Integrating Occupational Health and Safety and Worksite Health Promotion: State of the Science. The NIOSH Total Worker HealthTM Program: Seminal Research Papers 2012. DHHS (NIOSH) 2012-146.
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Reduced Sickness Absence & Improved Health
Reduced:• Ergonomic risks• Cardiovascular risks • Job stressors
Reciprocal improved outcomes such as morale, engagement, and employee retention
Sorensen G and Barbeau E. Integrating Occupational Health and Safety and Worksite Health Promotion: State of the Science. The NIOSH Total Worker HealthTM Program: Seminal Research Papers 2012. DHHS (NIOSH) 2012-146.
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Obesity: Improving the Job
Punnett L and the Center for the Promotion of Health in the New England Workplace. Recent trends and research in worker safety and health. February 25, 2014 NIOSH Total Worker Health® Webinar
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Du J and Leigh JP. Effects of wages on smoking decisions of current and past smokers. Annals of Epidemiology 2015; 25: 575-582
Smoking: Improving the Job
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Stress: Improving the Job
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Goh, J., Pfe!er, J., & Zenios, S. A. Workplace stressors & health outcomes: Health policy for the workplace. Behavioral Science & Policy, 1(1), 2015, pp. 43–52. https://behavioralpolicy.org/article/workplace-stressors-health-outcomes/
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Before Work
After Work
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Workplace Flexibility
1/3 turnover rate
Reduced turnover.Customer retention 96% $6 million 2 years
17% Increased productivity
Office of Disability Employment Policy. Workplace flexibility: A strategic business approach for an inclusive workplace. http://www.dol.gov/odep/pdf/workplaceflexibility.pdf
Issues Relevant to Advancing Worker Well-being Through Total Worker Health
®
Control of Hazards and Exposures• Chemicals• Physical Agents• Biological Agents• Psychosocial Factors • Human Factors• Risk Assessment and Risk Management
Organization of Work• Fatigue and Stress Prevention• Work Intensification Prevention• Safe Staffing• Overtime Management• Healthier Shift Work• Reduction of Risks from Long Work Hours• Flexible Work Arrangements• Adequate Meal and Rest Breaks
Built Environment Supports• Healthy Air Quality• Access to Healthy, Affordable Food Options• Safe and Clean Restroom Facilities• Safe, Clean and Equipped Eating Facilities• Safe Access to the Workplace • Environments Designed to Accommodate
Worker Diversity
Leadership• Shared Commitment to Safety, Health,
and Well-Being• Supportive Managers, Supervisors,
and Executives• Responsible Business Decision-Making• Meaningful Work and Engagement• Worker Recognition and Respect
Compensation and Benefits • Adequate Wages and Prevention of
Wage Theft• Equitable Performance Appraisals
and Promotion • Work-Life Programs• Paid Time Off (Sick, Vacation, Caregiving)• Disability Insurance (Short- & Long-Term)• Workers’ Compensation Benefits• Affordable, Comprehensive Healthcare
and Life Insurance• Prevention of Cost Shifting between
Payers (Workers’ Compensation, Health Insurance)
• Retirement Planning and Benefits• Chronic Disease Prevention and
Disease Management• Access to Confidential, Quality
Healthcare Services• Career and Skills Development
Community Supports• Healthy Community Design• Safe, Healthy and Affordable Housing
Options• Safe and Clean Environment (Air and Water
Quality, Noise Levels, Tobacco-Free Policies)
• Access to Safe Green Spaces and Non-Motorized Pathways
• Access to Affordable, Quality Healthcare and Well-Being Resources
Changing Workforce Demographics• Multigenerational and Diverse Workforce• Aging Workforce and Older Workers• Vulnerable Worker Populations• Workers with Disabilities• Occupational Health Disparities• Increasing Number of Small Employers• Global and Multinational Workforce
Policy Issues• Health Information Privacy• Reasonable Accommodations• Return-to-Work• Equal Employment Opportunity• Family and Medical Leave• Elimination of Bullying, Violence,
Harassment, and Discrimination• Prevention of Stressful Job
Monitoring Practices• Worker-Centered Organizational Policies• Promoting Productive Aging
New Employment Patterns• Contracting and Subcontracting• Precarious and Contingent Employment• Multi-Employer Worksites• Organizational Restructuring, Downsizing
and Mergers• Financial and Job Security
November 2015Total Worker Health® is a registered trademark of the US Department of Health and Human Services 25
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1. Design work to eliminate or reduce safety and health hazards and promote worker well-being
Safety comes first
2. Integrate relevant systems to advance worker well-being
Privacy protection
3. Demonstrate leadership at all levels of managementLong-term culture-building
4. Promote and support worker engagement throughout program design and implementation
Equal access to all employeesVoluntary
Fundamentals of Total Worker Health
IMPLEMENTING TOTAL WORKER HEALTHTHROUGH
HEALTHIER SUPERVISION
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CHARACTERISTICS & BENEFITS OF HEALTHIER SUPERVISION
• BE THE SUPERVISOR YOU WOULD WANT TO HAVE
• MEANINGFUL WORK AND ENGAGEMENT
• LEAD OR MANAGE
• ENHANCE YOUR OWN LEADERSHIP & MANAGEMENT SKILLS
• INTERACTING WITH YOUR TEAM
• DESIGN METHODOLOGY
• BENEFITS OF HEALTHIER SUPERVISION
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Characteristics of Meaningful Work
http://web.hec.ca/criteos/fichiers/upload/MOW_in_MTimes_EMM200804.pdf
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Employee EngagementJust how engaged are American workers?
• What is engagement?
• 2014 Gallup Wellbeing Survey– 31.5% employees engaged– 51.0% not engaged– 17.5% actively disengaged
• 2016 Gallup Wellbeing Survey– 34.1% employees engaged– Sets new record since polling began in 2011– Previous high was in March 2011 at 33.8%
Source: 2014 and 2016 Data Gallup Survey on Employee Engagement www.gallup.com
Increasing Engagement
• Whose job is it?
• Strategies
• Active vs. Passive
• What level of management is accountable for this?
• What metrics can we use to follow it?
LEAD or MANAGE?
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Leadership vs. Management
Accomplishes a GoalExplains the VisionMotivates Others
Mobilizes ResourcesCommunicates Well
Source: http://changingminds.org/disciplines/leadership/articles/manager_leader.htm
Vision & StrategyCreating ValueInfluence and InspirationHas FollowersCharismaticPeople FocusedProactive Risk & Change SeekersSets directionRaises expectationsAsks questions
Policies & ProceduresCounting Value
Power & ControlHas Subordinates
Manages WorkWork Focused
Authoritarian StyleReactive
Risk Averse & StabilityPlans Details
Maintains Status QuoGives Directions
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Enhance Your Own Leadership and Management Skillset
• Get to know yourself better– 360° profiles, DISC, personality instruments
• Actively communicate – The power of “Good Morning”
• Work on transparency• Recognize and reward every day• Set clear expectations and reset regularly
How do you interact with your team?
• “Management by walking around”
• Keeping it professional
• Getting personal
• Exit interviews
• Stay interviews
• Who’s at “flight risk” on your team?
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Solving Problems Using Design Methodology
• Empathize: seek to understand the perspective of the person(s) experiencing the problem
• Define: mutually reach consensus on the nature of the problem
• Ideate: openly brainstorm wide set of possible solutions
• Prototype: pick the most promising solution for a “rough trial”
• Test: try out the solution and evaluate outcome
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https://www.advisory.com/talent-development/employee-engagement-initiative/members/expert-insights/2011/how-important-is-having-an-effective-manager
Benefits of Healthier Supervision
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http://www.monster.com/about/a/dangerously-stressful-work-environments-force-workers-to-seek-new-empl4162014-d3126696
The most commonly reported workplace stressors include: Supervisor relationship (40%) Amount of work (39%) Work-life balance (34%) Coworker relationships (31%)
“What does your office do to help alleviate stress in the workplace?” 13%: Extra time-off11%: Ability to work from home66%: Nothing
Importance of Healthier Supervision
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Wrike. Work Management Report 2015. https://www.wrike.com/blog/2015-work-management-survey-report
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http://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2016-04-22-transformational-managers-may-be-bad-for-workplace-health-/Karina Nielsen & Kevin Daniels (2016) The relationship between transformational leadership and follower sickness absence: the role of presenteeism, Work & Stress, 30:2, 193-208
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Dow Scott and Tom McMullen. The Impact of Rewards Programs on Employee Engagement. WorldatWork. June 2010. https://www.worldatwork.org/waw/adimLink?id=39032
Quality of leadership had the strongest relationship with effectively engaging and motivating employees.
BREAK
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HEALTHIER SUPERVISION AND TOTAL WORKER HEALTH
• CREATING THE RIGHT ENVIRONMENT FOR YOUR DIVERSE WORKFORCE
• INTEGRATING WORK AND LIFE CHALLENGES
• ALTERNATIVE WORK ENVIRONMENTS
• BENEFITS OF WORK-LIFE INTEGRATION
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“Timing is Everything”
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Many More Older Workers
“Chronologically Gifted”
“Age to me means nothing. I can't get old; I'm working. I was old when I was twenty-one and out of work. As long as you're working, you stay young."
— George Burns (1896-1996)
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The National Center for Productive Aging and Work (NCPAW)
Jim Grosch & Juliann Scholl
Co-Directors
• Manage physical hazards, e.g., noise, slips/trips
• Provide ergonomically-friendly work environments
• Provide aging workforce management skills training for supervisors
• Invest in training & skill-building for all workers• Encourage cross-generational interactions
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Improving the JobTo Be Age Friendly
• Accommodate medical self-care
• Support return-to-work
• Design jobs with worker involvement Match tasks to abilities, function Offer flexibility: Self-paced,
scheduling, transitional
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Improving the JobTo Be Age Friendly
5. Partnership for Solutions [2004]. Chronic conditions: making the case for ongoing care. Baltimore, MD: Partnership for Solutions. [http://www.partnershipforsolutions.org/DMS/files/chronicbook2004.pdf].
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Invisible Illness
• Approximately 96% of people who live with a health concern have what is known as an “invisible illness”.
• These people do no use a cane or any assistive device and may look perfectly healthy.
58SOURCE: 2002 US Census Bureau
Common Invisible Illnesses • ADHD
• Anxiety disorders
• Allergies
• Asthma
• Autism
• Bipolar disorder
• Brain injuries
• Chronic fatigue syndrome
• Chronic pain
• Circadian rhythm sleep disorders
• Personality disorders
• Primary immunodeficiency
• Reflex Sympathetic Dystrophy
• Rheumatoid arthritis
• Schizophrenia
• Scleroderma
• Sjogren's syndrome
• Transverse Myelitis
• Ulcerative Colitis
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• Celiac Disease
• Crohn's disease
• Depression
• Diabetes
• Endometriosis
• Epilepsy
• Fibromyalgia
• Food allergies
• Hyperhidrosis
• Inflammatory bowel disease
• Interstitial cystitis
• Irritable Bowel Syndrome
• Lactose Intolerance
• Lupus
• Lyme Disease
• Migraines
• Multiple Sclerosis
• Multiple Chemical Sensitivity
• Myasthenia Gravis
• Narcolepsy
Managing Culture in the WorkplaceCognitive Diversity
• A blend of different backgrounds, experiences and perspectives within a team
• Capitalize on unique skillsets to fill knowledge gaps
• Encourage innovation and creativity
http://www.goodwill.org/blog/career-and-financial-advice/eight-ways-to-pitch-your-diverse-background-as-an-employment-asset/
Managing Culture in the WorkplaceCultural Challenges
• “The sum total of ways of living built up by a group of human beings and transmitted from one generation to another” (Websters)
• Leadership Challenges:– Minority recruitment & retention – Managing perceptions– How do you foster diversity and culture?
• A diversity conscious culture is more likely to recruit, attract, and retain talent.
• A diverse workforce serves customers and partners in a more meaningful way.
Source: http://thediversitycoach.com/managing-culture-diversity-in-the-modern-workplace/
Dr. Howard chats with others at the 2015 Cincinnati Meet and Greet NIOSH Diversity Steering Council 2010-2013
Diversity Month across NIOSH
Spokane, Washington: “Back to Our Roots” potluck
Denver, Colorado:Volunteers donating blood for
the “Gift of Life”
Atlanta, Georgia: “Diversity in Food & Activity”:
Line dances after a communal salad bar lunch
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Managing Culture in the WorkplacePerception & Reality
• Change is hard when it comes to shaping culture– Identifying what the culture is and how it can be improved
• Viewpoint Surveys, Focus Groups, Staff Meetings, Open Door Policy
– Implementing a coordinated ongoing effort– Making a personal commitment
• Effective culture management requires everyone to be on the same page, both in the spoken and unspoken policies and behaviors
Diversity Efforts Can Enhance Employee Engagement
• Utilize conflict and diversity as an asset, not a liability
• Managing diversity:– The basic concept of managing diversity accepts that the
workforce consists of a diverse population of people. The diversity consists of visible and non-visible differences, some of which include: gender, ethnicity, educational level, family of origin, disability, sexuality, age and religion.
Benefits of Implementing Work-Life Integration
• Improves health and well-being of employees (and benefits family members also)
• Less stress on employees leads to increased productivity
• Flexibility and supervisor support is key to overall job satisfaction and employee engagement
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Integrating Work and LifeChallenges
• Work-Life interface is a concern of ALL workers.• Work – life conflict is prevalent.
– Nearly 60% of workers experience conflict– At least 20% reporting they often/always are in conflict.
• Demands on families are increasing - which affects wellbeing in all spheres of life.– Work can be modified to improve balance and support
well-being using alternative work schedules.– Increasing supervisory flexibility is often highly effective
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STAR Study Results
• Increased– Control over work time– Supervisor support for personal and family life– Saying have "enough time" with family
• Decreased– Work-to-family conflict– Family-to-work conflict
• No effect on work hours, intensity overall– Parents' work hours declined - 1 hr/week
• Decreased burnout, stress, psychological distress at 12 months, though only among respondents who started STAR before merger underway
SOURCE: Kelly, Moen et al. 2014. American Sociological Review.68
Alternative Work Environments• Possible? Impossible? Uncomfortable?• Value of telework and flexi-time• Setting clear expectations with your staff• Fairness
– Actual & Perceived– Avoidance of “all or none” policies or blanket
approaches
• Reasonable Accommodations
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TOOLS FOR HEALTHIER SUPERVISION
• PERFORMANCE MANAGEMENT
• HELPING UNDER-PERFORMERS
• EMPLOYER & EMPLOYEE RECOGNITION
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Performance ManagementUtilize Performance Plans to Gauge Potential
• Individually-based plans are intended to stretch your employees, to develop potential, and grow opportunities– Use SMART goals (specific, measurable, aligned, realistic, timely)
– NOT generalized to series or position type
– Encourage employee’s input
– Should align with duties listed on position description
– Become familiar with local union/bargaining unit requirements
Performance ManagementUtilize Performance Plans to Gauge Potential
• Be aware of knowledge gaps – Use performance discussions to discuss areas for
growth and improvement
– Utilize individual development plans to encourage learning and gaining new skills
Performance ManagementSeek Solutions
• Job Rotations
• Continuing Education
• Mini-Internships or Fellowships
• Mentoring Program
• Coach-Approach
• “Stay” Interviews
Helping Under-Performers
WON’T Employees (Conduct Problems)Do not obey written/unwritten rules
Deliberate
Some conduct problems can appear as performance problems
CAN’T Employees (Performance Problems)Do not meet expectations of the quality, volume, and speed of the work
Origin can be multifaceted
Combination
Helping Under-PerformersLook for the Cause
Make sure the cause of the problem is not management or an organizational or procedural problem.
Ensure the employee has been adequately instructed on how to perform the job and given the right feedback.
Determine if there are external obstacles preventing acceptable performance (medical condition, substance abuse, life-family conflict)
Take a hard look at whether or not the employee has the specific skills, knowledge, or ability to perform in the position.
Helping Under-PerformersProvide Resources for Improvement
Additional job aids (e.g., desk guide, manual references, examples of acceptable work products)
Closer supervision or an on-the-job coach
Referral to the Employee Assistance Program (EAP) for substance abuse or other personal problems
Reassignment
Job restructuring
Helping Under-Performers
Don’t go it alone. Get help early.Focus the employee’s attention on the problem.
Informal measuresFormal counselingFormal performance improvement plan/period (PIP). This provides information about exactly what he or she is doing wrong and what they must do to keep the job.
Take a performance-based action.If the PIP does not cure the problem, close out with a removal, demotion or a reassignment. Always consult with your servicing Employee Relations Specialist.
Engagement Challenges: Addressing the “Difficult” Worker
• First ask: Am I being the “difficult” one?• The value of asking why?• Avoiding management by neglect• Examine expectations
– Demands of job vs. resources available
• Job fit, training, reassignment• Engagement, meaningful work• Getting help; use available resources
– Other leadership– EAP– Employee relations
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Special Considerations
• Workers with disabilities– Apparent– Hidden/invisible– Privacy issues– Reasonable Accommodations
• Impaired workers• Aging workers• Working parents/caregivers
– Sandwich generation
• Recognizing Red Flags
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Employee RecognitionDo it early and often but learn your employees’ preferences
Public vs. private praiseAcknowledging staff at All Hands or team meetingsMore subtle acknowledgements for “introverts”Letters from the Division Director or other senior leader
New opportunities, promotions, trainings, details and similar interventions can reward and recognize
A promotion is not always a financial increase or a new positionFor an eager worker, it may be additional duties, new responsibilities, or a chance to be on a workgroup or make a presentation
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Employee Recognition
• Certificate of Appreciation
• Service Awards
• Monetary awards
• On-the-spot Awards
• Time-off Awards
• Suggestion Awards
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Enhance Employee Engagement
• Increase social interactions among staff– Utilize cross-training and
workgroups as a relationship builder amongst your staff
– Cross-generational efforts
– Use work and non-work anchors for connecting individuals Bike to Work Day
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Summary: Enhance Your Leadership and Management Skillset
• Get to know yourself better• Actively communicate • Work on transparency• Set clear expectations and be willing to reset when needed• Intervene early when performance or conduct issues arise• Recognize and reward your team every day• Attend to work-life-family issues: your own and your team’s• Learn new things. Enhance your own leadership skills regularly• Get help when you need it
BREAK
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GROUP ACTIVITY
DESIGNING AN INTEGRATED APPROACH TO ADDRESS SAFETY AND HEALTH ISSUES
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Group Activity Instructions1. Break into groups and identify representatives
2. Choose a real-life setting
3. Identify a safety, health, and/or well-being issue
4. Discuss key organizational factors
5. Choose 1-2 interventions that could improve the issue
6. Plan the first steps of your intervention
7. Report back to larger group at 11:15
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TWH & CDC RESOURCES
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Simple Steps to Get Startedhttp://www.cdc.gov/niosh/twh/steps.html
[3/22/2016 9:09 AM] Chang, Chia-Chia (CDC/NIOSH/OD):
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National Aeronautics and Space Administration
University of Colorado Center for Worker Health and Environment
Dartmouth-Hitchcock Medical Center
Kentucky Department for Public Health
Mount Sinai Health System
Kentucky Injury Prevention and Research Center
National Safety Council
Nebraska Safety Council
University of Michigan
International Brotherhood of Boilermakers
SAIF Workers Compensation
University of North Carolina
University of Georgia
Laborers’ Health and Safety Fund of North America
Western Kentucky University
Oregon Healthy WorkForce Center
University of Iowa Healthier Workforce
Center for Excellence
Center for the Promotion of Health in the New England
Workplace
Harvard T.H. Chan School of Public Health
Center for Work, Health, and Well-being
Centers of Excellence and TWH AffiliatesISSA -The Worldwide Cleaning Industry Association
Labor Occupational Health Program, University of California Berkeley School of Public Health
American Association of Occupational Health Nurses
Northern Kentucky University
Valley Health Alliance
American College of Preventive Medicine
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Assessment Toolshttp://www.cdc.gov/niosh/twh/tools.html
1. Integration of Health Protection and Health Promotion: Rationale, Indicators, and Metrics (Sorensen et al, 2013)
2. CDC Worksite Health ScoreCard (HSC)
3. NIOSH Organization of Work Measurement Tools for Research and Practice
4. NIOSH Quality of Worklife Questionnaire
5. Occupational Safety and Health Administration (OSHA) Form 33
6. American College of Occupational and Environmental Medicine’s Corporate Health Achievement Award
7. CDC Workplace Health Assessment
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Guidelines for Integrated Approacheshttp://www.cdc.gov/niosh/twh/tools.html
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Topic-specific resources of interest
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Free continuing education credits
http://www.cdc.gov/niosh/twh/webinar.html
Next webinar: September 2016
Slated topic: Productive Aging: Strategies for Developing Age-Friendly Workplaces
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Ways to Connect with Total Worker Health®
Twitter(@NIOSH_TWH)
LinkedIn Group
(Search “NIOSH Total Worker Health”)
TWH in Action! e-Newsletter
http://www.cdc.gov/niosh/TWH/newsletter/
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Contact
Email: TWH@cdc.gov
NIOSH Total Worker Health® website:
http://www.cdc.gov/niosh/twh
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