Servant Leadership Approach to Employee Wellness

Running head: A SERVANT LEADERSHIP APPROACH TO EMPLOYEE WELLNESS 1

A Servant Leadership Approach to Employee Wellness

Jeffrey Tabor

Mountain State University

GSL630 Business Research Methods

Wayne Oppel, Ph.D.

April 15, 2012

A SERVANT LEADERSHIP APPROACH TO EMPLOYEE WELLNESS2

Table of Contents

Chapter 1: Focus and Framing Page 3

Chapter 2: Deconstruction of the Literature Page 9

What Others Say May be Happening Page 9

What has been done in Similar Situations Page 12

What do Others Think about These Issues Page 16

Chapter 3: Methodology 0

The Research Page 21

Oversight of Data Collection Page 22

Anticipated Results Page 23

Chapter 4: The Results Page 24

Chapter 5: Plan of Action Page 30

References Page 34

Appendix A: The Wellness Program Survey Page 37


A Servant Leadership Approach to Employee Wellness

Chapter 1: Focus and Framing

Recent estimates of the cost of healthcare for employers who provide coverage to

employees in the United States suggest that the average cost will rise above $10,000 per

employee in 2012. An article on employersweb.com, states that “employers continue to

experience an increase in the quantity and cost of catastrophic claims” (employer’s web,

2012). Catastrophic claims are those that are very serious in nature to both the

individual’s life and the financial impact of everyone involved. Often those similar

catastrophic claims happen to people who aren’t insured and those costs can be written

off to that individual, but shifted to other insurers through increased cost of operations at

the facility, thus creating the increased cost. The increased quantity can only mean that

people as a whole are becoming less healthy and are having more traumatic health

conditions that lead to serious medical intervention. Everybody with any responsibility

for decisions that are affected by healthcare costs is looking at alternatives to curb the

rising costs associated with treating sickness.

Many employers may be thinking that they should simply stop providing

healthcare benefits to their employees, and that eventually all of these costs will be

shifted somewhere else. The impact of this is hard to determine, but one could theorize

that one outcome would be a lesser quality of life for employees who do not have access

to affordable healthcare, and ultimately a lower life expectancy in the United States.

While this may still seem like a good idea if only blindly looking at employee benefits in


relation to the overall operating budget of the organization, if one were to look at the

value that employees place on healthcare in relation to the overall performance of those

employees and the overall costs of operating, they would likely reconsider. Employees

who have the best qualifications will look at potential employers with a comparison of

what each has to offer, and existing employees will lose value for their employer if they

see that the employer is more concerned with profit than with the health and well-being

of the employees and their families. The best employees will be seeking jobs where

things like their family’s healthcare needs are provided as a part of their relationship with

their employer.

Many people, including the United States Government, are looking towards the

focus of healthcare being more on wellness than on sickness. Wellness is living life as

healthily as possible and making decisions about activities of daily life that have positive

effects on the long-term health status. Sickness is being treated for things that may have

been preventable had the decisions about activities of daily life been more focused on the

overall picture. The belief is that if you go to a healthcare provider on a regular basis and

get all of the prescribed checkups done, then you are more likely to not be surprised with

a catastrophic claim. Those catastrophic claims are those mentioned before which are the

costlier of most claims, as well as serious life risks for the patient. While the costs of

preventive visits to healthcare providers may rise, the correlation to overall costs creates a

decrease because health risks that create the catastrophes are caught and treated before

they become that catastrophe. This is essentially the financial difference between a

healthcare provider treating people for sickness and a healthcare provider seeing people

for wellness.


There are many studies that one can find through an easy web search that define

the types of results that people can expect through lifestyle changes. Results are

generally explained in the form of a financial return on the initial investment. Overall,

most studies find that a successful employee wellness program can provide the employer

a financial return on their investment. In doing so, it creates a better quality of life for

most of the employees involved through a sense of accomplishment and a better overall

state of health. In addition, it maintains and builds on the value that the employee places

on their relationship with the employer through the genuine view that the employer does

care about them and their overall well-being more than it simply concerns itself with

profits. The trouble still remains in putting a scientific application on making a wellness

program successful.

The need exists in the workplace that this study is to take place in to develop a

successful employee wellness program for both of those reasons. One being that the

average cost of healthcare coverage per employee is larger in this organization that it is in

the projected United States average at a rate of about one and a half times. The other

being that the organization is a healthcare provider itself, a small rural hospital, and the

employees expect that their needs are addressed, and this correlates directly to the values

that the employees place on their organization, as well as the values that the consumer

has for the organization. As consumers come into the healthcare organization, their

assessments of the quality of care that they are to receive include the personal appearance

and attitude of those employees that they come in contact with. In addition, if the

program can be a success and it creates a lifestyle change for some employees, then they


will carry the story of their success into the community, and ultimately the program can

become a business building public relations improvement for the organization.

The environment that this organization is in has a lot to do with the needs for the

program to help employees and consumers make lifestyle changes. Situated in a small

town in West Virginia, the demographics are typical of most of Appalachia. Many

people are poverty stricken and do not have access to healthy food choices or

opportunities for traditional exercise programs, which can be expensive. When

comparing health statistics, West Virginia continually ranks in the lowest or highest

among other states depending on the direction of the study, but either way the ranking is

generally worse than others. There is a high rate of tobacco usage, high obesity rates, a

high level of Diabetes diagnosis, and high level of heart disease. All of these factors can

be tied to a shorter lifespan, a lower quality of life, and the need for more focused

decisions about activities of daily life.

The organization where the study is taking place has a self-funded healthcare

plan, meaning that there aren’t any insurance premiums so to speak. Rather, there is a

Third Party Administrator of the health care plan, and they process all of the claims and

get paid on a per employee per month basis. While some healthcare plans provide very

intensive wellness programs as a part of being their customer, this particular Third Party

Administrator does not. This then shifts the need to develop the program solely onto the

employer. This can be viewed as a benefit because the design of the program will be like

a canvas to be painted as it is seen appropriate, and it will allow for the program to be

designed to suit the needs of the employees. There are two labor unions involved with

the organization and they represent approximately two-thirds of the employees of the


organization. They are very committed to the long-term success of the hospital for both

the needs of the community and the needs of their employees. A large majority of the

employees are committed to the long-term success of the hospital as well and likely will

be open to a program that can help them make a lifestyle change and that will help the

hospital remain competitive while still providing a great employee benefit package.

The research that is to be done as a part of this project will be outlined in more

detail later. As an overview, though it is designed to do a few things. First the research

will allow employees to begin to think about lifestyle changes and themselves, as well as

a different look at wellness. The research will solicit input from people about what types

of things they may benefit from the most in a wellness program, with the theory that the

program must offer educational opportunities for everyone and step outside of traditional

exercise programs. The study method is significant for the hospital in particular because

it could be a model that could be offered to small employers in the community to use for

their own initiatives. The entire project as a whole will be something that can be

modeled and used to suit the needs of different groups anywhere. The cultural

differences from one company to another in the same community can be big enough that

the needs from the two groups can be substantially different.

In the following pages there are a few separate chapters that each serves their own

purpose. The preceding has been an explanation of what has led to this study. In Chapter

2 there is a deconstruction of the literature that has been reviewed to both guide and

support the design of the study. Many resources have been reviewed, many of which are

not included in the writing because the project is a culmination of a passion of the author

for several years. All of the knowledge contained in this writing doesn’t come from those


sources discussed in detail, but any specific knowledge taken from a source has been

discussed and cited. In Chapter 3 the methodology of the study is discussed. The actual

survey as well as the methods of scoring and categorizing data will be discussed in detail.

Initially the discussion will center on the study before it has taken place, and then this

chapter will be followed by a discussion about the findings and the proposed course of

action.

Because the project is designed to be used in the workplace and portable to other

organizations as a tool for their workplace, a majority of the actual study will take place

in the workplace. The preliminary work and the literary review is something that isn’t

tied directly to each individual workplace, so others will be able to utilize what has been

gathered here for the most part. The initial work has been done solely by the author, with

data results to come from and be gathered by co-workers, and eventually a committee to

drive the program will be put into place for both the conclusion of this project and for the

maintenance of the program for the future. In essence the author is committed to

designing a program that can be portable to other employers and that can be shaped to fit

the needs of each individual workplace through their own committee.


Chapter 2: Deconstruction of the Literature

What Others Say May be Happening

The Need for Wellness

Wellness is a word that everyone knows, but the word can have many different

meanings. “Wellness entails a conscious commitment to positive outcomes; it embraces

taking actions and respecting principles for optimal functioning in all these areas”

(Electronic Ardell Wellness Report, 2011). In other words, wellness is more than just

eating and exercising, it is a way of life. It’s being taught everywhere, including the

school systems of America. “Teachers say they are moving away from competitive

sports as the primary gym class activity and toward a "lifelong fitness" curriculum that

encourages students to make exercise part of their daily lives” (Aubele, 2011). Teaching

a lifelong fitness curriculum at such an early age may be just what the country needs for a

long term solution to the future generations, but the majority of our population isn’t in

school, and all school systems haven’t adopted the change in culture yet.

“A healthy lifestyle can result in fewer illnesses and injuries, fewer doctor and

hospital visits, even less medication. America's health care costs are now described as

unsustainable. How much could that bill be reduced if, for example, the rising level of

obesity -- and the many serious medical conditions it contributes to -- were reduced? We

need, as individuals and as a nation, to start focusing on prevention and wellness, and

taking on obesity is an obvious place to start” (The Frederick News Post, 2012). These

facts are exactly the thing that has driven corporations and governments to get involved.


On a systemic level, healthcare is a huge problem, and the inattention to and lack of

responsibility on the individual level must be changed. In addition to this there are many

social inadequacies that hinder people from being able to afford nutritious food, or work

in a healthy environment, or get enough education to make these choices.

Many people may say that the United States has the best healthcare program in

the world. Op-Ed columnist Nicholas D. Kristof points out that:

“The United States ranks 31st in life expectancy (tied with Kuwait and Chile), according

to the latest World Health Organization figures. We rank 37th in infant mortality (partly

because of many premature births) and 34th in maternal mortality. A child in the United

States is two-and-a-half times as likely to die by age 5 as in Singapore or Sweden, and an

American woman is 11 times as likely to die in childbirth as a woman in Ireland (Kristof,

2012).”

Does the United States of America have the best healthcare system in the world? Perhaps

it is if you are a sick person, but why can’t the best healthcare system in the world avoid

premature births? Why doesn’t the best healthcare system in the world ensure that people

avoid sickness, rather than primarily focus on the treatment once the sickness happens?

Knowing and Doing

“As many as 42 percent of Americans say weight loss is one of their top goals for

the New Year. When asked which resolution they failed to achieve the previous year,

most said weight loss” (Hubbuch, 2011). Everyone generally knows that they are or

aren’t healthy. It is evident to most people that they have excess body weight, or that

smoking is bad for their lungs and heart, and that excess alcohol consumption can lead to

liver failure, etc. There are literally thousands upon thousands of resources for people to


go to if they really want to make a lifestyle change. Why do not they do it? “Alexander

Chernev, associate professor of marketing at Northwestern University's Kellogg School

of Management, who began a study last year to better understand who we think we are --

and who we want to be says that "On a day-to-day basis we're fairly myopic… Once a

year we sit back and look at the future. And then we switch to normal day-to-day mode"”

(Hubbuch, 2011).

People do not put a conscious effort towards their vision of their own future. The

article suggests this is very similar to many businesses. The visionary focus comes

around once a year at the budgeting and forecasting meeting and then slowly creeps away

until the same meeting next year. Even though businesses and individuals alike know

that their decisions should be more focused on long term goals, it’s easier to act in the

short term than the long term. “About 75 percent of respondents to a 2008 Franklin

Covey Products survey said they break their New Year's resolutions within three months

and almost one-third break them by the end of January” (Kampis, 2012).

What creates failure?

There are many theories about what creates failure. Depending on the situation,

likely many of those theories may apply. These are just a few of the theories that relate

to healthy lifestyle changes and the failure of those that attempt them.

“The number 1 reason a ton of people fail to achieve their fitness goals is they do

not have the correct mindset that is congruent with their fitness goals” (Wellness Tips for

You, 2011). The article goes on: “With the proper mindset, you do not have to deal with

the negative elements that take you off the path, such as being lazy, a master

procrastinator or an individual with a thousand excuses” (Wellness Tips for You, 2011).


Further into the article it offers a simple approach to avoid the pitfalls of having the

wrong mindset:

“In order to shift your mind into the proper mindset, you will need to:

Decide what you really want to achieve

Look within and confirm that you are committed and motivated on

what you want to achieve

Set your goals for what you want to achieve

Visualize what you want to achieve … and that you already

achieved it

Go for it … take action toward your ultimate goal”

Another theory doesn’t focus as much on the lack of positive motivation to

change as it does the lack of the correct methods of attempting to lose weight. Many

people think that the obvious thing to do is to eat less to lose weight. However, the

human body is a very well designed organization of systems that reacts appropriately as it

was intended to. “Most people trying to lose weight go on some type of diet program

which they often do not stay with a diet because the stress they experience tries (sic) to

stay on the diet is too much for them to handle. The body gets most of the nutrients the

manufacturing cells need to keep the opiod (sic) (neurotransmitter) levels normal in foods

such as milk, cheese and other dairy products we often eliminate these types of food

when we diet, so we can lose weight, we are also eliminating the foods of (sic) our bodies

must have to keep the stress cycle from starting. Most diets don’t encourage lifestyle

changes” (Health and Wellness Digest, 2011).


What has been done in similar situations?

Workplaces and Wellness

Workplaces are offering employees wellness programs as an incentive to shape

the employees’ bottom and the businesses’ bottom line, but some question if there really

is any difference in workplace wellness and individual wellness. An article by Neal

Starkman suggests that there isn’t any real difference. “Being well in the workplace isn't

much different from being well at home, on vacation, at school or anywhere else. The

circumstances and the people may vary, but you still need some fundamentals in order to

be well” (Starkman, 2012). People all need to make the commitment on their own, if

they aren’t someway committed, then they won’t act. Making a lifestyle change is a big

undertaking, and just because a workplace thinks it wants to offer a wellness program in

order save some money on healthcare costs and absenteeism, doesn’t mean that an

employee cares enough to make a change. The article ultimately suggests that

individuals have to make the commitment and take responsibility for themselves, and

workplace wellness programs can offer a support system when it is needed.

Elizabeth Simpson writes in The Virginia Pilot that many employers are now

using incentives to help make employees make the initial commitment to make a lifestyle

change. They are having employees do things such as health screenings in order to

determine if they are in need of coaching. This in turn gets employees aware of their

health and focused on their problems and finding the resources on how to fix them. In

exchange, the companies often offer gift cards or lowered health care premiums.

“According to the Kaiser Employer Health Benefit 2011 survey, 22 percent of companies

that offer health benefits included a risk assessment this year, up from 11 percent in 2010.


Thirty-five percent of those use it as a way to encourage participation in wellness

programs. Some of the incentives companies use are gift cards, premium discounts and

lower deductibles” (Simpson, 2011). However, workplace wellness programs aren’t

always successful.

What Creates Failure...in Workplaces?

It’s been said that a big group is just a bigger version of a small group, so if that

holds true, then it stands to reason that just as people fail to achieve their wellness goals,

then so do corporations. Nothing makes the big castles that are corporations

impermeable to failure, and the same general idea can keep them from succeeding as was

discussed with individuals.

At a Society for Human Resource Management Conference, Lynda F. Jeppesen &

Travis Dent were speakers on the subject of corporate wellness. “Many wellness

programs fail, say experts Lynda F. Jeppesen & Travis Dent, but there is a way to design

a program that gets maximum involvement, great payback, and widespread employee

appreciation…Jeppesen notes that 71% of employers offering wellness initiatives say

their programs are not very effective at lowering costs” (Bruce, 2011). The article goes

on to note that the major contributor to that level of failure is lack of participation. This

statistic says that even though wellness programs are likely developed by some of the

most educated people in the country, 71% of the programs are incorrectly designed, if

you can accept that a properly designed program will have a high level of participation.

Bruce’s article goes on to talk about the design of the healthcare system and the

fact that healthcare providers get paid more for sickness than they do for preventive

procedures:


“The current trend is treating people who are sick, rather

than focusing on preventative care. The result is that more

than 95% of the nation's health expenditures are for the

diagnosis and treatment of diseases. Furthermore, more

than 70% of those costs are attributed to preventable

illness. Certain lifestyle challenges make it hard to reduce

these costs:

Lack of physical activity (More than 60% do not exercise

regularly)

Rampant obesity (More than 73% of adults are overweight)

Diet and nutrition (Sugar & caloric consumption are at

record levels)

Alcohol abuse and tobacco usage remains high

Stress (More than 60% of absenteeism is due to

psychological issues and job stress)

Chronic illness (More than 90 million Americans have

chronic conditions)

Although some wellness programs may be working, says

Jeppesen, the facts are that:

Employee's average weight has increased each of the past 4

yrs


The average employee Body Mass Index (BMI) is rising

steadily and is considered obese as defined by the Centers

for Disease Control” (Bruce, 2011).

These things listed above are all of the same things that keep individuals from being

successful. These same things make groups unsuccessful.

What do others think about these issues?

What Does it Take?

Ellen Lindahl, RN, MPA, is the Director of Health Promotion for MVP Health

Care in Rochester, N.Y., and she has written an article that lays out just exactly what she

feels it does take to be successful. She breaks it down into ten categories of necessary

things for success. They are: “multi-level management support, program goals and

metrics, strong communications strategy, wellness committees and champions, program

incentives, ready access to programs, a culture of health, medical self-care and

consumerism, health assessment, and participation” (Lindahl, 2011).

An article titled: Corporate Wellness Programs Need Total Redesign: From Focus

on Health to Values describes what the opinion is of the writer for the Electronic Ardell

Wellness Report. Values drive everyone’s motives for action. Servant leadership would

tell one that they could share their ideas for how a person should act in a given situation.

If that person didn’t accept their ideas, then they had chosen their fate. The idea then is

that what it does take is to allow employees to learn whether they need to change, and

then be able to pick from what resources are available to make that change possible. The

article is grounded on the theories of Maslow and what people need out of life in order to

be well. The article lists these as things that classify people as well:


“A high self-esteem and a positive outlook.

• A foundation philosophy and a sense of purpose.

• A strong sense of personal responsibility.

• A good sense of humor and plenty of fun in life.

• A concern for others and a respect for the environment.

• A conscious commitment to personal excellence.

• A sense of balance and an integrated lifestyle.

• Freedom from addictive behaviors of a negative or health-

inhibiting nature.

• A capacity to cope with whatever life presents and to

continue to learn.

• Grounded in reality.

• A highly conditioned and physically fit body.

• A capacity to love and an ability to nurture.

• A capacity to manage life demands and communicate

effectively” (Electronic Ardell Wellness Report, 2011).

Another article, written by H. J. Cummins for the Star Tribune, discusses a recent

study about friends and their influence on your health. It states that “a lot of credit goes

to features that counteract the powerful lifestyle influences the new study documents,

experts said, and they include on-site fitness centers, sports teams, midday walking pals

and discounted insurance premiums for the health conscious” (Cummins, 2007). There

are many consultants that have made careers out of specializing in what it does take to be

successful. One of these successes is Colleen Reilly, who had her first job in the area of


prevention with Coors Brewing. “She said she was inspired by owner Bill Coors'

incentive program, which included a drawing for a Sterling Marlin car hood and a 20

percent discount on workplace health insurance for those who signed up. Reilly said she

then decided it was her calling to help companies create healthier employees. So she went

to work for the Mayo Clinic, where she helped create an e-health platform and online

health assessment” (Evans, 2008).

Many believe that what it does take is for an employee to be inspired by their

company to make a lifestyle change, and then for that company to support that lifestyle

change. In addition to school-aged children, most adults are tied to a workplace either

through themselves or a spouse, and this idea would have an effect. One of the ways for

companies to be supportive is to offer health coaches. “Three years ago, Medica started

using "health coaches" to call chronically ill patients and nudge them to adopt healthier

lifestyles. Now there's evidence the program is paying off. Since 2008, more than

29,000 members of the health plan have gone through the program. Those who stuck with

it lost an average of 11.6 pounds and reported they felt better both physically and

emotionally, according to a Medica survey of 1,051 participants” (Lerner, 2011).

Coaches can have a profound impact on the outcome of a wellness program, particularly

on an individual level. One of the executives for the company mentioned in the study

said that “even pro athletes work with coaches. “There’s not anybody who can't benefit

from a coaching experience"” (Lerner, 2011).

Servant Leadership

Robert Greenleaf developed a concept based on the principles of Christian beliefs.

These beliefs aren’t far off from any religion or belief; it just happens that Greenleaf


chose to communicate them from his personal beliefs. The servant leader is defined by

Greenleaf as a servant first, then a leader. (Greenleaf, 2002) This may seem like

semantics on the surface. However, upon deep examination, what motivates the person

of influence will determine which category they fall into. If the person is a servant first,

they believe that they have what others need to be able to have a better quality of life and

if they are right will eventually be a leader if they are chosen by the people. If they are a

leader first, then servant, then they are more likely to provide a service just out of an

arisen need throughout the course of their leadership.

In taking this concept into a business, Greenleaf says that “businesses are asked

not only to produce better goods and services, but to become greater social assets as

institutions” (Greenleaf, 2002). Businesses have access to resources that most people do

not have. For example, a hospital has access to medical professionals, medical research,

medical equipment, and grant resources to mention only a few. This type of organization

should be the community’s resource for not just sickness, but health as well. With all of

these resources available, a hospital could easily be an institution that changed the future

of someone, if not many people’s health. America is facing a future of impending health

risks and many stem from basic nutrition and sedentary lifestyles. Servant leaders in

healthcare institutions will promote their business as a center for sickness prevention as

well as health restoration.

The most important concept of this book is to think about your life as a window

of opportunity to make the world a better place. Society may teach that one must be

successful in order to be happy, and that success is measured by money and possessions.

However, that statement is wrong, and success can be measured by many different rulers.


Chapter 3: Methodology

The research to be performed for this project will take place in a small hospital in

a rural setting in West Virginia. The community is relatively small around the hospital,

with larger cities about forty miles away in two directions. The hospital employs about

250 permanent employees and varying amounts of temporary employees. Of those 250

employees, approximately seventy percent of them are represented by two different labor

unions. The Laborers International Union of North America (LIUNA) represents dietary,

maintenance, and nursing assistant employees. The United Steel, Paper and Forestry,

Rubber, Manufacturing, Energy, Allied Industrial and Service Workers International

Union (USW) represents nurses, radiology, respiratory, and business office employees.

The hospital employees are committed to the long-term success of the hospital, and the

employees have made many sacrifices to help keep the hospital successful in the past.

The management structure of the hospital is much like most traditional structures.

It is vertically aligned, but due to the hospital’s number of departments there is also a

horizontal presence. The direction of the hospital is led by a CEO, who reports to a

Board of Directors. There is another level of administrators below the CEO who make

up the Administrative Staff and who add to the decision making process of the CEO. The

Administrative Staff includes the CFO, the Director of Nursing, the Director of

Marketing and Public Relations and the Director of Human Resources. The rest of the

horizontal structure is represented by a large Department Leaders Staff of twenty or so

managers from various Departments.


The Research

The project that has been chosen to be performed is in an effort to increase the

quality of life for all employees of the hospital and the community. The theory is that the

project will develop a method of wellness program development that is specific to the

criteria and needs of the organization. This method will be something that can be taken

on by any organization and therefore will be a benefit to the community as well.

The data will be gathered through a survey that asks several yes or no questions,

and allows the participant to enter free text for answers to three different questions. The

yes or no questions are designed to provide a baseline about whether people know about

their health, whether they want to make a change in their health, whether they have tried

to make a change in the past, and if they would be willing to participate in certain types

of wellness initiatives. These questions are purposefully only yes or no choices in order

to make an appropriate determination of where people fit into certain categories in

relation to their own status. The free text information is a chance for participants to

openly express their ideas and will offer them a chance to contribute a potential initiative

for the wellness program even if they aren’t willing to participate on the committee. The

ideas from the free text entries will be used to complete a data clustering exercise where

like ideas are categorized into several like groups and teams can be assigned to work on

the appropriate topics.

Potential participants will be advised that their input will be kept confidential and

will not in any way be used against them. The data will be housed in a locked cabinet

where only the researcher has access to. Names will not be included on the survey, and

in the event that someone does include their name it will be scrubbed by the researcher


prior to the information being collected. Participants who complete surveys will be

entered into a drawing for a chance to win one of five gift cards worth $10 to a local

grocery store.

Oversight of Data Collection

Over the course of history, many researchers have done some very unethical and

inhumane experiments. This has led to the development of oversight by the United States

Government. The United States Department of Health and Human Services oversees

human research through its Office for Human Research Protection. This office also

credentials and oversees Institutional Review Boards and helps to provide guidelines for

ethical research. Mountain State University has an Institutional Review Board that will

review the research collection methods suggested for this project, and will ultimately

determine if the project can be completed as proposed. The hospital itself does not have

a review board or any policy on research within the hospital. However, the

Administrative Staff does oversee many things and has approved the project through the

support of the CEO.

Institutional Review Boards are an unfortunate necessary in our world. Due to the

horrific fact that some people have intentionally caused others harm for the sole purpose

of research, a system is in place for prevention of a reoccurrence. The review process

that this project will undergo, through the informal process of the organization and the

formal review by the University, will ensure that participants are treated ethically and that

the data is gathered in a manner that will cause minimal risk to participants


Anticipated Results

The study is intended to develop a wellness program that people will be able to

use. The theory of the researcher is that many people know that they need to make a

change, but that they just do not know how, or cannot make the commitment themselves.

Many people may have resources and ideas that will work for many other people, but

have not expressed them to each other. By contributing ideas and resources along with

making small gains in health, people will begin to get the small victories necessary to set

their sights on bigger improvements. The belief is that if the program is designed by

employee input, and the employer provides those things to employees, then the program

will be successful.

Servant Leadership principles tell us that we cannot force ideas onto people. In

transposing these principles to wellness programs, it becomes evident that the best way to

get someone to change is by providing them the tools and knowledge, and letting them

make the commitment. Without their commitment to the change, the change will not be

as effective. With something as critical as a lifestyle change, it is paramount that the

person making the change is committed or it will not be successful and they will likely

relapse to their old habits.


Chapter 4: The Results

The survey was given out to employees at the hospital and they were given ten

days to complete the survey and return it in order to be eligible for the drawing. The

drawing for the gift cards was an effective incentive for the employees to complete the

surveys, as a result the employees responded very well. Many employees around the

hospital talked about what a great thing it would be to have a program that they were

allowed to pick the contents of. Others in management talked about how surprising it

was that so many people responded. There were 86 completed surveys from 250

employees, which is approximately a thirty percent completion rate. Although the survey

was available to all employees, a thirty percent sample is a good representation of the

population and the results of the survey will be a useful tool in shaping a program.

The first question asked participants if they felt like they know enough about their

health to know if they need to make a lifestyle change. Seventy-seven people responded

yes, while only seven people responded with no. This data doesn’t make any

determination about the health status of people, but it does demonstrate that the

employees do feel like they are aware of their health status. The second question

somewhat demonstrates the health status of the employees. It asks the employees that

answered yes to first question if they do feel like they need to make a lifestyle change.

Seventy-two people responded with the answer of yes, while ten employees indicated that

they do not think they need to make a lifestyle change. While the results of the two

questions do not correlate exactly, with seventy-seven people answering yes to question


one and eighty-two people answering question two, the results do show that there is a

very large portion of employees who think they need to change their lifestyle in some

way. It is worth noting that even though people may think they need to change, some

may not need to. This is not a medical evaluation, but it is an indicator of how interested

some people may be in making a change. Believing that a change is needed could be an

indication that someone is willing to begin the process of making a change.

The third question asks employees if they feel like making a lifestyle change is

something that would be overwhelming to them. Often people do not know what it takes

to initiate a change or to motivate them. The author expected the results of this question

to be a higher percentage of choosing yes than no. However, fifty-six people indicated

that they thought a lifestyle change could be overwhelming, while thirty employees felt

like it wouldn’t be. This could be viewed two different ways. One way of viewing it is

that thirty people will not have any trouble making a change, and if they are given the

right tools they will make a change without any problems. The other possibility is that

thirty people have no idea just how challenging it is to completely change their normal

routine, such as is necessary to change a lifestyle.

The fourth question asks if the participant has ever tried to make a lifestyle

change before. Many people have tried to quit smoking, to start exercising, to eat

healthier, to stop drinking alcohol, or any other change of a bad habit. Seventy-four

people answered yes, that they had tried to make a lifestyle change before. Eight people

indicated that they have not tried to make a lifestyle change. The fact that the majority of

the participants have chosen to try to change their lives in the past will be an indicator of


what impact a wellness program can have. If there is a large portion of people who have

tried unsuccessfully, than the wellness program could change their outcome in the future.

The fifth question asks if the employees who have tried to make a lifestyle change

were successful. Forty-nine employees said that they were successful, while twenty-eight

employees said that they were not. This question indicates that a large portion of the

employees have been successful at making a lifestyle change in the past, but by reference

to question number one, many of these people still feel like they need to make a lifestyle

change. This indicates that a wellness program could help change many people’s lives.

If the wellness program is properly designed, there are forty-nine people to provide

support to others about how to make a lifestyle change, and seventy-two people who

think they need to make a lifestyle change. If proper opportunities are provided and

people have an opportunity to share their success stories, the program can gain support

from the people who are participating and benefiting from that very support. Of the

people who were not successful, many of them know what made them unsuccessful and

have offered thoughts in the second free-text space on the survey. The seventh question

affirms this when seventy-four people responded that they thought a wellness program

could help them make a lifestyle change. Five people responded that they did not think a

wellness program would help them to make a lifestyle change.

The eighth question asks if employees have ever completed a health risk

assessment. A health risk assessment is a series of questions that provide a high-level of

assessment for people’s risk of having a health problem. It is an indicating tool that

people can use as a baseline for measuring their risk from unhealthy factors in their life.

The factors can range from family history to a sedentary lifestyle. Only twenty-two


people had ever completed a health risk assessment, while sixty-three had not. The next

question asks if employees would be willing to do a health risk assessment and seventy-

two employees responded that they would, while only eight said that they would not.

Health risk assessments were not well defined for the survey, and this number may

change if they realized that the assessment was as simple as answering some questions.

Even at this reported response, the majority of people have not done a health risk

assessment, and the majority would be willing to do a health risk assessment.

The next question asks if employees would be willing to be referred on to one of

the hospital’s in-house specialists based on the results of their health risk assessment.

Depending on what types of things were identified, employees could be referred on to a

physician, or a dietician, or even physical therapy. Sixty employees indicated that they

would be willing to be referred, while twelve employees would not be.

The last three questions are designed to gauge participation in certain types of

wellness program activities as well as participating on the wellness committee. Fifty

people reported that they would participate in wellness support groups, while twenty-two

reported that they would not. Forty-six people indicated that they would be willing to

take part in a wellness competition, while twenty-six would not. Twenty-three people

indicated that they would be a part of the wellness committee while forty-four would not.

Of the three free text areas of the survey, many results were offered with many of

them being common themes. The first question asked people what helped make their

lifestyle change a success. Responses were numerous, and were categorized into

nutrition, health, habit, exercise, and miscellaneous. Some of the nutrition responses

were drinking less sugary drinks, cutting out caffeine, eating more whole grains, eating


less processed foods, and drinking more water. A few of the health responses were

getting diagnosed with a changeable disease such as Diabetes, having a major life event

such as a heart bypass, and having high blood pressure. Almost all of the habit responses

were tobacco cessation, while another was to surround yourself with positive people.

The exercise responses were to do regular exercise at a gym, to have an exercise partner,

and to walk. The miscellaneous responses were seeing other people struggle, looking

good, and faith or religion.

The second free text question offered was what has made you fail to make a

lifestyle change in the past or what could be offered to help you make a lifestyle change.

Again, they were categorized into nutrition, exercise, habit, health and miscellaneous.

There were an overwhelming number of responses to the nutrition category, with many of

them relating to healthier lunch options in the workplace cafeteria, while others were

about meal planning and cooking education. There were a few exercise suggestions to

include classes for proper exercise techniques, to walking teams on breaks, and gym

memberships. The habit responses were centered on smoking cessation, breaking

routines, and time management. The miscellaneous responses were almost all about will

power, determination, and getting burnt out. The health responses were about stress and

stress management.

The third free text question asked people a broad question of what other

suggestions they might have to make the program successful. Responses were

categorized into nutrition, exercise, habits, and miscellaneous. The majority of the

nutrition responses were around healthier options for lunch and nutrition education.

Responses categorized as exercise related were to develop a walking area and to have an


exercise class. There was one habit response of providing tobacco cessation resources.

There were many miscellaneous responses, but the more notable ones were to offer

incentives for participation, to make options available for all shifts, and to provide group

support settings.

Overall, the survey participation level was good. The results of the survey were

much in line with what was anticipated. Many people have not had a health risk

assessment done, but would be willing to. This could be a key identifier in the needs of

the group as well as on an individual level. Many people indicted that they would like to

see support group type activities as well as competitions. A good mesh between the two

could be team activities that would provide the support group type focus, with some

attention to a competition but not based on an individual level. The free text responses

indicate that many people would benefit from a change in their nutritional intake. They

may like educational classes as well as simple options for lunch in the workplace

cafeteria.


Chapter 5: Plan of Action

The original goal of this project was to develop a program that would benefit

employees within the hospital, but also serve as a learning experience for small

businesses in the community surrounding the hospital. The hospital that this project took

place at is like many other rural hospitals, as it struggles to remain competitive and keep

its doors open. This program will be a supplement to the wellness options that the

hospital plans to offer to area employers. As employers look towards doing health fairs

for their employees, they will be able to add this model and begin a wellness program

that is homegrown and suited to their own population. It will require some effort on their

part, but the majority of the work will have been done by this project. This project will

be the basis of a turnkey wellness program that will provide employers with the means to

determine what their own employees need from a wellness perspective, and if needed the

hospital will share its educational resources as it is a community hospital, and educating

the community is a part of its role.

As an action plan within the hospital, the results of the survey will be divided up

amongst key participants in the wellness committee. Some of the key participants are the

Director of Human Resources, the Director of Physical Therapy, the Director of

Nutritional Services, the Director of Education and the Employee Health Nurse. The

plan is to get all parties together and have them choose the topics in the free text

responses that they think they can help with, then let them develop their own plan of

action for contributing to those subjects. In businesses that may not have these resources,


they could develop sub-committees based on individual interest, and people could take

the lead on whatever initiatives their employees expresses the need for.

The things that the Human Resource Department could help with are facilitating

an employee health fair, and getting employees screened for basic biometrics necessary

to complete a health risk assessment. The health risk assessment will be something that

can be completed by employees at their pace online. The Human Resources Department

can populate an Excel spreadsheet with relevant data such as e-mail addresses, names,

biometric data, etc. and then create a mass e-mail using mail merge to notify people of

the web link for the health risk assessment and to inform them of their individualized

biometric data from the health fair.

The Physical Therapy Department can develop exercise education programs that

will enable employees to learn how to exercise effectively. They will need to take into

account that some employees may not have a very good baseline to begin with and will

likely need to start very slowly. Walking competitions could be taken on by them with

team based activities focused on. It will be critical for their focus to also include other

employers and to develop programs that other employers can easily implement in their

facility.

The Nutrition Services Department will perhaps play the largest role in changing

the outcome of the program. Many people responded that they were interested in getting

assistance with their nutrition. The cafeteria lunch options are the sole responsibility of

this department and they will have the biggest impact on offering the chance for many

people to make a change in their nutrition habits. If some people begin to learn new

habits from purchasing the lunch at the hospital, they will carry those habits home with


them for dinner for themselves and their family. The dietician in the department will

likely be instrumental in providing support for nutritional education for all employees,

and will also likely be able to provide some additional support for other local employers.

The Director of Education will be able to provide assistance with or sole

leadership for many educational opportunities. This department will likely take on the

stress management, time management, and support group facilitation. Stress

management can include a number of topics from money management, to relaxation

techniques.

The Employee Health Nurse will be the provider of many things to many different

groups. This role can provide assistance with the health risk assessment process. This

role can provide assistance with the educational portion of many facets of the program.

Nurses play a key role in educating patients, and patients are no different than employees.

Likely both sets of people have the same issues and questions and needs.

Robert Greenleaf said “leaders work in wondrous ways. Some assume great

institutional burdens. Others quietly deal with one person at a time” (Greenleaf, 2002).

Many leaders take on roles far beyond the concept of what it takes to be a leader.

Making the personal connection to an individual’s needs is the central them behind

making a difference. People are different. People need different things out of life, out of

love, out of relationships, out of a means to make a lifestyle change. To provide

leadership in this relationship, one must seek direction not from within oneself, but from

with those that are willing to be led. To be a servant is not to be a ruler, but to be a

builder, a promoter of someone else’s own thoughts and needs. Leading in this way is


the path where one will find the ability to change the lives of others, and that is the

essence of leadership.

“Servant leaders differ from other persons of goodwill because they act on what

they believe. Consequently, they “know experimentally” and there is a sustaining spirit

when they venture and risk. To the worldly, servant-leaders may seem naïve; and they

may not adapt readily to prevailing institutional structures” (Greenleaf, 2002). Being

able to step out of what is traditional and being willing to take on a program from the

ground up as built by those that will benefit from the program is the true reflection of

what Greenleaf had in mind when he wrote his book on Servant Leadership. To be able

to let go of what one thinks they know to accept what they didn’t know is the spirit of

serving, the spirit of doing what a servant leader was intended to do.

If leaders can adapt the message of this project to their travels through

organizations everywhere, then the employees and other followers of institutions and

organizations everywhere will be able to develop sound programs that will capitalize on

the needs and wants of others. By building programs in this manner, the programs will

enjoy the success of providing a service to others.


References

(2012, January 6). EDITORIAL: Staying resolved. Frederick News-Post, The (MD).

Aubele, M. (2011, November 26). Schools put new emphasis on getting, staying fit.

Valley News Dispatch (Tarentum, PA).

Benefits, Compensation, Recognition, Health & Wellness, Retirement, Work Life |

Average Cost of U.S. Health Coverage per Employee is Expected to Cross the

$10,000. (n.d.). EmployersWeb.com. Retrieved January 21, 2012, from

http://www.employersweb.com/en/communities/health_care/health_plans_manag

ed_care/average-cost-of-us-health-coverage-per-employee-_gtljga98.html

Bruce, S. (2011, July 18). Why Do Traditional Wellness Programs Fail?—HR Daily

Advisor—BLR. HR Daily Advisor - Practical Tips for Human Resource

Professionals. Retrieved December 4, 2011, from

http://hrdailyadvisor.blr.com/archive/2011/07/18/HR_Policies_Procedures_Well

ness_Programs.aspx

Corporate Wellness Programs Need Total Redesign: From Focus on Health to Values.

(2011). Electronic Ardell Wellness Report (E-AWR), (559), 2.

Cummins, H. J. (2007, August 13). Businesses getting workers, bottom lines in shape.

Star Tribune (Minneapolis, MN).

Evans, A. (2008, July 31). Ex-Puebloan finding healthy profits in Denver: Colleen Reilly

scores with employee wellness programs. Pueblo Chieftain, The (CO).

Greenleaf, R. K. Servant Leadership: A Journey into the Nature of Legitimate Power and


Greatness... 25th Anniversary ed. New York: Paulist Press, 2002. Print.

Hubbuch, C. (2011, December 28). Americans uniquely determined, unable to lose

weight. La Crosse Tribune (WI).

Institutional Review Board. (n.d.). Mountain State University - Official Site, Mountain

State WV, Mt State University, Beckley College, College of West Virginia|

Mountain State University. Retrieved February 4, 2012, from

http://www.mountainstate.edu/students-current/irb/

IRBs and Assurances. (n.d.). United States Department of Health and Human Services.

Retrieved February 4, 2012, from http://www.hhs.gov/ohrp/assurances/index

Kampis, J. (2012, January 1). New Year's resolutions — why can't we keep them?

Decatur Daily, The (AL).

Kristof, N. D. (n.d.). Op-Ed Columnist - Unhealthy America - NYTimes.com. The New

York Times - Breaking News, World News & Multimedia. Retrieved January 7,

2012, from http://www.nytimes.com/2009/11/05/opinion/05kristof.html

Lerner, M. (2011, December 30). Health coaches pay off at Medica. Star Tribune

(Minneapolis, MN).

Lindahl, E. (2011). Employee Wellness Programs. American Fitness, 29(5), 54-56.

Simpson, E. (2011, November 14). Employers use incentives to reward healthy behavior.

Virginian-Pilot, The (Norfolk, VA).

Why A Ton Of People Fail To Achieve Their Fitness Goals. (2011, October 9). Wellness

Tips For You | Your Guide To Health, Wellness & Fitness. Retrieved December

4, 2011, from http://wellnesstipsforyou.com/why-a-ton-of-people-fail-to-

achieve-their-fitness-goals/


Why Do Most Diet Fail. (n.d.). Health and Wellness Digest Online. Retrieved December

4, 2011, from http://www.healthwellnessdigest.com/why-do-most-diet-fail/

Workplace Wellness | LIVESTRONG.COM. (n.d.). LIVESTRONG.COM - Lose Weight

& Get Fit with Diet, Nutrition & Fitness Tools | LIVESTRONG.COM. Retrieved

January 7, 2012, from http://www.livestrong.com/article/12518-need-workplace-

wellness/


Appendix A

Wellness Program Survey

Wellness programs are designed to help employees make lifestyle changes to improve

their overall health. This has many benefits for you and the hospital. Hopefully, the

biggest impact is a better quality of life for you.

This short survey is intended to allow you to shape the components of the wellness

program to better suit your needs. As you complete the survey think about the many

resources the hospital has access to through our employees. As a group, our resources

can be pooled to fit whatever you need out of a wellness program. In addition, this

program will hopefully be extended to the public in the future, so if you do not think you

have any needs please express what you think the community will need, e.g. your parents

or a neighbor. I’ll let you know the types of things I personally will ask for from the

program as an example.

For me, I would like to have some resources to plan healthy meals. My wife and I are

very busy, as I’m sure many of you are. Our kids are young and I know that as they get

older our available time will be filled with more and more activities. I’d like to be able to

plan healthy meals for our family. I’ve looked at cookbooks and watched cooking shows,

but in reality it just isn’t something that is easy to do on your own. I’d love for the


wellness program to provide a class on planning and preparing meals for the week. I’d

like to be able to do this on the weekend as a family and have the week’s meals at least

partially completed in advance.

We already raise a garden every year. We can tomatoes and green beans and freeze corn.

We keep potatoes for the year. I do not use fertilizer or pesticides and I think I am doing

a pretty good job of getting cheap and healthy food, getting exercise, and reducing stress.

However, I know there is more I could learn about the subject, and I know that there are

others in our workplace and in our community that do not know the first thing about

raising a garden and are afraid to try. I’d like for the wellness program to offer a class on

gardening, and maybe a class on canning and preserving.

Those are just some examples to get you thinking. We really need everyone’s input in

order to be successful, and any resources that can reasonably be provided will be.

Remember, there are no silly ideas. Your survey will be kept confidential and will not be

used against you in any way. Please be sure not to include your name on the survey in

any place.

As a courtesy for taking the time to fill out the survey, when you turn in the survey

to Human Resources, or to your supervisor, you will be entered into a drawing for a

gift card for Kroger. You do not have to put your name on the survey, but you do

have to turn in the completed survey and make sure Human Resources (or your

supervisor) knows it was you that completed it to be eligible for the drawing.


Survey to be completed and returned

Examples of lifestyle changes include eliminating/avoiding use of tobacco products,

eating healthier, exercising more frequently, coping with stress better, etc.

Do you feel like you know enough about your current health situation to know if you

need to make lifestyle changes? ____Yes ____No

If you do know enough about your current health, do you think you need to make

lifestyle changes? ____Yes ____No

Do you feel like making a lifestyle change is overwhelming? ____Yes ____No

Have you ever tried to make a lifestyle change before? ____Yes ____No

Were you successful? ____Yes ____No

If yes, what things made your lifestyle change successful that may benefit someone else?

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

__________________________________________


If no, do you know why you weren’t successful? ____Yes ____No

If you do know, what was it, or what types of things could be offered to help you?

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

__________________________________________

Do you think that a wellness program could help you make a lifestyle change?

____Yes ____No

Have you ever completed a Health Risk Assessment? ____Yes ____No

Would you be willing to do a Health Risk Assessment? ____Yes ____No

Would you be willing to accept a referral to one of our in-house specialized groups, based

on your Health Risk Assessment results? Ex.: Dietician, physical therapy

____Yes ____No

Would you participate in wellness support groups? ____Yes ____No


Would you participate in wellness competitions? ____Yes ____No

What else would you suggest for us to make this program successful?

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

______________________________

Are you willing to participate as a part of the wellness committee?

____Yes ____No If yes, then please separately communicate your interest so that

privacy of your information can be maintained.

Thanks for your help.

Servant Leadership Approach to Employee Wellness

Documents

Transcript of Servant Leadership Approach to Employee Wellness