The Value Proposition of Occupational Health: - PowerPoint Presentation

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The Value Proposition of Occupational Health: The Added Value of Occupational Health Applications in the Workplace

Tee L. Guidotti, MD, MPH, DABTOccupational + Environmental Health & MedicineTee.Guidotti@gmail.com

“We protect the health of the people who make our world and keep it running.”

 Kathryn Mueller, Past President, ACOEM

DisclosureTee L. Guidotti is a practicing occupational and environmental medicine specialist and consultant. He has no business interests in the Kingdom. Supporting evidence: The Kingdom is not easily compared to other countries, economies, and societies. I have therefore avoided giving figures or numbers that may be misleading. Sources for supporting evidence will be given at the end of this presentation, but the most important source is:

Jonas Steel, Jeroen Luyten, Lode Godderis. Occupational Health: The Global Evidence and Value. Society of Occupational Medicine, KU Leuven, London, 2018.

Basic OH ServicesPolicyPlanningSurveillance

Environmental monitoringPsychosocialInjury prevention/safetyOccupational healthFirst aid

Diagnosis

This is the World Health Organization’s model for providing essential OH services in developing countries.

Against a background of change

Value and ValuesValue = what something is worthWhat is the “value proposition” of OH?

Value proposition A value proposition is a promise of value to come.It is a compelling reason to buy or do something. It means “faster, better, simpler, more adaptable, easier to use, smart”.

It makes a product, service, or enterprise worth more.It also relieves pain.

Values = what we believeTo enhance performance of the enterprise for a purposeTo ensure compliance with regulations because they protect usTo respect our values

The PainPain = discomfortArises from gap between where organization is and where management would like to goThree types:Financial

StrategicPersonalDecisions are based on feelings.Discomfort is telling us something.When things seem unfair, they probably are.

Adroit management establishes trust and credibility.Patrick Renvoise, Christophe Morin. Selling to the Old Brain. San

Franciso, SalesBrain Qbook edition, 2004. Corporate cultureTrue values revealed by actions

Questions every manager must askWhat am I doing for the enterprise?

What is the enterprise doing for the good?Who’s life is my responsibility? Beyond that?

How can I be a better person by being a better manager?

What are my values? What are the values of the enterprise?Is what we are doing sustainable? How can it be made so?How can we make the enterprise stronger?How can we survivecontinueprosper in the face of challenges?How can we improve over time, whether we think we need to or not?The Reflective Manager

Two Views of the Value of Occupational HealthEnterprise levelManagers emphasize:

Moral – is it right?FinancialCost of careCost of lost productivityCost to employeesImproved business performance

LegalRegulationLiability for actions, consequencesUnanticipated consequences (e.g. disaster)

Population levelPublic health emphasizes:Injury/disease prevention Burden of disabilityPlatform for health promotionSustainability emphasizes:EconomicEnvironmentalSocialSociety emphasizes:Reasons why enterprise existsPlatform for growth, not stagnationProfitPlanetPeople

How do they benefit?Employer

Reduce lossSickness absencePresenteeismLost productivityImprove quality of work

Better relationshipsReputationFewer management problemsRegulatory complianceGreater efficiency

Other StakeholdersReduce loss to societyBurden of disabilityLost wealthProtect quality of lifeWorkers in partnership with bossReputation as a good place to workin worldEmployee / worker

Reduce risk

Disability

Lost earnings

Out of pocket expenses

Improve quality of life

Better relationships with boss

Motivation

Fewer management problems

Regulatory compliance

Meaningfulness of workGreater efficiency

Value of Occupational HealthCosts and benefits cannot be easily compared across countries and economies (that’s why I am not giving you numbers)Benefits of OH are positive to all stakeholders: employees, enterprises, societyThe moral case reflects on the enterprise and its managersThe financial value depends on the national system for worker’s compensation, social security, and healthcareExternalization of costs – when employer dumps it on workers and society

Socialization of costs – when costs are spread among community for a good reasonCost shifting – when one sector (e.g. compensation) shifts costs over to another (healthcare system) Disincentives and shielding – when employer has no incentive to improve

Work and HealthThe Illness/Injury AgendaWork-related disordersWork-aggravated disordersConditions affecting work capacityImpairment assessment, disability preventionThe Prevention AgendaHealth promotion and wellnessPeriodic health surveillanceFitness for duty

Environmental medicineThe Business AgendaReduce loss ( = best outcomes, reduce avoidable injury/illness)Increase productivity ( = improve worker’s health and fitness)The Sustainability Agenda

EconomicEnvironmentalSocial

Understood it 321 years agoThe “Triple Bottom Line”

Pillars of OH  Integrated StructurePreventionPrimary prevention (health protection in the workplace)Secondary prevention (early and effective treatment)Tertiary prevention (of disability)Human  environment interfaceFitness for duty, impairment assessment, disability management, accommodation

Population health managementWellness - individual health managementSustainability, social and workforce

Jaresh

, JordanPut together in a new way that is fit for purpose today.

Keys to a healthy workplace (WHO)

Leadership commitment

Involving workers

Business ethics and legalityContinuous improvementSustainability and integration

The Vocabularies of Prevention

Public Health and Preventive Medicine

Managed Care

Health and productivityWorker’s InterestPrimary Prevention

Prevention guidelines

Audits

Demand Management

Health promotion

Keep workers healthy

Secondary Prevention

Prevention (screening) guidelines

Surveillance

Health monitoring

Disease prevention

Treat disease early

Better outcomes

Tertiary Prevention

Practice guidelines

Disease management

Disability management

“Wellness”

Case management

Early and safe return to work

Maintain physical capacity

Avoid disability

After a slide first developed by Dr. Ron Davis, President, AMA.

The terminology we use is critically important in reaching stakeholders but also in reflecting our values.

Individual Response:Behavioral or Biological

Social

Environment

Health,FunctionFig. 19.1PhysicalEnvironmentHeredity,ConstitutionDisease,Disability

Well-being

Healthcare

Prosperity

Population Health Issues

This is our role on the big stage; our vital presence in public and population health.

Basic Deming Cycle: Continuous Quality Improvement

Plan

→

Study → Do (or Check) → Act → (Repeat) Should be the same for OH as for production!

ResourcesPaul J. Nicholson. Occupational Health: The Value Proposition. Society of Occupational Medicine, London, 2017. https://www.som.org.uk/sites/som.org.uk/files/Occupational%20health%20-%20the%20value%20proposition_0.pdfT.L. Guidotti et al., eds. Occupational Health Services: A Practical Approach.

London, Routledge, 2012, 2/ed.Jonas Steel, Jeroen Luyten, Lode Godderis. Occupational Health: The Global Evidence and Value. Society of Occupational Medicine, KU Leuven, London, 2018.

Unique Services of OEMOccupational history, exposure assessmentDisability prevention and managementMedicolegal servicesImpairment assessment and managementCausationRisk management (through anticipation)Program managementPopulation health management (epidemiology)Formal management (MBA-type)

Informal management (“doctor-type”)Fund of knowledge in occ/env hazardsGeneral (toxic/physical/etc.)Specific sector (e.g. oil and gas)