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East Tennessee Children’s Hospital: Long Term Success in Improving Population Health

Learn how East Tennessee Children's Hospital implemented an innovative, outcomes-based wellness program to improve the health of its employee/spouse population.


Company Overview
East Tennessee Children's Hospital (Children's Hospital) is a regional children's hospital based in the Knoxville, TN area. Children's Hospital has been providing healthcare to their community for over 75 years, extending coverage to a significant amount of the southeast region of Tennessee, southeast Kentucky, and parts of southwest Virginia.

Health and Wellness Need
Children's Hospital offers an Employee Health and Wellness clinic to their population that has been in place since 2007. The hospital had a set of employee awareness and education programs designed to promote one-on-one individual health and wellness, but these programs were not impacting the larger employee population. The employee population at Children's Hospital is challenged, as is much of the Southeast, by regional and cultural lifestyle choices.

Children's Hospital initially tried to administer their own wellness program. As with most hospitals, they faced budget constraints and limited internal resources to manage the program. They also had the added complexity of scheduling and administering a program for employees that worked multiple shifts. Their greatest challenge was overcoming employee concerns about coworkers administering and having access to personal health information. Children's Hospital identified a significant opportunity for improved levels of participation in their wellness program with measurable outcomes.

Children's Hospital decided they needed a results-oriented health and wellness program that would drive measurable outcomes. During a pre-employment screening at the Employee Health and Wellness clinic, a new Children's Hospital staff member shared a success story with her Director of Employee Health and Wellness, Tom Jackson, FNP. This staff member's story highlighted her positive lifestyle changes prompted by participation in her spouse's employer's wellness program that was provided by Interactive Health. She had been referred to her healthcare provider for medication treatment and lifestyle change counseling as a result of her Interactive Health biometric screening, and has since quit smoking and controlled her blood pressure and cholesterol.

Impressed by this story, Tom reached out to Interactive Health and a handful of other wellness providers for more information. After some initial conversations with Interactive Health, Tom asked to learn more. Interactive Health provided Children's Hospital with a full presentation of the program and its components, first to their Employee Health and Wellness team and ultimately to the CEO and Hospital Board who voted to adopt the program.

Implementation of a Results- Oriented Program at Children's Hospital
Wasting no time, Interactive Health and Children's Hospital quickly implemented a results-oriented program with a full health profile (including cholesterol/LDL/triglycerides and blood glucose) and Thyroid-Stimulating Hormone (TSH) test offered to all full-time and part-time employees and spouses on the health care plan. The program was closely tied to the Children's Hospital employee health and wellness brand and logo, with which workers were already familiar. The hospital also offered an incentive, nearing a 20% discount in health care premium, tied to employee and spouse participation.

Implementation Challenges
Children's Hospital anticipated possible concerns about confidentiality and therefore lower-than-desired participation from employees. In collaboration with Interactive Health, Children's Hospital held a series of rollout meetings to explain the preventive program and address any employee concerns. As word-of-mouth spread positive feedback throughout the hospital, employees became more receptive to the new health and wellness initiative. By the time the second series of employee meetings was held to discuss the new program, there was an overall positive employee response.

Transforming a Population's Health
Since implementation, the Children's Hospital wellness program has been successful. Participation rates are very high, with 1,119 employees (65%) and 499 spouses participating in 2014. The addition of the Interactive Health wellness program to Children's Hospital's Employee Health and Wellness Clinic services has encouraged and supported important wellness changes among employees and spouses.

Perhaps more importantly, the actual health outcomes for Children's Hospital employees have improved dramatically.

  • Tobacco use was a concern for Children's Hospital at the program's inception. The percentage of tobacco users at the hospital dropped from 9% in 2012 to 4% in 2014.
  • Among those employees who needed to improve their blood pressure in 2013, nearly 80% did so by 2014.
  • Similarly, nearly 60% of those asked to improve their glucose levels or triglycerides made improvements from 2013 to 2014. Children's Hospital has won Interactive Health's "Healthiest Company" award for the last two years. The hospital has been an advocate about the Interactive Health program, speaking openly about the program and the positive impact on employee health.

Full Suite of Resources Available
Each year, Children's Hospital's wellness program has been enhanced while still operating under the hospital's pricing constraints. Children's Hospital has continued to offer a number of other programs and resources to help its employees care for their health, such as:

  • An Employee Assistance Program (EAP) which offers free confidential counseling services to employees and their families
  • A Smoking Cessation Program with one-onone confidential counseling, individualized treatment plans, and medication if necessary
  • A confidential "Be Well for Life" weight management program that provides individualized assessment and wellness counseling about daily eating and exercise as well as twice-monthly appointments with wellness professionals to counsel and motivate employees on their weight loss journey
  • Fitness memberships to local gyms discounted as much as 50%
  • Google maps of quarter-, half-, threequarter- and full-mile walking routes starting at the hospital that are printed and kept in kiosks, as well as an indoor walking map of the actual hospital used for rainy days or for employees looking for a quick 5-10 minute walk break
  • Listings of community fitness and wellness activities
  • Clinic services including wellness counseling for cholesterol, blood pressure, and blood glucose management as well as treatment for minor, acute illness and injury

 

Children's Hospital has also developed a comprehensive health and wellness website for their employees to use as a resource. The site includes information and links to all of the benefits and programs offered, such as the wellness clinic, weight control and smoking cessation programs, fitness discounts, community activities, and walking maps.

Importantly, it also links to the Interactive Health website for employees to access their confidential health history, personal health score and goal, tracking and trending of lab results, webinars and monthly newsletters. For employees seeking information, the Children's Hospital health and wellness website offers educational resources on a wide range of topics. Mental health resources include titles like "Get the most out of your day in the office" and "Benefits of slumber", while physical health resources include, "Relief for neck and shoulders" and "Skin health in the summer". There are also eating resources, like a healthy eating handbook, recipes, instructions for portion control, and information on the benefits and drawbacks of coffee.

Future of the Program
Interactive Health is currently preparing to augment Children's Hospital's wellness program to include both A1C Smart Testing (testing individuals at risk for diabetes) and condition outreach health coaching. Children's Hospital is concerned about prevention of diabetes, and is planning to increase efforts to reinforce the positive movement they have experienced among their employee and spouse population. Considering the great success they have seen so far, along with the hospital's commitment to employee health and wellness, this seems like a perfect enhancement to their existing program.