www.each.com.au/health-promotion

More information can be found at:

EACH SOCIAL AND COMMUNITY HEALTH 46 WARRANDYTE RD, RINGWOOD 3134PHONE: 03 9871 2640EMAIL: dterrill@each.com.au

A Healthy Workforce

The Key Piece of the Productivity Pie

Evaluation Case Study Of An Industry Based Partnership

Written by Desiree Terrill EACH, August 2013

1

ContentsDowell Health & Wellbeing Team 2013

The Industry partnership between EACH Workplace Health Promotion and Dowell has involved an innovative strategic systems approach to enhancing the health and wellbeing of employees.

During a me of economic weakness, market downturn, a limited budget, and me, Dowell has achieved signifi cant workplace health and produc vity gains.

Achievements that have occurred since implemen ng Dowell’s Health and Wellbeing Program in July 2011 include: a reduc on in high risk chronic disease from 6/9 to 3/9 risk factors for staff ; reduced absenteeism by 17%; reduced staff turnover by 16.4%; reduced injury frequency rates by 19.5%; improved produc vity by 12.2%; and an es mated return on investment of $1,226,743 (Figure 1).

The global fi nancial crisis has highlighted the cri cality of fi nding sustainable workplace health solu ons to improve health and prevent illness, whilst also increasing crea vity and innova on to posi on businesses for the future. A healthy workforce has shown to be a compe ve advantage at Dowell who now meets 88% of Workplace Health Best Prac ce. In August 2013, the Health and Produc vity Ins tute of Australia (HAPIA) awarded Dowell with the ‘2013 Highly Commended Award for Corporate Health and Produc vity Management’. Partnerships between Community Health, Industry and other external partners has strengthened real world prac ce and research and provided a signifi cant return on investment for the business.

Achievements 02

Introduction 03

Method 04

Results 06

Discussion 10

Conclusion 12

Future recommendations 12

References 12

A Healthy Workforce – The Key Piece of the Productivity Pie

2

HAPIA Award Presenta on Sydney: LEFT Desiree Terrill (EACH), Sean O’Sullivan IHPA CEO, David Brumbaugh Dowell LEAN Manager, John Tucci Dowell General Manager.

Achievements

Securing an addi onal research partnership with Melbourne and Deakin University in 2012 has enabled exper se and greater resourcing to Dowell’s Health and Wellbeing Program to address iden fi ed workplace needs in mental health and wellbeing. The Beyond Blue research project conducted by Melbourne and Deakin University researchers is a $300K research grant to develop a good prac ce model in workplace mental health with a focus on anxiety and depression.

ACHIEVEMENTS OF DOWELL’S HEALTH & WELLBEING

PROGRAM 2011-2013

* REDUCTION IN CHRONIC DISEASE RISK FACTORS

32% Cardiovascular Disease

20% Smoking

16% Body Shape

3% Physical Inac vity

19% Healthy Ea ng Fruit Consump on

11% Healthy Ea ng Vegetable Consump on

* IMPROVED PRODUCTIVITY

12.2% Overall Employee Eff ec veness

* REDUCED LEAVE / INJURY/ STAFF TURNOVER

17% Sick Leave Absenteeism

19.5% Recordable Injury Frequency Rates

16.4% Staff Turnover

* IMPROVED WORKPLACE HEALTH BEST PRACTICE

80% Best Prac ce Standards

* RETURN ON INVESTMENT $1,226,743 Es mated Cost Savings

3

Evaluation Case Study Of An Industry Based Partnership 2011-2013

A snapshot of workplace health check results in 2011 (N=60) indicated Dowell staff were at high risk for 6/9 risk factors that could lead to chronic disease compared to the Manufacturing Industry (MI) Victorian average3:

DOWELL STAFF HIGH RISK FACTORS MI Victorian Average

cardiovascular disease 36% (30% above)

smoking 45% (20% above)

body shape 45% (19% above)

fruit consump on 70% (18% above)

type 2 diabetes risk 43% (11% above)

vegetable consump on 93% ( 2% above)

EACH’s health risk profi le analysis further indicated strong employee interest in back care management and promo ng posi ve mental health; as well as revealing high rates of staff turnover, sick leave absenteeism, reportable injury frequency; and produc vity 11% below Dowell’s target rate. In summary, the health risk profi le indicated a fi nancial risk for the business. A partnership was formed between EACH WHP and Dowell to create a healthy workplace program based on best prac ce evidence (Figure 2.)

Introduction

The vision of EACH Community Health Service (EACH) is to build healthy and inclusive communi es. EACH’s strategic direc on for 2011-2015 is developing leadership and strengthening business partnerships to maximise preven ve health eff orts in the City of Maroondah, Victoria. The Workplace Health Promo on (WHP) program is one strategy EACH has in place to reach priority popula ons within the community.

The workplace se ngs approach to health promo on is supported by the Victorian Public Health and Wellbeing Plan 2011–2015, the World Health Organisa on (WHO) Healthy Workplace Model (2010); the VicHealth Crea ng Healthy Workplace Program; and Healthy Together Victoria Workplace Achievement Program.

Workplace health promo on represents “the combined eff orts of employers, employees and society to improve the health and wellbeing of people at work”1. This is achieved through a combina on of improving the work organisa on and the working environment, personal skill development, community support, resourcing, health policy, and reorienta on of services.

The EACH WHP team has iden fi ed the priority group of male blue-collar workers in small-medium sized manufacturing worksites (50-250 employees) located in Maroondah as the priority se ng cohort. The Bayswater North Community Renewal region is the site of interest due to data indicated in the ABS (2011) SEIFA Index2.

This case study focuses on the evalua on of the Industry partnership between EACH WHP and Dowell, a manufacturer of mber and aluminum windows and doors. Dowell Bayswater (a

Boral company) is a small sized site located in Bayswater North, Victoria, employing just under 100 staff . Dowell is a culturally and linguis cally diverse worksite, with 85% blue collar workers, and an average age over fi y.

Strategies

FIGURE 2. DOWELL HEALTH & WELLBEING PLAN 2011-2014

Impacts Outcomes

Embedding Workplace

Health Promotion /

Organisational Systems

Change

Back Care

Mental Health

Physical Activity

Healthy Eating

Quit Smoking

Improved working conditions

(increased job control and

demand, social support,

commitment to OHS)

Increasing awareness of &

attitudes towards health &

wellbeing in the workplace

Productivity

Absenteeism

Staff Turnover

Reportable Injury Frequency Rates

IMPROVED Worker Health

Other Factors Internal (eg. Restructures) & External (eg. GFC) to Organisation

A Healthy Workforce – The Key Piece of the Productivity Pie

4

Method

Evidence based decision making and prac ce at Dowell has been underpinned by a literature review (published ar cles, grey literature, other public domain documents repor ng evalua on results using three library databases (Scopus, Medline, CINAHL) and Google / Google Scholar); ethics approval from the Human Research Ethics Commi ee June 2011 (HREC approval 2981); O awa Charter for Health Promo on guiding principles4; HAPIA Workplace Health Best Prac ce guidelines5 ; Systems Thinking Theory6,and data obtained from the health risk profi le analysis conducted by EACH.

The health risk profi le analysis consisted of a combina on of validated / best prac ce tools to provide baseline data as well as post evalua on feedback measures:

Work Health Checks data Dowell Workplace Health & Wellbeing audit tool based7

Work Safe Victoria Health & Wellbeing Staff Needs Survey8

WorkSafe Victoria Workplace Ameni es and Environment Audit9

Workplace Employee Sta s cs: absenteeism (including sick leave, unpaid sick leave, leave without pay), staff turnover, overall employee eff ec veness, reportable injury frequency rates

Health and Produc vity Ins tute Australia Best Prac ce Guidelines NSW Framework for Building Capacity to Improve Health tool10

Beyond Blue mental health staff survey (incorpora ng data on psychosocial job stressors) Staff sa sfac on surveys / Observa on / Focus groups

The table below outlines the founda ons of Dowell’s Health and Wellbeing Program 2011-2014 following analysis of health risk profi le data:

Aim Objec ve Indicators

To enhance the health and wellbeing of Dowell employees

1. To reduce chronic disease risk factors below the manufacturing industry average in Victoria

Dowell has an average of less than 4 chronic disease risk factors per employee

2. To create a health promo ng workplace environment

A collabora ve working partnership Sustainable changes to the physical work

environment for enhanced health Increased resource commitment by 50% in

allocated work me and fi nancial resources Sustainable changes to the psychosocial work

environment for enhanced health

3. To demonstrate a return on investment by mee ng HAPIA Workplace Health Best Prac ce standards

Reduce staff absenteeism by 10% by July 2014 Reduce staff turnover by 5% by July 2014 Reduce workplace reportable injury frequency

rate by 5% by July 2014 Increase produc vity by 5% by July 2014

Staff from all service areas support the development and implementa on of Dowell’s Health and Wellbeing Program. The focus is on par cipatory interven on planning in conjunc on with management, employees, and the Dowell Health and Wellbeing Commi ee (workplace champions) to develop tailored responses to health issues that impact Dowell. Figure 3 represents the strategies undertaken to achieve Program aims and objec ves. All of the listed strategies undergo con nuous monitoring and evalua on. This is essen al to addressing implementa on issues and progressing Program content from a systems based approach to WHP.

Primary, secondary and ter ary preven on strategies to undertake workplace health at Dowell is a signifi cant focus to empower staff . Combining macro and micro systems change strategies provide the poten al to reduce exposure to risk factors, equip individuals with skills and knowledge, and provide treatment op ons to rehabilitate workers if necessary.

5

Evaluation Case Study Of An Industry Based Partnership 2011-2013

FIGURE 3. WORKPLACE HEALTH STRATEGIES AT DOWELL 2011-2013

NOTE: Highlighted words in the table represent key systems change strategies

ACTION AREA DOWELL WORKPLACE HEALTH PROMOTION STRATEGIES PrimaryPreven on

SecondaryPreven on

Ter aryPreven on

Workplace Policy

development health and wellbeing policy smoke free worksite pre-work warm up stretching guidelines mee ng catering guidelines health & wellbeing as an OHS standing agenda item improved communica on including: annual newsle er publica on

to CEO, Board of Management and Staff ; mee ngs; conference presenta ons

Environment health and wellbeing commi ee workplace health coordinator and administra ve assistant rostering & realloca on tasks to reduce workloads and improve

effi ciency cultural sensi vity incorporated in program delivery par cipatory decision making for workers, staff sugges on boxes LEAN program increasing variety of work / job control over work

decisions healthy vending machine op ons provision of fresh fruit lunchroom upgrades site hygiene standards locker storage renovated male toilet ameni es (aluminium factory) University ethics approval to undertake health research return to work programs workers compensa on system

Personal Skill Development

sourcing grants to fund and resource the Program management skill development training targeted health literacy training and educa on in mental health

/ back care / physical ac vity /nutri on

Community Ac on

suppor ng and working collabora vely with health and wellbeing champions

engaging competent providers conference presenta ons

Reorienta on Services

EAP provider restructuring job descrip on of OHS dedica ng 10% more me to

health and wellbeing revised OHS repor ng and data collec on procedures shi ing organisa onal culture – valuing employees and promo ng

trust research partnerships with EACH, Beyond Blue and Melbourne

and Deakin University to undertake a workplace mental health project on depression and anxiety

“The direc on and goals of the Health and Wellbeing Team has been well presented. Ac ons and implementa on take longer than expected, but are understandable considering resource and me limita ons. It has been overall a posi ve and worthwhile project” DOWELL PARTNERSHIP SURVEY FEEDBACK, 2013

A Healthy Workforce – The Key Piece of the Productivity Pie

6

Results

Overall posi ve improvements in baseline indicators have occurred since the Industry partnership formed in July 2011 (Figure 4):

FIGURE 4. DOWELL HEALTH AND WELLBEING PROGRAM RESULTS BAYSWATER 2011-2013

KEY:

above MI Victorian Average below MI Victorian Average health risk factor improvements

WorkHealth Check HIGH RISK Results (conducted by Royal District Nursing Service)

2011N= 60

2013N= 51

Change Manufacturing Industry (MI) Prevalence of Modifi able Risk Factors Average7

Type 2 Diabetes risk 43% 37% 6% 32% although a reduc on was observed, s ll 5% above average

Cardiovascular Disease 36% 4% 32% 6% now 2% below (MI) average

Body Shape 45% 29% 16% 26% although a reduc on was observed, s ll 3% above average

Smoking 45% 25% 20% 25% now in line with (MI) average

Physical Inac vity 68% 65% 3% 70% now 5% be er than (MI) average

Blood Pressure 20% 20%no

change 29% no change observed but s ll 9% below (MI) average

Cholesterol 23% 29% 6% 27% an increase was observed, now 2% above (MI) average

Healthy Ea ng

Fruit Consump on 70% 51% 19% 52% now 1% be er than (MI) average

Veg Consump on 93% 82% 11% 91% now 9% be er than (MI) average

=Total Number of High Risk Factors

6/9 3/9 = improvement in 3 high risk factors

Overall Employee Eff ec veness: Dowell Target Rate

Timber Factory Average 74% 89% 15% 85% now 4% above target rate

Aluminium Factory Average 73% 83% 10% 85% although an increase was observed – s ll 2% below target rate

Industry Average (WorkHealth Goal)

Sick Leave Absenteeism 789 days 658 days 17% 10% WorkHealth Goal to reduce by 10% - performing 7% above in 2013

Recordable Injury Frequency Rate2011 2012 2013

19.5% 5% WorkHealth Goal to reduce by 5% - performing 14% above in 20133.34% 24.07% 19.37%

Staff Turnover 40.63% 24.24% 16% 21.3% although a reduc on was observed, performing 3% below in 2013

HAPIA Best Prac ce Guidelines 1/12 10½/ 12 80% Now meets 88% HAPIA Best Prac ce

Figure 4 shows that in 2011, Dowell staff had blood pressure and cholesterol below the manufacturing industry Victorian average, as well as consumed fruit within recommended guidelines. However staff overall had poor health with 6/9 high risk factors for chronic disease: risk of type 2 diabetes; cardiovascular disease; body shape; smoking; physical inac vity; and low fruit and vegetable consump on. Repeated workplace health checks conducted by the Royal District Nursing Service in June 2013 showed an improvement overall in staff health.

7

Evaluation Case Study Of An Industry Based Partnership 2011-2013

The following improvements were observed in reducing risk factors for chronic disease:

32% reduc on in cardiovascular disease 20% reduc on in smoking 16% reduc on in body shape 6% reduc on in risk for type 2 diabetes 3% reduc on in physical inac vity 19% increase in fruit consump on 11% increase in vegetable consump on.

No change was observed in blood pressure. There was an increase of 6% in high total cholesterol risk.

In 2013, the overall health of Dowell staff would be considered very good in comparison to 2011 workplace health check results. Dowell staff now have 6 risk factors be er than the Manufacturing Industry Victorian average and reduced chronic disease risk associated with: cardiovascular disease; smoking; fruit and vegetable consump on, blood pressure and physical ac vity (Figure 5).

FIGURE 5. DOWELL WORKHEALTH CHECKS HIGH RISK RESULTS FOR CHRONIC DISEASE 2011-2013

100%90%80%70%60%50%40%30%20%10%

0%

Type

2 D

iabe

tes

Card

iova

scul

ar D

iseas

e

Body

Sha

pe

Smok

ing

Heal

thy

Ea n

g -

Frui

t Con

sum

p o

n

Heal

thy

Ea n

g -

Veg

Cons

ump

on

Phys

ical

Ac

vity

Bloo

d Pr

essu

re

Chol

este

rol

Dowell Health Check High Risk Results 2011

Dowell Health Check High Risk Results 2013

WorkHealth Check Manufacturing Industry Average 2013

DOWELL STAFF RISK FACTORS

MANUFACTURING INDUSTRY VICTORIAN AVERAGE

2011 2013

cardiovascular disease 30% above 2% below

smoking 20% above in line with average

body shape 19% above 3% above

fruit consump on 18% above 1% below

type 2 diabetes risk 11% above 5% above

vegetable consump on 2% above 9% below

blood pressure 10% below 10% below (no change)

physical inac vity 3% below 5% below

cholesterol 4% below 2% above

A Healthy Workforce – The Key Piece of the Productivity Pie

8

A steady increase was observed in overall employee eff ec veness (12.2% average increase from July 2011-June 2013). Timber factory produc on exceeded the 85% target rate in 2013 to 89% eff ec veness rate and the aluminum factory steadily increased employee effi ciency by 10.2% but fell 1.8% short of the business target rate.

FIGURE 6. OVERALL EMPLOYEE EFFECTIVENESS DOWELL 2011-2013

73%

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0%

2011 2012 2013

Year

78%82.20%74%

84% 89%

Empl

oyee

Effi

cien

cy R

ate

“The Dowell Health and Wellbeing Program has been a process of developing a great team to gather informa on through employee surveys and sugges ons of highlighted issues that we can eff ec vely work upon in reducing or promo ng employee/employer happiness and produc vity. Sta s cs have shown we have a number of issues that would not have been brought up or worked on if it was not for EACH’s help and support that they have shown us” DOWELL PARTNERSHIP SURVEY

FEEDBACK, 2013 .

“A large part of the LEAN Journey is about employee engagement and ge ng the best from your workers in rela on to produc vity & problem solving. The Health & Wellbeing Program is helping to create an environment where employees are more willing to get involved, because they are more happy & healthy in the workplace, and comfortable enough to put forward ideas & sugges ons to help improve processes & their work environment” LEAN COORDINATOR, 2013 .

mber

aluminium

target (85%)

Par cipa on rates in healthy workplace ac vi es are extremely high with 84% of staff par cipa ng in at least one or more of the following since commencement of the Program: pre-work stretching exercises, walking groups, yoga, 10,000 Steps Challenges, massages, health literacy/educa on sessions. Incen ves provided have included $20-$50 Bunnings gi cards, movie ckets, and gym subsidies for par cipa on a endance. However the provision of hot food catering at various events has been a key mo vator for staff . Many of the healthy workplace ac vi es are provided during staff working hours to assist with maximum par cipa on.

Management par cipa on in health ac vi es alongside staff demonstrates leadership commitment. Staff engagement and a endance for mental health ini a ves increased by 22% in 2013 compared to 2012 highligh ng staff enthusiasm and commitment to the Program. Focus group feedback, staff sa sfac on surveys, and researcher observa ons indicate posi ve organisa onal and employee impacts as a result of the industry based healthy workplace partnership. The high levels of staff engagement, together with changes to workplace policy, crea ng a suppor ve work environment, suppor ng community ac on at Dowell and reorien ng services has been integral in enhancing workplace health and produc vity with an es mated return on investment of $1,226,743 since commencement of the Partnership.

Workplace health promo on has been successful at Dowell as a result of shi ing the tradi onal workplace health promo on focus from individual behaviour change to a strategic systems approach. Using a systems approach and u lising strategies to modify the context within which workers exist rather than solely a emp ng to change the individuals themselves has demonstrated signifi cant benefi ts through an increase in overall employee eff ec veness (12.2%), a reduc on in absenteeism (17%), staff turnover (16.4%) and injury rates (19.5%). Noteworthy changes have been possible at Dowell because of the use of a mul determinants approach to workplace health.

9

Evaluation Case Study Of An Industry Based Partnership 2011-2013

For example, Dowell u lized a mul layered approach to workplace health because of the impact working condi ons have on staff health outcomes. To reduce back strain and injuries, an educa on session will provide the worker with the knowledge to understand how to perform a task with a correct li ing technique. However, if the worker is fa gued from long hours worked, work overload and pressure, has lack of control over work and par cipa on in decision making, has poor social support, or an unclear work role and poor management; it will become inevitable the worker will become stressed at the frustra on of not having a suppor ve environment to implement what they have just learned about back care. Health educa on together with a suppor ve work environment, policy, reorienta on of services, and community ac on collec vely provide the solu on to crea ng the desired outcomes of reduced back injury (Figure 7).

This suite of mul pronged interven ons has created a signifi cant impact in reducing back care claims and associated recordable injury frequency rates (19.5% reduc on) and associated costs in the last year. An integrated approach to address all key health issues at Dowell is thus crea ng program sustainability.

FIGURE 7. SYSTEMS CHANGE CASE STUDY EXAMPLE – BACK CARE MANAGEMENT

Primary Strategies Secondary Strategies Ter ary Strategies

Needs iden fi ca on Reorganisa on of mber s llages and workbench layouts

/ new chairs and tables in lunchroom areas The LEAN Manager increasing the variety of job tasks Ergonomic assessments conducted of key staff tasks The stretching program was rolled out Na onally for

factory staff in paid work me Health and Wellbeing Champions con nue to lead and

mo vate factory staff in morning stretching exercises (in addi on to increasing social interac on between staff )

Revised communica on strategies

An EACH physiotherapist provided personal skill development seminars to staff

10,000 Steps x4 week Staff Challenges A pilot warm up stretching session was

provided by a personal trainer for 10 weeks

In partnership with a Labour Hire provider an in-depth 9 week manual handling educa on program was later rolled out for all staff .

Workers compensa on system

Return to work programs

Partnerships developed with external organisa ons have also added credibility and exper se in raising health and safety awareness as well as enhancing Dowell’s reputa on. Securing an addi onal research partnership with Melbourne and Deakin University to undertake a Beyond Blue research project ($300K) in developing a good prac ce model in workplace mental health with a focus on depression and anxiety has enabled exper se and greater resourcing to Dowell’s Health and Wellbeing Program in diffi cult economic mes.

Dissemina ng lessons learned from the innova ve partnership is one way EACH and Dowell are able to contribute to the evidence base in workplace health good prac ce from a local and interna onal context. Seminars /Conferences presented at, as a result of the Industry partnership includes:

Workplace Health Promo on Network Annual Members Forum (June, 2012) King and Wood Mallesons, Sydney. “Industry and Community Health Working in Partnership”

Health and Produc vity Annual Congress: Workplace Health – The Key to High Performing Companies (August, 2012) Daltone House, Sydney. “Bridging Workplace Health Promo on Theory to Prac ce”

Se ng the Pace: A Systems Approach to Se ngs Based Health Promo on at EACH (August, 2012) New Hope Blackburn, Victoria. Co-Presenta on Dowell and EACH. “Lessons Learned from a Health Promo ng Workplace Partnership”

Monash University, School of Occupa onal Health, Presenta on to Third Year Health Promo on Students (September, 2012). Peninsula Campus, Victoria. “Transla ng Workplace Health Promo on Theory to Prac ce”

NSW Health Promo on Symposium: Crea ng Environments to Improve Health (November, 2012) Wesley Centre, Sydney. “A Systems Approach to Bridging Workplace Health Promo on to Prac ce”

21st Na onal Conference of the Australian Health Promo on Associa on (June, 2013) Sydney Conven on and Exhibi on Centre, Sydney. “Crea ng Mentally Healthy Workplaces: A Victorian Case Study using Systems Thinking”

21st IUHPE World Conference on Health Promo on: Best Investments for Health (August, 2013) Pa aya Exhibi on and Conven on Centre, Bangkok. “Mul sectoral and Mul stakeholders: Partnership and Collabora on for Health Promo on: Building the Evidence Base on Integrated Workplace Mental Health Promo on”

A Healthy Workforce – The Key Piece of the Productivity Pie

10

Discussion

According to the O awa Charter, working condi ons and employment are a social determinant of health4. Employment provides the income required to obtain food and shelter, as well as providing an important source of control. Work occupies the largest amount of ac ve me in an adult life. As such, working

condi ons have the signifi cant poten al of infl uencing health in either a posi ve or nega ve direc on due to the amount of me spent at work. The mo va ng factor of a healthy workforce is that it contributes to a sense of control of oneself, which according to O awa Charter principles, may posi vely impact employee health (as demonstrated in 2013 WorkHealth Checks results Figure 5). In 2011, Dowell employees recorded above the Victorian State average in 6 out of 9 high risk factors for chronic disease, indica ng poor health overall. Australian employees average 4 health risk factors per person11. In 2013, Dowell employees recorded reduced risk for chronic disease with only 3 out of 9 high risk factors, indica ng signifi cant health gains and an improvement be er than the manufacturing industry Victorian average.

A workplace health promo on informa on session held in July 2011 with senior management and staff was the beginning of the communica on process informing the inten on for an onsite Health and Wellbeing Program. Leadership support and par cipa on, together with reward incen ves has been an essen al element in crea ng strong staff engagement. Dowell recruited passionate employees interested in contribu ng to the health and safety culture and developed them as workplace champions following informa on sessions to all staff on WHP. The focus was on inclusion of staff from all areas within the business including factory, offi ce and service staff . The team of champions, alongside management commitment and reward incen ves, has been infl uen al in promo ng the Program and its overall success. Avenues to communicate and promote the Program were via tool box talks, lunchroom no ce boards and displays, informa on brochures, engaging interpreters to liaise with culturally and linguis cally diverse employees, site emails, annual newsle ers, and dissemina ng lessons learned at numerous conferences.

review of the Program at the end of June 2013 reaffi rms management commitment and staff expecta ons that systems changes are posi vely infl uencing the WHP process.

Intersectoral and community partnerships have been an important avenue in WHP to overcome challenges of addressing the social determinants of health, and are also an essen al feature that created a suppor ve physical and psychosocial work environment. Mutual goals and benefi ts, with clear roles and responsibili es, create the founda on for successful partnerships based on trust, leadership and eff ec ve communica on. Seven people across diff erent levels within the business (factory / offi ce /service) volunteer on Dowell’s Health and Wellbeing Commi ee to support and implement healthy workplace strategies. The Commi ee meets quarterly but ini a ves are run on a monthly basis.

Ongoing par cipa on of the Health and Wellbeing Team to support the suite of strategies to create a healthy workplace at Dowell highlights both management and employee commitment. In a qualita ve survey10 of the partnership process at Dowell (conducted in June 2013), a 100% (N=7) response rate was achieved. It revealed that 28.6% commi ee members rated the Team within a ‘Networking – Coordina ng’ phase; and the other 71.4% rated the Team in a ‘Coopera ng-Collabora ng’ phase. These two phases indicate a willingness to increase the capacity for each other for mutual benefi t and common purpose. More importantly, these fi ndings suggest this phase of a partnership is representa ve of a high level of trust between partners and signifi cant me sharing to create a more seamless service system. Addressing ‘so ’ lifestyle behaviour change issues such as physical ac vity and nutri on was the entry route used to engage staff ini ally together with an annual staff newsle er outlining key ac vi es undertaken. This assisted in building health awareness, trust, and workplace champions and took a lot more me than ini ally an cipated (18 months).

Incorpora ng the right blend of Management and staff from all service areas, and providing incen ves and recogni on has been integral in the staff engagement process. More specifi cally

The WHO Healthy Workplace Model4 has been adopted as the process oriented framework to support best prac ce for se ngs change via leadership engagement and worker involvement. This was achieved through a combina on of collabora ve partnerships, crea ng sustainable changes to the physical and psychosocial work environment; and increased resource commitment to Dowell’s Health and Wellbeing Program. Workplace strategies were successful as a result of focusing on a ‘systems approach’ where WHP has become an integral part of day to day opera ons rather than a ‘health project’ within Dowell.

A public health approach to systems changes typically categorises strategies according to three levels: primary, secondary and ter ary. Primary preven on approaches are preven ve; secondary approaches are ameliora ve; and ter ary approaches are considered reac ve (See Figure 3). By tackling worker issues at the source, and working at all levels of Dowell to develop comprehensive preven on / reduc on strategies, it is becoming possible to increase health and performance related benefi ts including improved produc vity (12.2%) and reduced sick leave absenteeism (17%).

The benefi ts of systems change at both the individual and organisa onal level are occurring as a result of combining macro level, primary preven on ac vi es to improve psychosocial working condi ons, with micro-level, secondary strategies to improve the capacity of staff to cope be er6,12. U lising health risk profi le data, Dowell were able to tailor specifi c systems change strategies into the workplace ac on plan. This was important to create trac on for the program and ensure staff needs were being supported via workplace policy, environment support, personal skill development, community ac on support, and reorienta on of services. Systems change strategies included: communica on; rostering; increasing variety of work; job control over work decisions; training; support; restructuring of job descrip ons. “71% of Health and Wellbeing Team members fully agreed the program’s workplace health strategies are aligned with Dowell’s mission and core business” (Partnership Survey, 2013). The annual partnership

11

Evaluation Case Study Of An Industry Based Partnership 2011-2013

the con nued par cipa on and support of staff volunteers on the Health and Wellbeing team; health and wellbeing as a standing agenda item on Dowell OHS monthly mee ngs; addi onal resource commitment by Management to the Program; and development of a Boral Health and Wellbeing Policy, are refl ec ve of just a few organisa onal culture changes suppor ng and promo ng a healthy workplace. Three notable considera ons have also had a signifi cant impact on high staff engagement. The recent appointment of a new site Opera on’s Manager, as well as ongoing support and contribu on by the OHS Manager and the LEAN Manager to the Health and Wellbeing Program has accelerated the number of strategies being rolled out across site and has provided substan al senior leadership support.

The budget for Dowell’s Health and Wellbeing Program has included ongoing monetary contribu ons as well as increased me alloca on. Dowell and EACH have collec vely contributed $25K towards ini a ves over the last two years. Commitment to resource the Program has steadily increased by Dowell from commi ng 0-20 hours per month suppor ng workplace health and wellbeing ini a ves in 2011, to 140+ hours per month in 2013, in addi on to restructuring the OHS Manager’s

job descrip on to integrate health and wellbeing from 10% of me in 2011 to 20% in 2013. EACH WHP has allocated a senior project offi cer to support Dowell’s Health and Wellbeing Program two days a week since commencement of the partnership.

In 2011, the baseline data revealed there were 789 days of staff absenteeism (9.1 average days leave per employee) compared to 658 days in 2012 (7.93 average days leave per employee). Following the healthy workplace industry partnership, Dowell are now below the Na onal average rate (8.5 days) for manufacturing industry workers13. A 14% absenteeism decrease was reported for mber factory workers while a 25% decrease was reported for aluminum factory workers during the same me period. This represents an average 17% reduc on ($24,890) in absenteeism (131 days). Interes ngly only a 6% average decrease was observed for the Finance/Sales/Service/Despatch workers and they had the least amount of par cipa on in workplace health promo on ac vi es.

The most signifi cant improvement to baseline data changes was in the area of staff turnover. This reduced from 40.63% in 2011 to 24.24% in 2012. This has reduced signifi cantly to more closely represent the industry average of 21.3%14. According to the Australian Human Resource Ins tute15, businesses that reduce staff turnover by 5% per

year will save approximately $280,000 per year for every 100 people they employ. According to these fi gures, Dowell has saved $917,840 by reducing staff turnover by slightly more than 15% (including recruitment, selec on, and induc on).

With the introduc on of new technology and increasing diversity of the workforce, it has become a necessity to improve new occupa onal health and safety repor ng processes to refl ect an accurate account of records. As a result, data in early 2012 showed an expected spike in Recordable Incident Frequency Rates (RIFR) across Victorian Dowell sites. In conjunc on with the Boral ICare program, retraining of staff through tool box talks, presenta ons, observa on and conversa on training, the quality improvement process was improved to ensure accurate repor ng. The diff erence between the fi nancial year of 2012 and 2013 represents a 19.5% reduc on in RIFR and 33% reduc on in recordable incidents ($289,013) due to new policy changes and staff training of ac ve and personal interven on. Organisa onal systems changes highlight a noteworthy knock on eff ect in reducing workplace injury and associated hours lost, represen ng a healthier workforce and signifi cant cost saving to the business. Figure 8 shows the number of success factors and challenges to the Program along the journey:

FIGURE 8. DRIVERS OF ENGAGEMENT /CHALLENGES CONTRIBUTING TO HEALTHY WORKPLACE OUTCOMES:

Drivers of Engagement Challenges

Con nuous tailoring & monitoring Programs & surveys are completed in working hours Trust and rela onship development Work collabora vely A lot of face to face ac vity (both project people & par cipants) Senior leadership Realis c meframes of what can be achieved Provide incen ves Clear informa on Staff workplace champions Variety of interven on op ons Understanding culture / language / mo va ons between partnerships and worksites Use exis ng and network linkages Non-threatening suppor ve approach Shared values and mutual respect

New ground – s gma Availability of me Collec on baseline data Produc on deadlines CALD worker inclusion Intensity of rela onship support

required to keep everyone on the same page and involved

University red tape (ethics process)

A Healthy Workforce – The Key Piece of the Productivity Pie

12

Conclusion

Intersectoral partnerships are an important element in addressing the social determinants of health. Clear roles and responsibili es outlining mutual goals and benefi ts create the founda on for eff ec ve partnerships based on trust, leadership and eff ec ve communica on. Collabora ve partnerships are an essen al feature in the workplace se ngs approach to maximise employee health and produc vity. The EACH / Dowell Industry partnership has demonstrated signifi cant success as a result of this. Dowell staff now exhibit be er health, with a lowered chronic disease risk compared to the manufacturing industry average in Victoria in 2013.

Embedding workplace health promo on in occupa onal health and safety prac ces at Dowell has created sustainable work prac ces. A systems change approach, senior management support, acknowledgement of both staff and management priori es, use of exis ng resources, integra on, recogni on for the determinants of health, monitoring and evalua on, and long term planning, have been key factors contribu ng to Dowell achieving the status of becoming a health promo ng workplace and increasing best prac ce by 80%.

In the last year of the Industry partnership, it is an cipated that workplace benefi ts will con nue to accrue to individual workers through be er health, to the business through lower absenteeism / staff turnover / workplace injury, and will begin to reverse even further the impacts and burden on physical, mental and behavioural outcomes if all twelve HAPIA workplace health best prac ce standards are to be achieved. Systems changes are integral in protec ng and promo ng the health and safety of Dowell staff and the Dowell working environment.

Future recommendations for:

DOWELL

Con nue working towards achieving all 12 HAPIA Workplace Health Best Prac ce standards by June 2014.

Review of the pilot back care program. Endorsement of the Health and Wellbeing Policy. Resource commitment goals for the Health and Wellbeing

Program 2014-2016. Explore the feasibility of the Health and Wellbeing program

becoming a na onal Boral ini a ve.

EACH COMMUNITY HEALTH

Con nue the industry partnership with Dowell un l June 2014 to support workplace health and wellbeing.

Present the fi ndings of the case study at the Safety Ins tute of Australia Conference in 2014.

Write a journal publica on of the partnership fi ndings from workplace health promo on.

Advocate to the Health and Produc vity Ins tute of Australia the fi ndings of this case study in addi on to no ng the importance of incorpora ng working condi ons into best prac ce standards. Research evidence together with this case study demonstrates working condi ons are a key component infl uencing workplace health and produc vity outcomes.

GOVERNMENT

Inves gate the feasibility of legisla ve changes rewarding employers for achieving and sustaining benchmark risk factor profi les in their workforce either through tax or grants incen ves.

1World Health Organisa on (2010), Healthy workplaces: a WHO global model for ac on, Sourced May 2011 www.who.int/occupa onal_health/5keys_healthy_workplaces.pdf 2Maroondah City Council (2011). City of Maroondah Community Profi le, Sourced May 2011 h p://profi le.id.com.au/maroondah/seifa-disadvantage3Healthy Workers Portal WorkHealth (2012). Industry Profi le Report: WorkHealth checks in Victoria’s Manufacturing industry, Sourced May 2013 www.workhealth.vic.gov.au/fi les/fi le-resources/industry-report-manufacturing4World Health Organisa on (1986). O awa Charter for Health Promo on: First Interna onal Conference on Health Promo on. WHO Geneva.5Health and Produc vity Ins tute (2010). Best Prac ce Guidelines, Workplace Health in Australia, Sourced June 2011 www.hapia.com.au

References

www.each.com.au/health-promotion

More information can be found at:

6LaMontagne, A.D., Keegel, T., & Vallance, D.A. (2007b). Protec ng and promo ng mental health in the workplace: Developing a systems approach to job stress. Health Promo on Journal of Australia, 18, 221-228.7WorkHealth Victoria (2011), Workplace health and wellbeing audit tool. Sourced June 2011 www.workhealth.vic.gov.au/fi les/fi le-resources/?a=36293 8WorkSafe Victoria (2011). Health & Wellbeing Staff Needs Survey. Sourced May 2011 www.workhealth.vic.gov.au/fi les/wh_beac ve_poster-download/?a=18762 9WorkSafe Victoria (2011). Workplace Ameni es and Environment Audit, Sourced May 2011 www.worksafe.vic.gov.au/__data/assets/pdf_fi le/0004/9229/Workplace_ameni es_CC.pdf 10NSW Health (2011), NSW Framework for Building Capacity to Improve Health, Sourced May 2011 www.health.nsw.gov.au/pubs/2001/pdf/framework_improve.pdf

11Gwini S., Botlero.,R., Roberts, M., & Sim., M. (2012). 500,000 WorkHealth Check Sta s cal Report. WorkSafe Victoria, Melbourne.12LaMontagne, A. (2012). Job Strain and Health Behaviours – Developing a Bigger Picture. American Journal of Epidemiology, 10, 1-5.13SafeWork Australia (2012). Key Work, health and safety sta s cs Australia. Sourced June 2013 www.safeworkaustralia.gov.au/sites/SWA/about/Publica ons/Documents/677/Key_Work_Health_and_Safety_Sta s cs_Australia_2012.pdf14AMMA Resource Industry Employer Group (2013) AMMA research paper: labour turnover. Sourced May 2013 www.amma.org.au/assets/Policy/Papers/20130227AMMA%20Research%20Paper%20-%20Labour%20Turnover.pdf 15Australian Human Resource Ins tute (2012). The 2012 Insync Surveys Reten on Review: How to reduce turnover and retain your high performing employees. Sourced May 2013 www.brw.com.au/rw/2009-2014/BRW/2012/10/11/Photos/ce1ff fd8-13ce-11e2-bede-8b0dcf7c8f6b_the_2012_insync_surveys_reten on_review%20(1).pdf