Accommodating Age

As today's workforce gets progressively older, employers are recognizing the business benefits of enhancing the health and safety of aging employees.

Thursday, September 1, 2005
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The folks at Greenville (S.C.) Hospital System didn't start out looking for reasons why a surprising number of their employees, primarily nurses and other caregivers, voiced a desire to retire early.

When a chronic health-care worker shortage reared its head in 2003, the center undertook an extensive workforce-planning study, mainly by analyzing employee age by profession. Among the results, it found the average GHS nurse was 37 years old (compared to 41 nationally), but it was the story behind the seemingly youthful average that proved most intriguing, according to Doug Dorman, GHS' vice president of HR.

Most tellingly, the GHS study reported that despite that relatively young average age, GHS had a surprisingly disproportionate number of employees on the extremes, so the workforce was mostly very young employees or employees in their 50s, 60s and even 70s.

In short, the average didn't reflect the true age scenario. Also, through exit interviews done both via mail and face-to-face, a clear majority of GHS employees choosing early retirement cited the "physical toll of their jobs" as the No. 1 reason to leave early.

The second largest employer in Greenville County, with more than 7,600 employees and 1,000 physicians, GHS knew it had to do something to keep those valuable caregiver employees from leaving early -- especially with its high number of caregivers in the 50-, 60- and 70-year-old age range and a health-care worker shortage gaining speed.

It attacked the problem head-on with a complete structural overhaul, including renovation and new construction as part of a larger capital project.

Currently, GHS is in the process of reconstructing four new-patient wings across five floors on its main campus. Construction spans 20 nursing units and approximately 250,000 square feet. A strategic component of this renovation -- as well as past construction projects -- involves incorporating innovative design to ease physical stress on caregivers.

Included in the redesign:

* Care stations situated between every two patient rooms to reduce travel distances for nursing staff. These "mini-nursing stations" allow staff to stay close to assigned patients, with less walking to the conventional nurses' station.

* Patient rooms with windows facing the care station. Automated window blinds allow nurses to remotely observe the patient, reducing unnecessary trips to the bedside.

* Decentralized storage rooms adjacent to care stations to house linens and supplies, eliminating long walks.

* Marmoleum, a linoleum product, to replace carpet in clinical and public areas. This flooring offers increased resiliency, as well as significant hygienic and maintenance advantages. The floor's "give" takes pressure off joints and reduces strain for those constantly on their feet. And, because the smooth Marmoleum replaces carpet, the new flooring facilitates pushing beds and carts, further reducing physical stress.

The modifications go beyond physical renovation, however. For example, when it comes to lifting, GHS is partnering with Diligent, a company that specializes in clinically supported injury-prevention programs.

"We're reducing manual transfer and repositioning tasks by training employees to use new lifting equipment," Dorman says. The changes, he adds, are causing a ripple effect felt throughout the organization, as all employees come to understand and support them.

"We're not separating anyone out, and we're making progress as rapidly as we can," he says.

Based on national statistics and a recent workers' compensation study in Ohio, the GHS strategy may do more than boost the hoped-for employee retention. It should also result in lowering workers' compensation and disability coverage costs among a slice of the population that has a disproportionately higher recovery rate from injuries than the rest of the American workforce.

For example, the Work Loss Data Institute, in its Official Disability Guidelines 2004, mined several national databases to demonstrate that older workers have longer periods of disability than their younger counterparts.

In its 2004 study, the Ohio Bureau of Workers Compensation compared its data to results described in general medical literature and found the recovery rates of workers by type and injury is slower for older workers.

As the U.S. population grows older due to longer life expectancies, decades of lower birth rates and the bulk of baby boomers (75 million Americans whose ages are between 40 and 60) entering their senior years, it's only natural that the American workforce will grow older accordingly. Employers will need to adjust not only to retain those workers, but also to keep them healthy on the job.

"Age is not a disability. Aging is not a disease," says Ken Mitchell, vice president of Corporate Return to Work Development at UnumProvident Corp., the Chattanooga, Tenn., insurer.

"The worker over the age of 40 will become the single largest worker group in the U.S. workforce within the next five years. Employers need to understand the realities and opportunities of this group. Protecting their health and productivity will be a critical corporate investment."

Mitchell's words go directly to the point that HR executives, and senior management in general, should pay very close attention to how their work environments (from a health and safety standpoint) match up with their demographics. With the baby boomers getting older, how the work environment affects employees who have crossed the 50-year age milestone is especially important -- and can significantly affect the bottom line.

Aging Problems

In fact, new research conducted by UnumProvident focuses on the aging American workforce, and particularly on the potential health and productivity predicaments that demand a response from employers, medical providers and the workers themselves. Its study, Health & Productivity in the Aging American Work Force: Realities and Opportunities, reveals:

* Although workers age 40 and older experience a lower incidence of work injuries, short-term disability and unscheduled absences than younger workers, the average amount of time they will miss due to an injury or illness is greater by nearly a third.

* Workers older than age 40 account for 50 percent of all short-term disability claims and up to 75 percent of long-term disability claims.

* Primary reasons for long-term work disruptions for this age group include impairments of the musculoskeletal and circulatory systems, as well as mental and cancer disorders.

* The additional presence of risk factors such as smoking, lack of exercise and obesity can result in health-care costs for this population that are nearly 300 percent higher than the younger workforce.

"Employees are living longer and have more active lives that require them to work well into their 60s, creating a myriad of concerns including health-related issues," Mitchell says. "The good news here is that there are tried and proven effective steps that management can take to lessen this occurrence and benefit not only aging employees, but all employees."

UnumProvident's research notes that excessive health-care costs for aging workers are driven by relative health risks, such as smoking, obesity, uncontrolled blood pressure and more.

Companies that develop programs to support and promote preventive health care among their baby boomer employees will encourage behavior that can counter this trend. By putting programs in place that provide incentives for workers to have healthier lifestyles, lost time and health-care costs can be reduced.

Making Accommodations

Mitchell cites UnumProvident customer Coors Brewing Co. of Golden, Colo., as an example of a corporate culture that is focused on the health and wellness of its employees, in all age groups. As such, the company has had a measurable impact on productivity, particularly with its 5,000-employee U.S. workforce.

Coors employees have access to a full range of health-and-wellness resources for their use, including a variety of fitness programs, a health coach, on-site physical therapy and medical center, a 25,000-square-foot wellness center and health-risk appraisals that come with a $200 premium-reduction incentive.

In addition, Coors has a transitional work program through which employees, managers and physicians create flexible options for employees to return to work. These options include, among other things, phased-in work schedules and modified workloads, until the employee can get back to 100 percent.

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"What we are using is a system that stresses prevention, but also accommodates reaction to illness and injury that managers and employees can be comfortable with," says Eric Grobecker, human capital management manager of Coors Brewing. "We've struck a balance between the needs of the company to remain productive and the issues related to the health of our employees."

The Coors model has impressive results, including a 66 percent decrease between 2003 and 2004 in submitted long-term disability claims and a higher percentage of employees on long-term disability returning to work within the first year.

"It's about creating a focused, yet flexible plan for managing productivity," Grobecker notes. "You have to have a system of incentives, education and opportunities for employees to maintain their health. Our employees of all ages can see we are committed to keeping them well, and these programs have been received tremendously."

Mitchell stresses that employers need to be cautious, ensuring programs such as those at Coors benefit the entire employee population -- not just certain age groups.

"You don't want to name it as a specific program for older workers, because that could be setting up a protected class according to the Americans with Disabilities Act," he warns. Coors, he adds, found older workers account for the most users in its flexible-work program.

Dorman says while GHS originally set out to reduce the number of valued, experienced employees leaving sooner than later, the added benefits of lower workers' comp and/or disability costs are a welcome bonus.

"In many cases, caregivers have very physical jobs, so the steps we're taking help the 55-year-old worker walk or lift less. But they also benefit a 25-year-old [by helping him or her] become less exposed to a workers' compensation or disability-related accident," Dorman says. "Also, we believe these changes will help convince our employees to stay in the profession longer, with less burnout from the physicality that comes in a caregiver role."

In addition, GHS is piloting the use of cell phones to allow nurses to communicate more easily and reduce travel. It's also expanding the use of automated guided vehicles, which automatically deliver food and linen to hospital floors. Robotic carts that travel programmed routes will further minimize the need to push heavy carts.

Shift in Thinking 

According to Dorman, the vision behind the project represents a true shift in organizational thinking. GHS no longer expects its caregivers, regardless of age, to expose themselves to physical discomfort in order to provide quality care. Instead, GHS is committed to support workers by taking advantage of improved facility design, modern technology and evidence-based injury-prevention research. Dorman says expected benefits include:

* Improved retention.

* Decreased injuries.

* Enhanced recruiting.

* Anticipated ROI.

Modifications on behalf of an aging workforce are expected to fully pay for themselves over time, mainly by reducing the high cost of turnover. "It's too early for many return-on-investment numbers," Dorman says. "Certainly, we have done some up-front cost-benefit analyses."

But overall, he says, "we will see ROI by keeping people in the workforce longer and [making] a stronger commitment to their health." The only real certainty, he adds, is that the shortage of health-care professionals is only going to get worse, and being an employer of choice requires real commitment in the face of some uncertainty.

In GHS' case, workers' compensation and disability-insurance costs were not the main motivation. In fact, GHS had already reduced workers' comp costs 50 percent over the past eight years through safety training, changing floor finishes and other ergonomic-based programs. But with those safety changes as the foundation, the organization took a step back and determined what the next step toward ensuring employee health and safety should be.

"Everyone is trying to address workers' compensation costs," says Dorman. "We believe we were ahead of the curve on that front. I do think most colleagues in HR and other professions are looking to do the same, but it takes a major commitment from senior management and the dollars to get it done. It's not a quick fix. We didn't get into it overnight. And as demographics change, we'll have to evolve with them and continue to adapt."

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