Methodology Employee Turnover and Workplace Environment - PDF

Document Sample
Methodology Employee Turnover and Workplace Environment - PDF Powered By Docstoc
					Final Report



Employee and Workplace Health:
British Columbia Community Social
Services Sector

September 2006
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



TABLE OF CONTENTS

INTRODUCTION / PURPOSE OF THE STUDY .............................................................................. 2
 Methodology................................................................................................................ 3
FINDINGS: HEALTH AND HUMAN RESOURCE INDICATORS .............................................................. 5
 Absenteeism/Sick Leave ................................................................................................. 5
 WorkSafeBC: Work-Related Claims ..................................................................................... 5
 Short-Term Disability: Non-Work Related Claims .................................................................... 6
 Long-Term Disability: Non-Work Related Claims ..................................................................... 6
 Employee Turnover ....................................................................................................... 6
FINDINGS: EMPLOYEE HEALTH SURVEY................................................................................... 7
 Introduction ................................................................................................................ 7
 Demographics .............................................................................................................. 7
 Physical Work Environment .............................................................................................. 9
 The Psychological and Social Work Environment.................................................................... 10
 The Stress Satisfaction Offset Score .................................................................................. 12
 The Business Health Culture Index .................................................................................... 13
 Health Status and Personal Health Risks ............................................................................. 13
 The Patient Health Questionnaire: Screening for Depression ..................................................... 16
 Chronic Health Conditions and Productivity ......................................................................... 18
 The Stanford Presenteeism Scale...................................................................................... 18
FINDINGS: WORKPLACE HEALTH SYSTEMS REVIEW .................................................................... 20
 Structure of the Systems Review ...................................................................................... 20
 Limitations and Caveats................................................................................................. 21
 Results ..................................................................................................................... 21
DISCUSSION OF FINDINGS.................................................................................................. 23
CONCLUSIONS ............................................................................................................... 25
REFERENCES................................................................................................................. 26
APPENDIX A: COMMUNITY SOCIAL SERVICES EMPLOYEE HEALTH SURVEY 2005 ................................... 27
 About This Survey ........................................................................................................ 27
 Instructions................................................................................................................ 28
APPENDIX B: EMPLOYEE HEALTH IN COMMUNITY SOCIAL SERVICES (EHCSS) WORKPLACE HEALTH SYSTEMS
REVIEW....................................................................................................................... 34
 About the EHCSS Project................................................................................................ 34
 What is the Workplace Health Systems Review? .................................................................... 34
 Benefits of Conducting a Workplace Health Systems Review ..................................................... 34
 How the Systems Review is Organized ................................................................................ 35
 How the Systems Review is Conducted ............................................................................... 35
 How the Systems Review is Scored .................................................................................... 35
 Reporting of Results ..................................................................................................... 36
 Glossary of Terms ........................................................................................................ 37


                                                                                                                      Page 1
    Final Report
    Employee and Workplace Health: British Columbia Community Social Services Sector



ACKNOWLEDGEMENTS

We would like to thank WorkSafeBC and Healthcare Benefit Trust for providing significant funding for this
project.


This report has been made possible through the efforts of representatives from the 14 community social
services organizations which participated in the study and a Steering Committee representing the
Community Social Services Employers’ Association (CSSEA), Union Bargaining Association (UBA),
WorkSafeBC and Healthcare Benefit Trust.



Project Steering Committee

•      Professor Neil Boyd, Principal Investigator, School of Criminology, Simon Fraser University
•      Chris Anderson, Regional Coordinator, B.C. Government Employees’ Union
•      Kathie Best, Director, Member Services, Community Social Services Employers’ Association
•      Roz Kennedy, Staff Representative Benefits, B.C. Government Employees’ Union
•      Shelagh Locke, Industry Specialist-Health Care, Industry and Labour Services, Worker & Employer
       Services Division, WorkSafeBC
•      Aili Malm, PhD. Technical Analyst, School of Criminology, Simon Fraser University
•      Jan Mitchell, Program Manager, Prevention & Health Promotion Services, Healthcare Benefit Trust
•      Carmel Murphy, Project Coordinator, Senior Consultant, Prevention & Health Promotion Services,
       Healthcare Benefit Trust
•      Dr. Larry Myette, Project Consultant, Director and Occupational Medicine Consultant, Strategic
       Workplace Health, Healthcare Benefit Trust
•      Lorne Rieder, Chief Executive Officer, Community Social Services Employers’ Association




                                                                                                     Page 2
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



INTRODUCTION / PURPOSE OF THE STUDY

The Employee Health in Community Social Services initiative is a collaborative study involving the
Community Social Services Employers’ Association (CSSEA), the Union Bargaining Association (UBA),
Healthcare Benefit Trust (HBT) and WorkSafeBC. The primary objective of the study is to conduct a risk
assessment of individual and organizational health, in order to create workplace health risk profiles for
CSSEA, its member organizations and the UBA. It is hoped that these profiles will, both collectively and
individually, permit CSSEA member organizations to prioritize health issues, conduct evidence-based
workplace health planning and evaluation, and allocate limited resources in a more useful manner. This
project has also involved the development of two tools that we have used to assess issues related to
workplace health and safety: the employee health survey, and the workplace health systems review. Both
of these tools, reproduced in this report as Appendix A and Appendix B, represent a valuable outcome of
the collaboration. These tools can continue to be used to assess individual and organizational workplace
health and safety, on an ongoing basis.


Fourteen CSSEA member organizations were invited to participate in the project; this report summarizes
the findings of the study. We are confident that the findings from these 14 organizations can be usefully
generalized to all CSSEA member organizations within the province; this study surveyed organizations that
represented key areas of the province -- the Lower Mainland, Vancouver Island, the Southern Interior and
the North. Additionally, we surveyed both community living and general services sectors, and the full
range of job classifications that exist within CSSEA. We might add that within this aggregate portrait of
CSSEA organizations, there are, not surprisingly, some differences across individual organizations, given
the different occupational responsibilities that they have within the community social services sector.



Methodology

During the past year a research team from HBT collected data at the 14 participating organizations. First,
we conducted focus groups with employees and managers in four regions of the province, giving them the
opportunity to describe to us their concerns about health and safety within their workplaces. The results
of these focus groups were transcribed and became the basis for further data collection and for the
creation of both an employee health survey and a workplace health systems review. There were
essentially three kinds of data collected at each of the 14 sites.


a)   Health and Human Resource Indicators – We gathered information at each site regarding
     absenteeism/sick leave, employee turnover, medically-related time loss from both work related
     (WorkSafeBC claims) and non-work related (sick leave, short-term and long-term disability claims)
     causes.




                                                                                                 Page 3
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



b)   Employee Health Survey – We developed a questionnaire (see Appendix A); we received a total of
     1,013 responses from individual employees at the 14 sites. The survey canvassed perceptions of the
     site’s physical environment, its social and psychological environment, individual health-risk
     behaviours, issues related to the chronic diseases of employees and the impact of these diseases on
     productivity.


c)   Workplace Health Systems Review – We developed a focus group instrument (see Appendix B) to
     assess the effectiveness of current workplace health management structure and processes within
     each of the 14 sites, based on responses from a group of employees at each organization. More
     specifically, we considered policies, procedures and practices on health promotion, health and
     safety, management principles, human resources, and support systems.




                                                                                                 Page 4
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



FINDINGS: HEALTH AND HUMAN RESOURCE INDICATORS


Absenteeism/Sick Leave

We learned that most CSSEA organizations could not easily provide annual data for absenteeism for their
organizations. Some organizations were not able to provide these data because of a lack of structured
record-keeping, an inability to access data pooled from a variety of sites, or simply because they did not
have the time to provide us with the data requested. We also note that absenteeism is not tracked on a
CSSEA-wide basis.


Of those organizations that did provide us with data, we found that an annual range of 6 to 12 days per
employee was the norm; these numbers were slightly reduced in 2005. We heard of two explanations for
the reduction: first, increased use of the early intervention program by employees, and second, a
response to changes in the collective agreement. We do not have any data that would allow us to
evaluate these claims.



WorkSafeBC: Work-Related Claims

The injury rate for all CSSEA organizations
in 2003 was 4.3 per 100 full-time
equivalents (or 4.3%). Three-quarters of
these claims were for sprains, strains and
tears, and nearly half of those were due to
over exertion. Overall, 42% of work loss
claims within all CSSEA organizations are
attributable to injuries resulting from client
handling and 19% result from aggression.


There was significant variation within the
14 organizations that we studied, with
some organizations having less than one per
cent time-loss claims, and others having more than 10 per cent time-loss claims, on an annual basis. Most
of the differences observed across organizations appear to be attributable to the kind of work engaged in
by the employees of the organization. Specifically, those service providers with a significant residential
care component -- requiring their employees to undertake client lifting, handling, and personal care -- are
most likely to experience higher rates of time loss claims.




                                                                                                  Page 5
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector




Short-Term Disability: Non-Work Related Claims

Many CSSEA organizations have become involved in a newly created program, the Community Social
Services Early Intervention Program (CSSEIP), administered by the Healthcare Benefit Trust and supported
by the UBA and CSSEA. Most organizations that we studied began referring employees to the program in
2004 and 2005.



Long-Term Disability: Non-Work Related Claims

There were too few cases of long-term disability at each site to permit statistically meaningful analysis at
the site level (reporting on small numbers of cases also has the potential to compromise individual
confidentiality). But we can report that the pattern of long-term disability within CSSEA organization
differs quite significantly from the healthcare sector. In healthcare, most long-term disability flows from
musculoskeletal injury; in community social services work, most long-term disability flows from
depression, anxiety, and stress disorders.



Employee Turnover

Employee turnover is considered a key human resource indicator for employee satisfaction and
engagement. Turnover is very costly to an organization -- estimates range from the equivalent of one
year’s salary for turnover of front-line staff to two years salary for professional staff and management.
Turnover of senior management is even more costly, given the time and costs of replacement and the
inevitable disruptions for the organization. Turnover rates for 2003 and 2004 were known for 8 of the 14
organizations that participated in the project and the rates differed considerably between regular (full-
time and part-time) and casual employees. In the eight CSSEA organizations for which we had data,
annual turnover of regular staff ranged from 4% to 27% and annual turnover for casual employees ranged
from 16% to 133%. The differences in turnover between regular and casual employees are to be
anticipated, given the job security and benefits attached to the status of a regular employee, whether
full-time or part-time.


Data from 114 CSSEA member agencies indicates an average turnover rate of 11.9% for regular (full-time
and part-time) employees and 39.2% for casual employees.




                                                                                                   Page 6
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



FINDINGS: EMPLOYEE HEALTH SURVEY


Introduction

More than 1,000 (1,013) employees within the 14 organizations responded to the employee health survey;
the rates of response varied by site from approximately 40 per cent to 70 per cent. The topics canvassed
within the survey included perceptions about the physical work environment, the psychological and social
(psychosocial) work environment, personal health status and health risk behaviour, the relationship
between personal health and the individual’s ability to contribute within the workplace, and, finally, basic
demographic information regarding age, gender, education, marital status, family commitments, and the
nature of the work engaged in.



Demographics

In Table 1 we present basic demographic information for the 1,013 employees who responded to our
survey. The key demographic variables of age, gender, and educational attainment point to a sample that
has three times as many females as males, an average of about 41 years of age, slightly more likely to be
single, divorced or separate than married, and relatively well-educated, with 80 per cent of employees
having either a college diploma or a university degree.


As a caveat, we cannot be sure that the characteristics of the approximately 50 per cent of employees
who chose not to respond to our survey are similar to the characteristics of those who did respond.
Additionally, the relative contributions of casual, full-time and part-time employees to our survey tended
to vary by site, though full-time and part-time employees were most likely to be our respondents at our 14
sites.




                                                                                                   Page 7
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 8
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector




Physical Work Environment

Perceptions of the safety of the physical environment within the 14 sites varied amongst employees and
across sites. Table 2 summarizes employees’ perceptions of various risk factors in the physical
environment of their workplace. We have included only those risk factors where the percentage of those
expressing concern (agree or strongly agree with the statement that there is an issue of safety or well-
being) was greater than 25 per cent of all respondents. There was only one issue on which a majority of
respondents agreed that there is a significant hazard in the physical environment: the risk of physical
strain; a significant minority identified working with physically or verbally abusive clients or family
members, infectious disease, and working alone as critical risk factors.




                                                                                               Page 9
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector




The Psychological and Social Work Environment

The questions in this section of the survey are designed to identify workplace stressors that can be
attributed to perceived imbalances between workplace demands and employee control, between
employee effort and reward or recognition, or between work and home life. Questions also focus on the
degree of fit between employee knowledge, skills and values, on the one hand, and job demands and
workplace culture, on the other.


In the case of the 14 sites, when we turn to the subject of the psychological and social nature of the work
environment, we find generally favourable responses. Tables 3 and 4 summarize employees’ perceptions
of various risk factors in the psychosocial environment. Table 3 shows the factors that indicate strong
satisfaction with the working environment.




                                                                                                 Page 10
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector




Two areas of concern raised by employees focused on “nerves” and stress flowing from time pressures and
feelings of mental fatigue at work; a majority of respondents agreed that there is stress from mental
fatigue at work and, in the view of a significant minority, there is stress from time pressures.




                                                                                             Page 11
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector




The Stress Satisfaction Offset Score

The psychosocial environment is known to influence worker health and well-being. We used the Stress
Satisfaction Offset Score (SSOS), an index developed by Dr. Martin Shain (Shain M, 2001) to assess the
relationship between job stress (measured by time pressure and mental fatigue) and job satisfaction
(measured by reward and involvement in the work). Based on their responses to four questions -- two
determining job satisfaction and two determining job stress -- each employee is awarded a score between
-2 and +2. A negative score means that there is both job stress and a lack of job satisfaction, a positive
score means that there is job satisfaction with little or manageable job stress, and a score of zero means
stress and satisfaction cancel each other out: there is either job satisfaction with job stress, or little job
satisfaction alongside little job stress.


Figure 1 below shows the breakdown of SSOS for respondents from our 14 sites. This chart demonstrates
that there is much evidence of individual job satisfaction, but that this job satisfaction is, for a majority
of employees (approximately 60 per cent), offset by job stress. As Figure 1 indicates, less than 50 per
cent of employees are experiencing job satisfaction without job stress (score of +1 and +2).




                                                                                                   Page 12
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector




The Business Health Culture Index

The Business Health Culture Index (BHCI) is the average SSOS for the entire workforce. It is a collective
measure of the relationship between job satisfaction and job stress for the 14 sites that we studied. A
negative score means that the workplace is characterized by more stress than satisfaction and is working
against the achievement of the organization’s objectives. A positive score means the workplace is
characterized by more satisfaction than stress and works for the achievement of the organization’s
objectives. The collective BHCI for the 14 organizations is 0, suggesting that the positive psychosocial
attributes that create job satisfaction within these sites are offset by job stressors, typically experienced
as time pressure and mental fatigue.



Health Status and Personal Health Risks

When asked about their personal health and well-being, a majority of respondents indicated that they
have a very positive outlook: 85% of respondents thought that their overall health was excellent, very
good or good. Similarly, when asked about their mental health, 82% of respondents selected a rating of
either excellent, very good or good. The full breakdown of self-rated health status for all respondents is
shown in Table 5.




                                                                                                   Page 13
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



Although a majority of employees has a very positive assessment of their physical health status, a majority
of employees also indicated that there are three areas of their personal lives in which they see elements
of risk: lack of regular exercise, poor diet/nutrition, and excessive stress. Further, these respondents
indicated that they would be interested in participating if their workplace offered health promotion
programs designed to reduce personal health risks in these areas.


Table 6 indicates which health risks are seen as most common for those who responded to our survey. The
table also provides a “readiness to change” score, making the point that both the identification of a risk
and a willingness to change that risk are crucial for the success of any program or initiative. Any score of
more than 3.5 is indicative of a substantial readiness to change: a score of 3 is a positive response to the
assertion, “I intend to change within the next month”, and a score of 4 is a positive response to the
assertion, “I am trying to change now”.




In the case of those employees who responded to our survey, lack of regular exercise, poor diet, and
excessive stress are the most common risk factors in the workforce, and respondents have also indicated
that they are very interested in changing these risk factors. With stress, exercise, and diet, we can see
both a prevalence of self-perceived risk, and a willingness to change that risk. With tobacco, alcohol, and
illicit drug use, however, we see an identification of risk in a minority of employees, but a lack of
readiness to change those risks.




                                                                                                  Page 14
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



A “readiness to change” score that is between 3 and 4 indicates that the respondents answered either (a)
they are intending to change this specific behaviour within the next month (3), or (b) they are trying to
change this specific behaviour now (4). A score of 5 represents a person who has made a change in the
specific behaviour and “wants to stay that way”. As Table 6 indicates, most employees who identify
exercise, diet, stress, weight, and sleep as personal risk factors, are either planning to change in the next
month, or trying to change now; this represents a significant “readiness to change”. As Table 6 also
indicates, there is much less employee interest in changing tobacco consumption, excessive alcohol
intake, and illicit drug use.


The average number of risk factors reported by our respondents was 3. Figure 2 demonstrates that about
45% of respondents can be considered at low risk (0-2 risk factors), about 30% can be considered medium
risk (3-4 risk factors), and about 25% high-risk respondents (5 or more risk factors). There was a
significant relationship between the average number of risk factors and gender: women were statistically
more likely to report a greater number of risk factors than men. We found no relationship between
individual age and the average number of risk factors.




                                                                                                   Page 15
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector




The Patient Health Questionnaire: Screening for Depression

We included the Patient Health Questionnaire (PHQ-9) in the survey to screen respondents for the
presence and severity of depressive symptoms. Table 7 shows the nine symptoms of depression and the
percentage of respondents who indicated that they have experienced the following symptoms either more
than half of the days, or nearly every day within the past two weeks.




                                                                                           Page 16
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



When we asked employees to relate these symptoms to their ability to function effectively, 43 per cent of
employees indicated that these problems have been making their lives at least somewhat more difficult,
hindering their ability to do their work, to take care of things at home, and to get along with other
people. Seven per cent of employees indicated that these problems had made their lives either “very
difficult” or “extremely difficult” and perhaps most significantly, nearly 6 per cent of respondents (or 60
people) indicated that they were considering hurting themselves several days or nearly every day.


As the number and severity of symptoms increase, the PHQ-9 score and the likelihood of a diagnosis of
major depression also increase. Those whose PHQ-9 score is 5 or greater are considered to have screened
positive for depression. A positive screening test for depression does not mean that the employee has
depression -- the diagnosis can only be confirmed following an assessment by a medical or mental health
professional, and there are likely to be many false positives within this grouping (individuals who screen
positive, but are not actually clinically depressed). However, those with a PHQ-9 score of 10 or higher are
highly likely to be experiencing a major depressive episode.


Table 8 shows the PHQ-9 scores for all respondents. You can see that 37% of respondents had a PHQ-9
score greater than 5, a positive screening test. Twelve per cent of respondents -- or 120 people -- had a
PHQ-9 score of 10 or higher, meaning it is highly likely that these employees are currently experiencing a
depressive episode. Although these employees are at work, their work performance may be impaired by
depressive symptoms.




                                                                                                 Page 17
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector




Chronic Health Conditions and Productivity

In Figure 3 we see that 63 per cent of respondents are affected by at least one chronic health condition --
allergies; depression, anxiety and emotional disorders; arthritis; back and neck disorders; migraine or
chronic headaches; stomach or bowel disorder; asthma; heart or circulatory disorder; diabetes. Almost 40
per cent of respondents are affected by at least two or more of these chronic health conditions, and 20
per cent have three or more.




The Stanford Presenteeism Scale

We included the Stanford Presenteeism Scale (SPS) to gather information on the impact of chronic
conditions on employee productivity. Productivity losses in the workplace are a combination of
absenteeism and presenteeism (the latter more costly to employee productivity). Presenteeism is defined
as the decrease in job performance that is associated with remaining at work while impaired by health
problems -- the employee is physically present, but there is a significant limitation imposed on
productivity by chronic conditions.




                                                                                                 Page 18
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



Table 9 shows the relationships between the most common chronic conditions and employee perceptions
of productivity losses, based on responses to the SPS. Presenteeism is shown in the table as work
impairment: the extent to which a health condition reduces a person’s ability to do their work (reduced
energy, ability to focus, ability to work with colleagues). Employee estimates of reduced productivity
typically increase as the number of chronic conditions increase. Allergies are, across our 14 organizations,
the most common condition and (subject to seasonal variation) are responsible for decreased work
performance. You will note that the degree of perceived impairment does not appear to differ
significantly across conditions, although the conditions themselves present the individual with often quite
distinct disabilities.




                                                                                                  Page 19
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



FINDINGS: WORKPLACE HEALTH SYSTEMS REVIEW


Structure of the Systems Review

A group of participants -- ideally representatives of all employees -- was asked at each of our 14 sites to
respond to a series of questions that we developed, delving into a number of key components of the
workplace health management system. These broad components and some specific elements are used as
indicators of the level of support that the organization provides for achieving employee and workplace
health. The systems review concentrates on the quality of organizational policy, procedures, structure
and processes necessary to effectively and efficiently plan, execute, and continuously improve workplace
health strategies. Systems review highlights are shown in Table 10.




                                                                                                 Page 20
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector




Limitations and Caveats

The systems review was intended to provide an assessment of the quality of key workplace structures,
processes and programs needed to support employee and workplace health within individual study
organizations. The results are based solely on the perceptions and expressed opinions of participants at
the focus group described above.


Focus group findings do not match the rigor of a formal workplace health audit, where the accuracy of
opinions is verified by objective measures and through direct on-site observation by a review team.
Additionally, the quality of the information extracted from our process is highly dependent upon the
organization’s ability to attract an informed and representative group of participants (management, union
personnel, and Joint Occupational Health and Safety Committee members).



Results

Each of the 14 organizations participating in the study was assigned a score for each component of their
health system. The average overall score for each component was then calculated and is shown as “0” in
the following graphic. The relative strengths or weaknesses of each component of an organization’s
systems were shown as a percentage above average or a percentage below average respectively. An
example of the chart given to each organization is set out below.




                                                                                               Page 21
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



Figure 4 shows that this organization has scored above the average for the study group in the realms of
wellness or workplace health promotion, support systems, and safety and health programs and policies.
The organization has an established work/life balance approach and some supportive human resources
policies in place. But, in the realm of management principles, it does not have a clearly established
occupational health and safety plan, directed by its occupational health and safety committee, and
coupled with a program of ongoing evaluation. Additionally, with respect to human resources policies and
programs, there is room for improvement in employee recognition and employee evaluation, and where
possible, there could be more support in the area of employee and family assistance.


Figure 5 compares the total scores of the 14 organizations participating in this study. As can be seen,
there is significant variation across the 14 sites. The most common limitations across all 14 sites were a
lack of ongoing evaluation of the occupational health and safety plan, improvements in employee
evaluation and recognition, and the development of a program of workplace health promotion.




                                                                                                Page 22
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



DISCUSSION OF FINDINGS

A.   Health and Human Resource Indicators


     CSSEA WorkSafeBC compensation claims have been calculated at 4.3 per cent annually; this figure is
     comparable to injury rates in healthcare, is substantially above rates seen in education, but
     approximately half the injury rates in construction, heavy construction, and warehousing
     (WorkSafeBC, Annual Report, Statistics, 2003). The average for all industries in 2003 was
     approximately 3%.


     We also learned of the significance of depression, anxiety, and stress disorders from looking at all of
     the long-term disability cases within the 14 organizations. More than half of the 40 disability claims
     within the study group were related to depression, anxiety and stress disorders. This portrait is
     markedly different from that of long-term disability in health care employees, where musculoskeletal
     injury is the leading cause of long-term disability.


     Absenteeism rates and annual turnover rates were not provided easily by most of the 14
     organizations in this study, and were not provided at all by six of the 14 organizations; this is a
     significant limitation for the development of evidence-based planning with respect to workplace
     health.


     We learned that it was difficult to compare one CSSEA site to another with respect to WorkSafeBC
     claims, absenteeism, turnover, disability claims and other demographic variables. Routine collection
     of this data could be of significant benefit for planning improvements to workplace health, both at
     the level of CSSEA, and within specific organizations.


B.   Employee Health Survey


     We learned that although an overwhelming majority of respondents to our survey viewed their
     physical health in quite positive terms, a majority also indicated that they do have concerns about at
     least three health risks -- lack of regular exercise, diet and nutrition, and excessive stress. A
     majority of employees would also like to change these behaviours, so as to reduce their risks. In
     fact, many of the common chronic conditions identified by our survey have been called “diseases of
     choice” because of the importance of personal health risk behaviour as a primary cause. On a
     positive note, there is available evidence that a variety of programs for change can be implemented -
     - programs that are cost-effective and can reduce health risks, improve health status, reduce
     treatment costs and enhance productivity (Pelletier KR, 2005).




                                                                                                   Page 23
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



     Depression emerged from the 14 organizations surveyed as an issue of some concern, though we
     would not want to suggest that it is a significant problem for all organizations. Of these
     organizations surveyed, we found 12 per cent of respondents with scores of 10 or more on the PHQ-9,
     a result that suggests that a significant minority of employees are currently suffering from
     depression. We do know that the causes of depression are both genetic and environmental, and it
     appears to be a problem that is growing within the global population. In fact, depression is currently
     the leading cause of work disability in women. Unlike more conventional work-related illnesses or
     injuries, depression does not conform to the accident model where a single toxic exposure leads to a
     predictable adverse health outcome. Like many chronic conditions, depression is a complex disorder
     and medical review articles identify multiple interacting risk factors: traumatic experiences, genetic
     predisposition, individual temperament, interpersonal relations and stressful life/work events
     (Kendler et al., 2002).


     There is a growing body of evidence implicating workplace stress as an important determinant of
     psychological strain and depression in predisposed individuals. Research has identified seven
     categories of common workplace stressors that need to be considered along with non-occupational
     determinants of depression: workload and work pace, lack of role clarity or work-family conflict, job
     insecurity, work scheduling, interpersonal relationships, job autonomy, and workplace culture
     (Sauter SL, Murphy LR, Hurrell JJ., 1990). Among Canadian workers, individuals with low decision
     authority, low skill use, high job insecurity, high demands, and low social support appear to be more
     likely to experience major depression (Wang JL, Patten SB., 2001).


     In our focus groups with CSSEA organizations in various areas of the province, we consistently heard
     from employees that budget cutbacks and wage reductions were imposing workplace stress. We do
     not have any data that would allow us to evaluate these claims.


C.   Workplace Health Systems Review


     The relative importance of each component of the systems review -- management principles, support
     systems, health and safety, and so on -- can only be assessed accurately if an integrated workplace
     health management approach is adopted. This means coordinating the assessment and management
     of OH&S; WorkSafeBC, short-term disability and long-term disability claims; health-related
     absenteeism; health promotion; Employee Family Assistance Programs; benefits and human resource
     development.


     The review of each organization’s support systems included an assessment of communication and
     information management. Information systems might be usefully expanded to gather health data
     from multiple sources and to expand the focus beyond a collection of so-called “trailing” indicators
     such as incident or claims data. The tracking of “leading” indicators (evaluation of health risk
     factors and evaluation of health promotion activities) could help provide a more comprehensive
     assessment of employee and workplace health risks that could be used for planning and resource
     allocation. An improved data collection and reporting system would assist in this process.



                                                                                                 Page 24
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



CONCLUSIONS

CSSEA organizations have many positive attributes. Respondents to our survey expressed satisfaction
about the work that they engage in, they trust the organization, and they believe that their supervisors
treat them fairly. But there is also some room for improvement in the psychosocial work environment;
about half of respondents did not agree with the statement that communication within the organization is
good, and they similarly do not feel that they are adequately rewarded for the work that they do. When
asked about potential problems in the physical environment, a majority identified one factor: the risk of
physical strain; a significant minority identified working with physically and verbally abusive clients and
family members, the risk of infectious disease and working alone.


As noted above, most employees report that the organization is fair and can be trusted. Our calculation
of the stress satisfaction offset score across all 14 organizations indicated that job satisfaction is offset by
job stress, associated with time pressure and mental fatigue from work demands. The Business Health
Culture Index score was 0, indicating that the 14 organizations, taken collectively, have a culture of some
job satisfaction, but a job satisfaction that is cancelled out by job stress. We must note, additionally,
that there was variation across organizations with respect to the Business Health Culture Index; some of
the study organizations had positive scores (+1), and a few had negative scores (-1).


More than 80 per cent of our respondents assessed their overall physical health as either excellent, very
good or good; they are similarly positive about their mental health, with a little more than 80 per cent
committing to the same description. A majority of respondents described personal health risks associated
with a lack of regular exercise, poor diet and nutrition, and excessive stress. On a positive note,
employees also expressed an interest in taking action to reduce this and other risks.


Not surprisingly, given that 80 per cent of respondents indicated that their mental health is excellent,
very good or good, only 12 per cent screened positive for depression at a level suggestive of a significant
difficulty. But there is also some cause for concern in this realm; 37 per cent of respondent did have a
positive screen for depression on the PHQ 9, and 24 per cent of respondents’ self-identified depression as
a chronic health problem. We also found that chronic health conditions -- allergies, depression and
chronic pain disorders -- are having a negative impact on productivity within the 14 sites.


The Workplace Health Systems Review typically revealed room for improvement within most organizations
in the ongoing evaluation of a clearly articulated occupational health and safety plan, and in the
development of more supportive human resources policies and programs. Our review also indicated a
general need to focus on employee recognition and employee and family assistance.


In summary, we hope that this report will provide a beginning of evidence upon which to build and to
evaluate a more comprehensive and integrated system of workplace health and safety, within the
community social services sector.




                                                                                                     Page 25
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



REFERENCES

Andrade L, Caraveo-Anduage JJ, Berglund P, et al. The epidemiology of major depressive episodes: results
from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. Int J Methods Psychiatr Res.
2003;12(1):3-21.

Burton WN, Chen C, Conti DJ, et al. The Association of Health Risks With On-the-Job Productivity. J Occup
Environ Med. 2005; 47(8):769-777.

Collins JJ, Baase CM, Sharda CE, et al. The Assessment of Chronic Health Conditions on Work Performance,
Absence, and Total Economic Impact for Employers. J Occup Environ Med. 2005; 47(6):547-557.

Goetzel RZ, Ozminkowski RJ, Baase CM, Bilotti GM. Estimating the Return-on-Investment From Changes in
Employee Health Risks on the Dow Chemical Company’s Health Care Costs. J Occup Environ Med. 2005;
47(8):759-768.

Goldfarb N, Weston C, Hartman CW, et al. Impact of Appropriate Pharmaceutical Therapy for Chronic
Conditions on Direct Medical Costs and Workplace Productivity: A Review of the Literature. Disease
Management. 2004; 7(1):61-75.

Judd LL, Akiskal HS, Zeller PJ, et al. Psychosocial Disability During the Long-term Course of Unipolar Major
Depressive Disorder. Arch Gen Psychiatry. 2000; 57:375-380.

Kendler KS, Gardner CO, Prescott CA. Towards a Comprehensive Developmental Model for Major
Depression in Women. Amer J Psychiatry. 2002;159 (7):1133-45.

Ormel J, Von Korff M, Van Den Brink W, et al. Depression, Anxiety and Social Disability Show Synchrony of
Change in Primary Care Patients. Amer J Public Health. 1993; 83(3):385-390.

Pelletier KR. A Review and Analysis of the Clinical and Cost-Effectiveness Studies of Comprehensive Health
Promotion and Disease Management Programs at the Worksite: Update VI 2000-2004. J Occup Environ Med.
2005; 47(10):1051-1058.

Sauter SL, Murphy LR, Hurrell JJ. Prevention of work-related psychological disorders: A national strategy
proposed by the National Institute of Occupational Safety and Health (NIOSH). American Psychologist.
1990; 45:1146-1158.

Shain M. Investing in Comprehensive Workplace Health Promotion: Stress Satisfaction and Health. Centre
for Addiction and Mental Health. 2001.

Stewart WF, Ricci JA, et al. Lost Productive Time and Cost Due to Common Pain Conditions in the US
Workforce. JAMA. 2003; 290(18):2443-2454.

Wang JL, Patten SB. Perceived work stress and major depression in the Canadian employed population 20-
49 years old. Journal of Occupational Health Psychology. 2001; 6:283-289.




                                                                                                  Page 26
    Final Report
    Employee and Workplace Health: British Columbia Community Social Services Sector



APPENDIX A: COMMUNITY SOCIAL SERVICES EMPLOYEE HEALTH SURVEY
2005

This is an ANONYMOUS questionnaire and all information provided will be kept in the strictest confidence!
Please do not put your name on this survey.


Your participation is VOLUNTARY but your input is very important because it will give us valuable
information about your health needs. Your responses will help shape future health policy and programs in
the Community Social Services sector.



About This Survey

This survey is endorsed by the:
•      Community and Social Services Employers’ Association and the Union Bargaining Association.


It was created with the assistance of:
•      Healthcare Benefit Trust (HBT) and WorkSafeBC.


We know that your work can affect your health and that your health can affect your work. However, until
now we have had no means of systematically gathering information about individual and organizational
health and safety risk factors. With your help we will be able to construct a health profile for the
Community Social Services sector and for your organization. This profile will guide the development of
future health policy and programs that should address your needs and improve your health and the health
of your organization.




                                                                                                Page 27
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector




Instructions

This questionnaire will take about 30 minutes to complete. You will be asked questions about where you
work and the type of work you do, the physical and social aspects of your workplace, and also about your
own health. Please read each question carefully and answer as accurately as you can. Remember, your
answers are completely anonymous and confidential.


Please indicate your response to
questions by completely filling in
the appropriate circle like this:


If possible, please use a pencil to fill in your survey so that you can easily change your responses.


The survey results will be used to identify key health issues and to shape health policy and program
development for both the Community Social Services sector and your organization.


An HBT representative will be on site to respond to any questions or concerns that you may have during or
after completing this survey.


Thank you for participating!




                                                                                                    Page 28
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 29
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 30
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 31
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 32
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 33
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector



APPENDIX B: EMPLOYEE HEALTH IN COMMUNITY SOCIAL SERVICES (EHCSS)
WORKPLACE HEALTH SYSTEMS REVIEW


About the EHCSS Project

The project is a jointly sponsored initiative with Community Social Services Employers’ Association
(CSSEA), WorkSafeBC, the Community Social Services Union Bargaining Association (CSSUBA), and the
Healthcare Benefit Trust (HBT). Its purpose is to identify health risks within a representative sample of
CSSEA member organizations and to develop system-wide as well as organization-based strategies for
implementing risk controls. This phase of the project will focus on conducting a health risk assessment
that will include data gathering, analysis and a report of findings. Data gathering will involve a Workplace
Health Systems Review, an Employee Health Survey and a review of WCB claims, absenteeism data and
incident reports.



What is the Workplace Health Systems Review?

The Workplace Health Systems Review is a systematic assessment of an organization’s management
system, operational practices and performance standards targeted at reducing health risks and supporting
employee and workplace health best practice. The Review is similar to an audit in that it includes general
performance indices but is less detailed and rigorous. Audits require the collection and management of
large volumes of information that is beyond the scope of this project. The indices are derived from
validated health and safety audit instruments and industry best practice (see References).



Benefits of Conducting a Workplace Health Systems Review

The Systems Review is an objective process that is based on industry best practice. It establishes
performance benchmarks that can guide decision making and organizational practice or systems change
over time. This review enables organizations to:
Conduct a gap analysis of their management system
Enhance operational problem solving and decision making re employee and workplace health
Benchmark an organization’s workplace health and safety performance
Enhance an organization’s ability to meet their Due Diligence responsibilities
Improve their accreditation score (if organization is accredited)
Raise organizational/employer awareness of workplace health and safety
Support continuous improvement




                                                                                                  Page 34
    Final Report
    Employee and Workplace Health: British Columbia Community Social Services Sector




How the Systems Review is Organized

The Systems Review has been organized into the following five sections:
Management Principles
Systems and Procedures
Health and Safety Programs
Supportive Human Resource Policy & Procedures and
Workplace Health Promotion Programs



How the Systems Review is Conducted

The Systems Review will be conducted by third party assessors in consultation with a team of union,
management and Occupational Safety and Health (OSH) representatives or site team. The review will take
upwards of 2 to 3 hours to complete. The assessors will meet with the site team and, together, will
determine a fair and representative score for each section. A copy of the review tool will be given to
each member of the team.



How the Systems Review is Scored

The System Reviews is divided into two scoring columns: a Factor Score column and a Performance Score
column. A factor score is applies is applied if the organization can demonstrate it meets a number of
performance criteria in relation to the specified factor.


Factor scores are applied:
•      On an all-or-nothing basis and appear in brackets beside each factor or performance statement e.g.
       (2)
•      Or as a range score (0-6). A range score is rated as follows: 0 = factor does not exist, 3 = only some
       aspects of the factor exist; and 6 = all aspects of the factor exist


Performance scores are applied on a scale from 0 - 2. A score of 0 means the criteria is not present, 1
means that it is present to some extent, and a score of 2 is applied if the criteria is definitely present.
The scores are then summed for each section.




                                                                                                   Page 35
    Final Report
    Employee and Workplace Health: British Columbia Community Social Services Sector



Scoring may be impacted by:
•      Differences in work performed at sites or service areas within one organization
•      Complexity or size of organization
•      Physical conditions at the work site


The scores assigned will be determined through a consultative process; when inconsistencies arise,
additional notes and observations will be made and appropriate recommendations offered.


Should any part of this Review instrument be determined “not applicable” to the organization, the value
of the “not applicable” part will be subtracted from the points possible. The adjusted score will then be
the score possible, and all calculations will be based on the reduced score possible. Note: whenever “not
applicable” is indicated, it must be adequately justified.



Reporting of Results

Only those sites participating in the EHCSS project and who have completed the Systems Review will
receive a report of their Review results. To ensure confidentiality, at no time will an organization or site,
other than the participating site, receive a copy of another site’s Systems Review results.


The Systems Review results from all participating sites will be compiled and reported in aggregate form.
No site names will be used. A final report summarizing the results of the risk assessment phase will be
sent to all participating sites.




                                                                                                   Page 36
 Final Report
 Employee and Workplace Health: British Columbia Community Social Services Sector




Glossary of Terms

Program: is an identified group of interrelated responsibilities and activities designed and implemented to
accomplish specified goals.


Workplace Health: Encompasses programs and services that support the physical, mental and social
wellbeing of an individual in relation to his or her working environment.


Occupational Safety & Health (OSH) Program: an OSH program is designed to control workplace hazards,
reduce risk and minimize work-related injuries and disease. An OSH program is required to meet
provincial regulations as established by the Workers’ Compensation Board. Under the regulations an
employer initiates a formal OSH program if the workforce has twenty or more workers; where the
workforce is less than twenty workers, the employer is require to initiate a less formal program based on
regular monthly meetings with employees for discussion of health and safety matters. The employer is
required to maintain a record of the meetings and matters discussed.


Disability Management Program: Is a proactive workplace-centered process of coordinating the activities
of labour, management, insurance carriers, health care providers and vocational rehabilitation
professionals for the purpose of minimizing the impact of injury, disability or disease on a worker’s
capacity to successfully perform his or her job.


Community Social Service Early Intervention Program (CSSEIP): This program is designed to facilitate
pro-active, appropriate and customized return to work programs for employees with occupational and
non-occupational injuries and illness.


Musculoskeletal Injury Prevention Program (MSIP) or Ergonomic Program: this program includes all
measures taken by an organization to mitigate, reduce or eliminate risks that result in an injury (sprains
and strains) to an employee due to lifting or transferring clients or objects, repetitive activities or static
or awkward postures.


Aggressive Behaviour Prevention and Management Program: this program refers to all measures taken
by an organization to mitigate or reduce risks that result in physical or mental harm from exposure to
violent or aggressive physical or verbal incidents in the working environment perpetuated by a client,
family member or general public.


Employee Assistance Program: this program includes third party counseling and support services that is
confidential in nature, and may or may not include family members. These services provide support to
employees who are suffering from mental distress or an addictive disorder.


Wellness Program: this program covers a range of activities that support the physical, mental, and social
health of the employee.




                                                                                                   Page 37
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 38
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 39
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 40
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 41
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 42
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 43
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 44
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 45
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 46
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 47
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 48
Final Report
Employee and Workplace Health: British Columbia Community Social Services Sector




                                                                                   Page 49

				
DOCUMENT INFO
Description: Methodology Employee Turnover and Workplace Environment document sample