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Worker Productivity: Ways Worker Productivity: Ways

to Measure It and to Measure It and

Demonstrate ValueDemonstrate Value

Jodi M. Jacobson, PhDJodi M. Jacobson, PhD

University of MarylandUniversity of Maryland

David Sharar, PhDDavid Sharar, PhD

Chestnut Global PartnersChestnut Global Partners

Presentation for the 23Presentation for the 23rdrd Employee Assistance Society of Employee Assistance Society of North America InstituteNorth America Institute

April 28, 2011, Las Vegas, NVApril 28, 2011, Las Vegas, NV

What is Productivity?What is Productivity?

Productivity Productivity –– amount of output per unit of amount of output per unit of

inputinput

How can we measure this?How can we measure this?

�� # hours worked to produce a good# hours worked to produce a good

�� Revenue generated by an employee or salaryRevenue generated by an employee or salary

�� Being present at workBeing present at work

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Alternate Ways to Consider Alternate Ways to Consider ProductivityProductivity

Cannot remove the human aspect from Cannot remove the human aspect from

work and productivitywork and productivity

Need a mix of quantitative and qualitative Need a mix of quantitative and qualitative measures to accurately measuremeasures to accurately measure

Begin with what you have an add selfBegin with what you have an add self--

report data to measure lost work timereport data to measure lost work time

Lost Work Time = Absenteeism + PresenteeismLost Work Time = Absenteeism + Presenteeism

Importance of Indirect CostsImportance of Indirect Costs

““You cannot manage what you canYou cannot manage what you can’’t measuret measure”” (Dr. Ron Goetzel)(Dr. Ron Goetzel)

Mortality: employee replacement, effect on family & Mortality: employee replacement, effect on family & friends, value of lost future incomefriends, value of lost future income

Morbidity: lost wages (paid sickMorbidity: lost wages (paid sick--time, unpaid sicktime, unpaid sick--time, time, payroll & benefit costs for absent employee), loss of payroll & benefit costs for absent employee), loss of vacation & personal leave, lost leisure time, disability, vacation & personal leave, lost leisure time, disability, idle employer assetsidle employer assets

Reduced productivity: returnReduced productivity: return--toto--work productivity, health work productivity, health capital investment, oncapital investment, on--thethe--job training, newjob training, new--hiring hiring administration & training, teamwork & communication, administration & training, teamwork & communication, institutional effect among coworkers, effect on family institutional effect among coworkers, effect on family membersmembers

3

0

4

8

12

2 3 4 5 or more

# of chronic conditions

Av

e.

los

t d

ay

s/y

ea

r Absence Presenteeism

Anxiety Dx

Obesity

Hypertension

Arthritis

High Cholesterol

Sleeping Problems

Other Chronic Pain

Fatigue

Depression

Back/Neck Pain

MedicalDrugAbsencePresenteeism

Source: Loeppke, et al.; JOEM. July 2007

Top 10 medical conditions by annual medical, drug, and productivity over cost per 1000 FTEs for all companies

$200,000 $400,000 $600,000

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Introduction to Health and Introduction to Health and Productivity Management (HPM)Productivity Management (HPM)

Health of a workforce is linked to productivity & health of Health of a workforce is linked to productivity & health of the economythe economy

Human capital should be invested, it is not a cost to be Human capital should be invested, it is not a cost to be managedmanaged

Human capital is 80% of the entire worldHuman capital is 80% of the entire world’’s capitals capital

“The integrated management of health & injury risks, chronic illness & disability to reduce employees total health-related

costs including medical expenditures, unnecessary absence from work & lost performance from work”

(Institute for Health and Productivity Management)

Summex, L., AJHP, 2005, vol. 19(4), 1-8

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Desired OutcomesDesired Outcomes

Primary OutcomesPrimary Outcomes

�� Reduce medical & Reduce medical &

pharmacy costspharmacy costs

�� Reduce healthReduce health--related related lost productivitylost productivity

�� Improve employee Improve employee

satisfactionsatisfaction

�� Reduce sick days and Reduce sick days and disability absencedisability absence

�� Reduce presenteeismReduce presenteeism

Secondary OutcomesSecondary Outcomes

�� Reduce healthReduce health--related related

lost productivitylost productivity

�� Improve employee Improve employee satisfactionsatisfaction

�� Reduce medical or Reduce medical or

pharmacy costspharmacy costs

�� Reduce sick days or Reduce sick days or disability absencedisability absence

�� Reduce presenteeismReduce presenteeism

IBI Survey of 450 employers (2010)

Introduction to Standardized Introduction to Standardized MeasuresMeasures

Need to assess your program and match Need to assess your program and match

outcomes with the needs of the employeroutcomes with the needs of the employer

One size does not fit all for EAPs and their One size does not fit all for EAPs and their customerscustomers

“the voice of the purchaser is more important than ever. It is essential that

purchasers, at the very minimum, understand the root causes of problems

involving health and productivity”(Pompe, 2011, JWBH, p. 15)

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Things to Consider Before Getting Things to Consider Before Getting StartedStarted……

TrainingTraining�� Need buyNeed buy--in from counselors and employerin from counselors and employer

TimingTiming�� Need a preNeed a pre-- and postand post--test score to measure changetest score to measure change�� Data needs to be collected consistently and Data needs to be collected consistently and

accuratelyaccurately

ProceduresProcedures�� How will you embed the questions into the EAP How will you embed the questions into the EAP

intake, assessment, and/or followintake, assessment, and/or follow--up?up?

Possible MeasuresPossible Measures(not an exhaustive list)(not an exhaustive list)

Blueprint for HealthBlueprint for Health

Endicott Work and Productivity ScaleEndicott Work and Productivity Scale

Gallop Employee Engagement Gallop Employee Engagement Health and Labour QuestionnaireHealth and Labour Questionnaire

Health and Productivity QuestionnaireHealth and Productivity Questionnaire

Stanford Presenteeism ScaleStanford Presenteeism Scale

Work Impairment ScaleWork Impairment ScaleWork Limitations ScaleWork Limitations Scale

Workplace Outcomes SuiteWorkplace Outcomes Suite

Work Productivity and Activity Impairment QuestionnaireWork Productivity and Activity Impairment Questionnaire

Worker Productivity IndexWorker Productivity Index

Work Productivity Short IndexWork Productivity Short Index

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Application to EAPsApplication to EAPs

Rationale for EAPs to Be InvolvedRationale for EAPs to Be Involved

1.1. Effectiveness in EAP should be defined as Effectiveness in EAP should be defined as improving health and productivityimproving health and productivity

2.2. Provide documentation regarding productivity Provide documentation regarding productivity payback payback specific to your programspecific to your program

3.3. Use empirical data to Use empirical data to differentiate your programdifferentiate your program

4.4. The value proposition is moving away from just The value proposition is moving away from just counting utilization to counting utilization to measuring resultsmeasuring results

5.5. Support for Support for ‘‘genericgeneric’’ EAP is at risk: EAP is at risk: purchasers purchasers prefer value to be quantified and data to be prefer value to be quantified and data to be crediblecredible

6.6. We are not paid in proportion to our effectiveness We are not paid in proportion to our effectiveness and this wonand this won’’t change without t change without embracing embracing outcomes.outcomes.

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What Questions Can Be What Questions Can Be Answered?Answered?

What is the relationship between your EAP What is the relationship between your EAP intervention and work effectiveness?intervention and work effectiveness?

How strong is the association between How strong is the association between your EAP and reduced absenteeism / your EAP and reduced absenteeism / presenteeism?presenteeism?

How can you reliably monetize How can you reliably monetize absenteeism to produce a cost benefit?absenteeism to produce a cost benefit?

How can your EAP provide your customer How can your EAP provide your customer with a credible and quantifiable report?with a credible and quantifiable report?

Practical Barriers to Practical Barriers to ImplementationImplementation

Uncertainty about a valid, short, affordable Uncertainty about a valid, short, affordable measuremeasure

Limited staff resources or data collection Limited staff resources or data collection capacitycapacity…… costs are not ZEROcosts are not ZERO

FollowFollow--up (postup (post--tests) are DIFFICULT to obtaintests) are DIFFICULT to obtain

Staff resistance to implementation (actively or Staff resistance to implementation (actively or passively)passively)

Access to scientific data analysis expertiseAccess to scientific data analysis expertise

Not sure we want to know the resultsNot sure we want to know the results

Not sure how to produce meaningful reportsNot sure how to produce meaningful reports

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Two Key Methodological BarriersTwo Key Methodological Barriers

Sample size is too SMALL to detect Sample size is too SMALL to detect

change with statistical significancechange with statistical significance

Response rate is too LOW to generalize Response rate is too LOW to generalize

findings to larger population of EAP users findings to larger population of EAP users

or the workplaceor the workplace

Overcoming BarriersOvercoming Barriers

Decide if your measure should be administered Decide if your measure should be administered with all clients or a representative samplewith all clients or a representative sample

Staff who collect data need to be invested and Staff who collect data need to be invested and understand the value of outcomesunderstand the value of outcomes

Make data collection a part of your normal Make data collection a part of your normal operational flow operational flow –– use technology when feasibleuse technology when feasible

SELL the postSELL the post--test during the pretest during the pre--test to get test to get good locator datagood locator data

In needed, get help with followIn needed, get help with follow--up, data analysis up, data analysis and report writingand report writing

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Health and Productivity Health and Productivity

QuestionnaireQuestionnaire

Introduction to the Health and Introduction to the Health and Productivity QuestionnaireProductivity Questionnaire

Developed by Dr. Ron Kessler at Harvard Developed by Dr. Ron Kessler at Harvard Medical School with the World Health Medical School with the World Health OrganizationOrganization

Validation studies in 1997Validation studies in 1997--19981998

Implemented in 23 countriesImplemented in 23 countries

Over 500,000 completed worldwideOver 500,000 completed worldwide

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HPQHPQ--SelectSelect

““Health status GPS for your companyHealth status GPS for your company””(Integrated Benefits Institute)(Integrated Benefits Institute)

Validated selfValidated self--report tool for health and report tool for health and workwork

Focus: absence, presenteeism, and lost Focus: absence, presenteeism, and lost productivity from chronic health conditionsproductivity from chronic health conditions

Currently administered by IBICurrently administered by IBI

Shorter, online, improved analysis and Shorter, online, improved analysis and businessbusiness--friendlyfriendly

HPQHPQ--Select (continued)Select (continued)

Full report includesFull report includes

�� Prevalence, treatment status, lost time from Prevalence, treatment status, lost time from absence and presenteeism, and lost absence and presenteeism, and lost productivity due to chronic conditionsproductivity due to chronic conditions

�� Report prevalence for acute conditionsReport prevalence for acute conditions

�� Provides data for the business case for Provides data for the business case for investing in employee healthinvesting in employee health

�� Provides a baseline to measure changes over Provides a baseline to measure changes over timetime

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Absenteeism and Presenteeism Absenteeism and Presenteeism QuestionsQuestions

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Scoring AbsenteeismScoring Absenteeism

2 ways to measure and score absenteeism2 ways to measure and score absenteeism

1.1. Respondent estimates how many hours worked Respondent estimates how many hours worked

over 4over 4--week periodweek period

Absolute absenteeism = 4xB4 Absolute absenteeism = 4xB4 –– B6B6

Relative absenteeism = (4xB4 Relative absenteeism = (4xB4 –– B6) / (4B4)B6) / (4B4)

Relative hours of work = B6/(4xB4)Relative hours of work = B6/(4xB4)

2.2. Respondent estimates how many hours worked in Respondent estimates how many hours worked in

past 7 dayspast 7 days

�� Absolute absenteeism = 4xB4 Absolute absenteeism = 4xB4 –– 4xB34xB3

�� Relative absenteeism = (4xB4 Relative absenteeism = (4xB4 –– 4xB3) / 4xB44xB3) / 4xB4

�� Relative hours of work = B3/B4Relative hours of work = B3/B4

Scoring PresenteeismScoring Presenteeism

Measure of actual performance in relation to Measure of actual performance in relation to possible performance. Higher scores equal possible performance. Higher scores equal lower lost performance.lower lost performance.�� Absolute presenteeism = 10xB11Absolute presenteeism = 10xB11

�� Relative presenteeism = B11/B9 (restricted to range Relative presenteeism = B11/B9 (restricted to range of 0.25 to 2.0)of 0.25 to 2.0)

Note: B10 is not used in calculations; it is used to help Note: B10 is not used in calculations; it is used to help respondent focus response to B11 on past 4 weeks respondent focus response to B11 on past 4 weeks by asking about earlier times (Bounded recall by asking about earlier times (Bounded recall question)question)

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Scoring Presenteeism (continued)Scoring Presenteeism (continued)

Combine RELATIVE absenteeism and Combine RELATIVE absenteeism and presenteeism into one score:presenteeism into one score:

�� First, create measure of relative work hours = 1 minus First, create measure of relative work hours = 1 minus

relative absenteeismrelative absenteeism

Limitations of not using full HPQ measureLimitations of not using full HPQ measure

�� Lose additional questions that allow for imputation Lose additional questions that allow for imputation

and consistency checksand consistency checks

�� Lost memory priming question seriesLost memory priming question series

�� Cannot add or compare data to larger master datasetCannot add or compare data to larger master dataset

H&P SnapshotH&P Snapshot

Estimation of typical prevalence, treatment, and Estimation of typical prevalence, treatment, and lost work time associated with chronic health lost work time associated with chronic health conditions for similar workplaceconditions for similar workplace

PredictsPredicts�� Health conditions (treated and untreated)Health conditions (treated and untreated)

�� Lost work time resulting from absence and Lost work time resulting from absence and presenteeismpresenteeism

�� BottomBottom--line impact of lost productivity costs in line impact of lost productivity costs in financial termsfinancial terms

Requires basic workforce demographic and Requires basic workforce demographic and financial informationfinancial information

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Workplace Outcome Workplace Outcome

SuiteSuite

Introduction to the Workplace Introduction to the Workplace Outcome SuiteOutcome Suite

Workplace focused (not a clinical Workplace focused (not a clinical

measure)measure)

Based on a formative measurement modelBased on a formative measurement model

Validated with demonstrated Validated with demonstrated

psychometricspsychometrics

Short, but precise (sensitive to change)Short, but precise (sensitive to change)

FREE with signed license agreementFREE with signed license agreement

You may use one, some or all scalesYou may use one, some or all scales

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Workplace Outcome Suite ScalesWorkplace Outcome Suite Scales

5 scales, 5 items per scale (new scales are being created)5 scales, 5 items per scale (new scales are being created)

Absenteeism: # hours away from work in past 30 daysAbsenteeism: # hours away from work in past 30 days…… can also can also use this to monetizeuse this to monetize

Presenteeism: proxy for productivity; extent to which problems Presenteeism: proxy for productivity; extent to which problems inhibit workinhibit work

Engagement: measure of Engagement: measure of ‘‘overover’’ involvement with the jobinvolvement with the job

Life Satisfaction: gauges importance of job to Life Satisfaction: gauges importance of job to ‘‘lifelife’’

Workplace Distress: looks at distress at work across problemsWorkplace Distress: looks at distress at work across problems

AbsenteeismAbsenteeism

Indicate past 30 days the total hours your personal Indicate past 30 days the total hours your personal

problem(s):problem(s):

Caused you to miss work altogether.Caused you to miss work altogether.

Made you late for work.Made you late for work.

Caused you to take off early.Caused you to take off early.

Pulled you away from your normal work locationPulled you away from your normal work location while still at while still at work.work.

Required you to be on the phone, eRequired you to be on the phone, e--mail, or internet while at mail, or internet while at work.work.

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PresenteeismPresenteeism

Indicate past 30 days the degree to which you agree with:Indicate past 30 days the degree to which you agree with:

I had a hard time doing my work because of my personal I had a hard time doing my work because of my personal problems.problems.

My personal problems kept me from concentrating on my work. My personal problems kept me from concentrating on my work.

Because of my personal problems I was not able to enjoy my Because of my personal problems I was not able to enjoy my work.work.

My personal problems made me worry about completing my My personal problems made me worry about completing my tasks.tasks.

I could not do my job well because of my personal problems. I could not do my job well because of my personal problems.

Data From Two Fortune 100 Data From Two Fortune 100 CompaniesCompanies

N = 197N = 197

Mainly affiliate network model with <10% Mainly affiliate network model with <10% of onsite internal modelof onsite internal model

Statistically significant resultsStatistically significant results

For Absenteeism, a nonparametric For Absenteeism, a nonparametric Wilcoxon signed rank test was used Wilcoxon signed rank test was used (p=.009)(p=.009)

Presenteeism was also statistically Presenteeism was also statistically significant (p=.000)significant (p=.000)

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Figure 1: Comparison of Pretest and Postest MeansH

ou

rs o

f M

isse

d W

ork

Pre

se

nte

eis

m s

co

re

Figure 1: Comparison of Pretest and Posttest Figure 1: Comparison of Pretest and Posttest means on the five scales of the WOSmeans on the five scales of the WOS

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Future of Health and Productivity Future of Health and Productivity Measurement for EAPsMeasurement for EAPs

What is the role, or potential of EAP?What is the role, or potential of EAP?�� Functioning independently orFunctioning independently or

�� Larger organizational initiativeLarger organizational initiative

HPM HPM –– program or concept?program or concept?

Linking measures to interventionLinking measures to intervention�� Who to focus on?Who to focus on?

How to share data:How to share data:�� with the organizationwith the organization

�� with the broader fieldwith the broader field

For More InformationFor More Information……..

PresentersPresenters

�� Jodi Jacobson Jodi Jacobson jjacobson@ssw.umaryland.edujjacobson@ssw.umaryland.edu

�� David ShararDavid Sharar

dsharar@chestnut.orgdsharar@chestnut.org

Thank you!Thank you!