Q&A with Dr. Susan Johnson, Wellness Program coordinator

Q: What is the Working Well project?
It is a three-year, $1.2 million grant funded by The Duke Endowment aimed at helping hospitals in S.C. reduce chronic disease associated with tobacco use, poor nutrition, physical inactivity and obesity. The target is to help our employees and make wellness an organizational priority, not just an after-thought or something we have to figure out how to do on our own time.

Q: Why are you so excited about it?
People spend the majority of their day at work. By making policy changes and access changes—what food choices they have or if they're given 10 minute activity breaks every day or they can walk outdoors without smelling smoke—will affect their productivity and well-being.

This program is going to address all those things. It's going to make healthy choices more affordable and more accessible.

The policy stuff a lot of people are going to be excited about because it will make healthier choices part of the cultural norm of MUSC. Imagine your typical workday including a break to do some yoga stretching, a walking meeting with your manager, a trip to the cafeteria to visit a designated healthy food station and finishing your day at the Wellness Center with a spin class.

Q: Where did the program originate?
In the summer of 2009, the S.C. Hospital Association and Eat Smart, Move More, S.C. partnered to provide the WorkHealthy America (WHA) Assessment to acute care hospitals in South Carolina. WHA is a program developed by N.C. Prevention Partners (NCPP) to assess, implement and maintain evidence-based and effective worksite wellness environments and policies. It was developed by NCPP's staff and advisory team of leading national experts in worksite wellness policy.

NCPP collected survey information from hospitals from December 2009 through February 2010, and analyzed the results in February 2010. Fifty-five hospitals and systems participated in the survey, representing nearly 85 percent of all acute care hospitals in the state.

Q: How did MUSC fare?
We participated in a comprehensive wellness survey with 55 other hospitals in S.C. to provide baseline data for this project. When comparing our scores with the average scores for S.C. hospitals, you can see that we have a lot of room for improvement and for me, these scores are a call to action and motivate me to do what I can to help MUSC become a leader in our state and beyond in the area of employee wellness.

Average overall scores for the state were: physical activity, D; nutriton, B; and tobacco, C. MUSC's scores were: physical activity, C-; nutriton, C; and tobacco, B.

Folks may be wondering how we scored so low, particularly in the area of physical activity. The survey focuses on an overall culture of wellness, based on core principles in each section.

So for physical activity, for instance, poor scores result from limited access to on or off-site physical activity equipment and facilities, limited use point-of-decision prompts to encourage employees to adopt active alternatives to sedentary behaviors and a lack of policies to encourage employees to be active and productive during the work day.

It may seem disappointing at first glance, but it's better to think of this as an opportunity for improvement. We just need to establish support, create a plan of action, and implement these initiatives in a coordinated way using our own resources as well as those in the community and provided by the grant.

Q: How did MUSC get involved?
Susan Johnson (far left) visits Wake Forest Baptist Medical Center, where they have areas designated for healthy food choices.

In October, a Working Well Boot Camp was held in Columbia to present the project to hospital executives and call for leadership in anticipation of a grant award. I had just joined MUSC in September and was so excited to hear about this project and attended that meeting. While there, I offered to be a part of the advisory team for the project and indicated that MUSC would like to be considered as a "Center of Excellence" as we began to meet the indicators for this distinction. In December 2010, the $1.2 million grant was awarded by The Duke Endowment with the project to run January, 2011 through January, 2014.

In recognition of our leadership in being one of the first 25 hospitals to commit to Working Well, we were invited to join the Working Well Staff at SCHA on March 10 and 11 for a two-day inside look at how North Carolina is successfully implementing this initiative. Including myself, other attendees included the two Working Well staff members, Kendyl Schultz and Jen Wright, SCHA Vice President Jim Head, and representatives from Palmetto Health, Laurens County Healthcare System, Greenville Hospital System, and Carolinas Hospital System.

Q: How did your training help?
It was an intensive two days that left us all extremely excited and motivated and at times a bit overwhelmed. The first day was the Prevention Academy, held at RivalHealth in Raleigh. We got to see results of a three-year N.C. Hospital Worksite Wellness Project established by NCPP. The next day we participated in tours of two hospitals that are designated by NCPP as Centers of Excellence. It was extremely valuable to be able to see these programs in action. For me, it was especially helpful to tour Wake Forest Baptist Hospital since they are similar to MUSC in terms of being a teaching hospital and university. By the end of the two days, our South Carolina group, along with folks from NCPP and our new New York city colleague who will be implementing the program in all New York city hospitals, had established an incredible bond as we look forward to working closely for the next three years on this project.

Q: How will it be implemented?
Each participating hospital begins by informing the administrative leadership team and establishing their support through completing and submitting a signed executive commitment to wellness, which MUSC did in November. We then are to identify Wellness Champions within the organization to serve on committees. I'm in the process of doing this. We then assess the organization's current policy and environment in relation to wellness and are given a customized plan of action. Tools to help us succeed in implementing our plan of action include online toolkits, assessments, webinars, workshops, support and networking opportunities. The project staff will provide us with free, customized assistance.

Q: How will making policy changes cause long-term improvements?
Changing policies makes the program sustainable. It means that after the grant is over and the staff has changed, the values, environmental changes and expectations relating to wellness will remain as a part of the organization. That is what leads to cultural change within an organization. Potential impacts include reducing health care costs for employees; decreased absenteeism, turnover and workman's comp claims; and increased moral and recognition as a leader in worksite wellness.

Q: What are your expectations?
My hope is that we can create an excitement within the organization at all levels for what is possible in making employee wellness a priority and a mission. Hospitals are natural leaders in prevention, and we have resources available to help our own employees and community members lead healthier lives and avoid unnecessary illness and health care costs. My goal for MUSC is that we step forward as leaders in this program and work together to become one of the first hospitals in South Carolina to receive the designation of a Center of Excellence. By doing so we will need to lead by example and make wellness a priority for ourselves, then help others do the same.

Q: How can people help?
We need people to rethink how they do business in their work areas in a way that makes wellness a priority. It's not going to be a one-size-fits-all solution. We are looking for employees in each unit to be creative in thinking of ways to implement this in their own unique settings. They need to be flexible in how they apply these policies. We are in the process of forming committees in the three focus areas of physical activity, nutrition and tobacco cessation. If you are interested in joining one of these committees or would like more information, send me an e-mail at johnsusa@musc.edu.