The program at Hughes illustrates how appropriate incentives can improve employee participation in an integrated health and wellness program. It also demonstrates direct cost benefits for the company.

The preceding discussions review the basis for and the components of a strategy for advancing employee integrated health (see Chapter 3 and Table 3-1), and the importance of building that strategy to advance key organizational objectives. The following discussion centers on the challenge of implementation—specifically, how can the organization’s initial support and engagement around integrated health goals be sustained for the needed long-term commitment? Further, how can the necessary organizational behaviors be integrated into the way the management and work force function, and into the processes the organization uses to get things done?

Public-sector enterprises, like their private-sector counterparts, will continue to experience major perturbations from sources such as government policies, catastrophic events, or transformational innovations, and these create powerful tendencies toward disengagement, loss of focus, and failure related to integrated health program commitments. In addition, even where disruptive forces are successfully negotiated, strategies can fail because of weak vertical or horizontal intraorganizational linkages or an erosion of senior management involvement and accountability.

Successful occupational health and safety functions (Fronstin and Werntz, 2004) have transitioned from their hierarchical “command and control” past to a systems approach to occupational safety and health. Systems approaches focus less on disconnected programs and more on

• Engagement of stakeholders;

• Identification and integration of inputs;

• Management of interfaces between components;

• Making trade-offs that emphasize the end goals, not the component parts, and have a disciplined process for measurement; and

• Assessment and change.

As shown in Table 4-1, occupational health and safety management systems (OHSMS) are outgrowths of the quality discipline best reflected in the total quality management approach of W. Edward Deming (Mahoney and Thor, 1994). Deming, General Electric (Six Sigma Program),

Front Matter (R1-R16)

Executive Summary (1-18)

1 The NASA Worksite (19-33)

2 Occupational and Preventative Health at NASA (34-52)

3 Workforce Health, Performance, Readiness, Resilience: The Case for Change (53-76)

4 Organizing and Managing Employee Integrated Health Programs and Policies (77-101)

5 Implementing Integrated Health Programs (102-149)

6 Data Integration and Health Management (150-170)

Appendix A: Glossary of Terms and Abbreviations (171-175)

Appendix B: Open Session and Workshop Agendas (176-179)

Appendix C: Committee Member Biographical Sketches (180-184)