Advancing Workforce Health at the Department of Homeland Security Protecting Those Who Protect Us (2014) / Chapter Skim
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9 Considerations for Implementation
9 Considerations for Implementation
Pages 239-260
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From page 239... ...
This chapter outlines some final considerations for implementation of the committee's recommendations, including projected benefits and priorities. IMPACT OF AN INTEGRATED HEALTH PROTECTION INFRASTRUCTURE The committee was asked to consider the impact of its recommendations on mission readiness, health care costs, and liability at DHS.
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It follows that workforce health and safety are essential factors in mission readiness. Although impacts of employee health programs often are measured in terms of decreased costs and injury rates, mission availability is a powerful measure of the combined effectiveness of preventive, curative, and rehabilitative interventions.
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in which employers are achieving cost savings through employee health protection and promotion initiatives. Although pioneering companies such as Johnson & Johnson have had integrated employee health programs in place for more than a decade (Isaac, 2013)
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By comparing projected and actual sick day utilization rates, the organization was able to demonstrate savings associated with its occupational health program in terms of 3 Johnson & Johnson's "shared services concept" for its Health and Wellness Program entailed integrating employee health promotion, disability management, employee assistance, and occupational medicine programs. Safety and industrial hygiene programs were managed separately (Ozminkowski et al., 2002)
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to reduce occupational injuries and return injured employees to work in a timely manner5 provide an example of the magnitude of savings that can be achieved just in workers' compensation costs through investment in workforce health protection initiatives. Between 2005 and 2012, TSA reduced workers' compensation claims by 78 percent, achieving an 81 percent reduction in continuation-of-pay costs and a 19 percent reduction in chargeback costs.
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. An operational medicine capability (Recommendation 8)
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. In addition to the aforementioned benefits, an important but often forgotten impact of strengthening the DHS health protection infrastructure as recommended by the committee is the potential for improvements in employee health.
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(R1) Term • Align/integrate occupational health and operational medicine functions under the Chief Medical Officer (CMO)
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Integration of the DHS health protection system will require, fundamentally, a significant culture change and a willingness to function and act like a single agency with a common mission focus. The committee believes that the first priority is therefore to gain the commitment of core leadership at the component and headquarters (i.e., Chief Medical Officer, Chief Human Capital Officer, Chief Financial Officer)
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To this end, the missionready DHS of the future will require an empowered and resourced Chief Medical Officer who, through partnership with the component agencies, BOX 9-2 Summary of Key Findings, Conclusions, and Recommendations for Integrating Workforce Health Protection at DHS Chapter 5: Leadership Commitment to Workforce Health Recommendation 1: Demonstrate leadership commitment to employee health, safety, and resilience through a unified workforce health protection strategy. Key Findings: • Vocal and active commitment from leaders at all levels has been integral to creating successful workforce health protection programs and develop ing a culture of health in the organizations examined by the committee.
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and the Office of the Chief Human Capital Officer, the latter being located within the Management Directorate. • The CMO lacks visibility and strategic input with respect to the workforce health protection functions currently administered at the headquarters level through the Office of the Chief Human Capital Officer; the result is a lack of role clarity for the CMO.
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• The absence of formal mechanisms for coordination and communication has resulted in stovepiped workforce health protection functions, contrib uting to inefficiency, a lack of accountability and transparency, and missed opportunities to achieve synergy through integration. • DHS needs to align its resources with its strategic objectives, develop performance metrics, and hold its health and line leadership accountable for occupational health and operational medicine outcomes.
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Recommendation 4: Establish Component Lead Medical Officers to align and integrate occupational health and operational medicine functions. Key Findings: • The current workforce health protection infrastructure at DHS is highly fragmented and markedly uneven across the component agencies.
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Conclusions: • A mechanism is needed to enable the CMO to collect information on op erational requirements from the component level, to engage components in the development of medical and public health policy, and to provide senior-level direction for an integrated DHS workforce health protection strategy. • Networking among component medical officers is critical and would best be realized through regular and formal direct interaction with the CMO.
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• Many workforce health protection functions span the intersection between health and human resources and therefore also require the involvement of the Chief Human Capital Officer. Input from other members of the DHS management team may be required as well to ensure adequate resourcing of occupational health and operational medicine programs and effective management of these programs within the larger DHS financial, acquisitions, and information management architecture.
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Key Findings: • Working collaboratively with nine DHS component agencies through the Emergency Medical Services Training and Education Advisory Com mittee, OHA has developed a centralized emergency medical services (EMS) system plan, established standards of care through baseline basic life support and advanced life support protocols, and acquired software for DHS-wide patient care reporting and tracking of EMS pro vider credentials.
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• The medical and operational needs related to those in DHS care or custody need to be addressed by a comprehensive DHS operational medicine program. • The diversity of operational and mission requirements among DHS's com ponent agencies prohibits a one-size-fits-all approach to the establish ment of a departmental operational medicine capability.
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• Injury and illness data (Total Case Rate and Lost Time Case Rate) , while reported at least annually to the DHS occupational safety and health program staff in the Office of the Chief Human Capital Officer as required by the Occupational Safety and Health Administration (OSHA)
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unify and standardize occupational health and workforce health protection activities across the department. • OHA has already acquired an electronic patient care record (ePCR)
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Conclusions: • In support of operational medicine services, a system is required to docu ment treatment provided to anyone receiving care from DHS providers. • A longitudinal health record to support occupational health, including readiness assessment, is required to document health issues that are relevant to employment, addressing primarily capabilities specific to job duties and deployments.
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Presentation at IOM Committee on DHS Occupational Health and Operational Medicine Infrastructure: Meeting 2, June 10-11, Washington, DC. FAMS (Federal Air Marshal Service)
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Key Terms
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