Leading Agendas For Behavioral Health And Well-being

Leading Agendas for Behavioral Health and Well-Being: The Experience of an Internal Integrated EAP/WORKlife Program Kathleen Beauchesne, PhD, MBA, MSW, LCSW-C Johns Hopkins Institutions EASNA Annual Conference 2006 Toronto

Goals and Objectives 



Discuss the critical leadership role that integrated EAP and WORKlife programs must achieve in work organizations Participants will learn:  



One tool for leading change How to develop Advisory Committees to achieve strategic objectives; the value of management committees and their importance to program goals and objectives; the use of leadership retreats; and The theoretical models used to guide leadership on these issues

Background Information 



Internal EAP, WORKlife and Student Assistance Programs Johns Hopkins Institutions  



Global organization 



Johns Hopkins Hospital and Health System Johns Hopkins University 55,000 faculty, staff, employees and students

FASAP, WORKlife and Student Assistance

The Challenge Facing Academic Medical Centers  

Three lines of “business” Challenges     

Technology Changes in funding patterns Health care reform Diversity Corporate competition

Critical Issues      

Adaptability and change Competition Recruitment and retention Productivity Benefits costs Value human resources

Leading Agendas for Change 

Integrated Human Services Model (IHS Model) 

Conceptual framework  



General systems theory Built on a systems model that reflects our view that universities generally (and JHI specifically) is a network of communities encompassing a complicated system of interrelated parts.

Administrative Structure: Office of Human Services 

Mission: to support the fundamental purposes of the JHI to provide cutting edge healthcare, education and research     

Career Management Program Center for Training and Education FASAP (EAP) Organizational Development and Diversity Office of WORKlife Programs

IHS Model 

   



Model is consistent with a life-span human development perspective for intervention; approach emphasizes growth and change Incorporates statements about desirable goals Focuses on sequential change Emphasizes techniques of optimization/empowerment rather than remediation Considers the individual or system as an integrated bio/psychosocial unit amenable to a multidisciplinary approach to service delivery Views individuals as developing in a changing cultural context

Key Elements of the IHS Model 

Systemic analysis 



Assessment 







psychotherapeutic, family-centered, career oriented, organizational and directed at training and development needs

Design evaluation and research studies to assist in a formal assessment of the model Client management systems 



is important; evaluate every request with a review of the context of the situation that comes to our attention as well as the impact of the problem on the person, their family, the work-team, other related organizational units and the organization as a whole

Interventions 



most critical and valuable service that can be provided

Timing of the intervention 



facilitates the planning and delivery of our interventions

an integrated management information system that facilitates the gathering of compatible utilization and evaluation data

Human services delivery team meets regularly to discuss cases and consider mechanisms for increased collaboration and integration 

The entire Human Services staff meets bimonthly to assure continuity

FASAP/WORKlife Integrated Infrastructure Model FASAP

WORKLIFE

  AA INFRASTRUCTURE

Employed Adults

 Early childhood education

Employees across the life span INTEGRATION Demographics driven Access Administrative Support Cognitive/psycho-educational approach Intake Life cycle model

MH and SA incidence and prevalence driven Licensed professionals Clinical approach/medical model

Mandated drug testing /managed care Disciplinary process Risk Assessment

Client Services Event Planning Data Management Financial Management

Follow-up Psycho-educational information Databases of community resources Credentialing of resources Core consultation skills Technology Serve same clients Supervisory training Team practice Advisory Board SAP Academic and social concerns Rooted in K-12 programs Safe, drug-free learning communities Resilience and student success Educational activities Support groups Integrated approach

Utilizes national policy Support groups

Theoretical Foundations     

Social exchange theory Social justice theory Role theory Life course/developmental perspectives Systems theory

Leading Change 

Framework: (Kotter, JP. (MarchApril,1995). Leading Change: Why Transformation Efforts Fail. Harvard Business Review) 

Eight Steps to Transforming Your Organization

Kotter’s 8        

Create a sense of urgency Form a powerful guiding coalition Create a succinct, compelling, noble vision Communicate the vision—do all you can Empower others to remove obstacles Create short-term wins Don’t declare victory too soon Anchor the change in the culture

Thoughts About Organizational Change           

Must occur through a series of phases Stalled change efforts can be re-started and re-invigorated Requires a considerable length of time Find plenty of programs and plans—but no vision It’s not necessarily about the data Frequent communication is essential Must create a coherent, intellectual framework that reflects the culture “Champion” models of change are not sufficient Coalitions are very powerful and can start small—but must grow Change must sink into the culture—a process that can take 5-10 years You must take care of the change effort and help people see the right connections

Key Issues and Critical Events: Opportunities for Organizational Change  

FASAP started 1987 Child care on campus defeated 1989  



WORKlife Programs 1993 









Task Force with 4 subcommittees Matrixed the recommendations and completed in 5 years

Proposal for Individualized Flexible Work Arrangements 1998 FASAP Budget Cut 40% 1998  



Leadership Retreat

Rex Chow Murder and the Campus Task Force on Violence 1996 Work Family Task Force Report 1997 



Aging Workforce Data 1993-1994

Work Family Conference 1995 



Provost’s Committee on the Status of Women (WEFIS Committee) Women’s Forum

Creation of the Management Committee Layoffs of EAP clinicians

Workplace Violence—Risk Assessment Policies and Procedures 2000  

3 Committees Institution-wide retreat

Key Issues and Critical Events: Opportunities for Organizational Change  

Developed first Student Assistance Program September 11th: Mental Health Disaster Planning Report/Child Care Disaster Planning 2002 and 2003  

Institution-wide Committee Steering Committee 



FASAP/ WORKlife Advisory Committee 2003 



   

Aging Workforce Data

Developed 2nd Student Assistance Program 



Child Care Disaster Planning/Gap Analysis

Advisory Committee

Provost’s Committee on the Status of Women 2004 Two students murdered off-campus in 2004/2005 Domestic Violence Task Force 2005 Flexibility Project of the Advisory Committee Workplace Violence Brochure: mailed to 55,000 faculty, staff and students

Organizational Structures Used to Achieve Change 

Advisory Committees 

   

Think tank

Management Committees Retreats Task Forces Work Groups

FASAP/ WORKlife Advisory Committee  





Charged by the Vice Presidents of HR Charge to FASAP and WORKlife  Provide guidance and direction to the leadership of the University and the Health System on how to update our policies, practices, and procedures to keep abreast of the changes in the nature of work, in the workforce, in our institutions, and in the economy Think Tank  Thought-leaders invited to be members Topical White Paper Reports Annually  Form a coherent, intellectual framework for addressing challenges facing the institutions

Goals of the White Paper 



 



Recognize that the issues are social issues that require Hopkins and other stakeholders working together Recognize the difference between policies and procedures geared to a workforce that no longer exists and the current realities facing Hopkins and its employees Reframe problems as systemic in the way the work gets done Develop institutional organizational support of work/life integration, health and well-being Recommend new policies and arrangements that mesh with current realities of Hopkins and its employees and families at all stages of life

The White Paper  

   

Survey of trends and impact on the institutions Integrated perspective  Systems approach  Life course/human development approach Capture knowledge Costs and investments Outcomes Bring the message home to Hopkins

From the Committee Meetings 

Describe the forces that will impact the workforce within Hopkins. 



Isolate the common themes across the institutions including aging, diversity. 



Address multiple types of workforces and the impact of the shifting demographics. There are different businesses across the institutions including health care, education and research. However, there are common themes.

The Committee believes there is enough commonality across the institutions that the themes will speak to everyone—however, there are trade-offs to this approach. The Committee will be able to focus more directly on specific issues in future white papers.

Examine the data on part-time employees. 

We know very little about these employees, and they make up a sizeable portion of our workforces.

Organizing Themes 





Concept of “organizing themes” as central driving points  Example: threats to academic freedom, shifting federal funding, current security policies, shifting demographics, shifting paradigms How do threats ripple through our workforce? How are our employees affected? Threats to excellence/threats to quality?

Trends Globalization Technology Economic Pressures Cultural Issues Flexibility

FASAP/WORKlife Advisory Committee White Paper Project

Time Squeeze Financial Pressures Spillover Accomodating Work Arrangements

Increasing Diversity

Government

Work Organizations

Work Hopkins Current Labor Force Health Recruit

Work and Personal Life

Family

Changing Labor Force Retain

Future Laborforce Well-being Community

Goals Maximize human capital Minmize human resources costs Improve organizational performance

Theory Role Theory Social Exchange Social Justice

Unions

Flexibilit Employee V Benefits Red Skills Prepa Work Red

Survey Results by Category: Top 6 

Employment, wages and benefits 



The workforce  



Increasing the diversity of our workforce Aging of our workforce

Work conditions   



Impact of increasing health care costs

Addressing health and well-being of employees Addressing the need for flexibility Necessity of supervisors to acquire new skills to manage in today’s complex environment

Missing categories  

Work and family Working with other stakeholders

Leadership Retreat       

60 leaders across the institutions Facilitated by OD Wrote goals statements Force field analysis Current and desired state Action steps on each trend Volunteers to work on committees

Setting Up the Model for Success: Flexibility Project   

Guided by the Advisory Committee Parts of this project are build on previous work Draws from the Retreat 



Examines the interrelationships between aging, health and well-being, diversity, increasing health care costs and supervisory training AND Flexibility Issue a report and recommendations to the committee

Other Important Tools    

White Papers Annual Reports Organizational Assessments/Audits and Gap Analysis Data   

 

Organizational demographics Benchmarking Trends

Consultants and Vendors Managing Up

Implications   

Our unique position in healthcare, education and research provides us with the opportunity to be a national leader We must make the link between what we know about what people need and our policies and practices Our traditional assumptions, values and beliefs about work must be examined   

Breadwinner models of work and family are embedded in the way we work today Adding additional hours to a person’s work day may lead to stress and burnout in knowledge and service workers Our organizational strategies deal with those individual problems brought to the office door

In Summary: 3 Points  

Developing another program or another service is not the only answer EAPS and WORKlife programs been privileged with a wide-ranging, rare, and unusual view of the personal and work-related stresses that a set of demographic, social, economic, political and cultural changes have wrought on the workforce 





At Hopkins, EAP and WORKlife have had the unique opportunity to assess the effects of these changes on employees of the Hospital and the University from those barely getting by to the most privileged of workers in healthcare, education and research. Among all our workers, reports of stress, overwork, job insecurity, and difficult balancing the dual roles of work and family are common

We have a responsibility to provide leadership and guidance on this set of issues

Questions

Kathi Beauchesne [email protected]