Supporting and Encouraging Employees
As employees look for support and resources for themselves, family member(s) and/or colleague(s), oftentimes employees have difficult questions to ask their manager, human resources department and others.
It is important to be equipped to answers these questions as they may be the first sign for support and engagement.
While each employee's story is different, it is important as an employer to observe signals an employee may be dealing with a SUD issue.
- Recurrent Tardiness
- Withdrawing from Work
- Less Engagement
- Performance Issues
- Behavioral Issues
Create a guide that can be leveraged by all employees to build awareness around SUDs and foster a work environment that is free of stigma and supports your employees' needs. Some suggested topics this guide could cover include:
- Support through your organizations medical benefits and how to request SUD treatment
- Information on how to access a Leave of Absence (LOA) when treatment is needed
- Internal programs and resources; e.g. your EAP
- Links to self-screening tools, community programs and resources
- List and description of relevant policies
Take advantage of the time of year when you already have your employees' attention. Use your company’s annual benefits open enrollment period as an opportunity to spread information about substance use disorders.
- Push information out to employee’s through home mailings or corporate communications. Employees may not know of available services or may not want to ask
- Focus on areas that show up in your medical plan claims data as areas of concern
- Include self-screening tools for employees and their family members to review in the privacy of their homes
- Feature Employee Assistance Program (EAP) services available to employees and family members
- SUD Cost Calculator
- Data Review: Medical and Disability Claims, EAP Utilization and Absences
- Employer Survey
- Focus Groups
- Communicating the State of the Epidemic
- Senior Level Commitment
- Cross-Functional Advisory Teams
- Gather and Share Personal Stories
- Assessing and Engaging the Organization Checklist
Empowering and Educating Managers
We know that addiction is one of the most pressing public health crises of our time. Most people have been impacted by addiction in some way.
The most important thing a manager can do is to support their employees by avoiding stigma and refraining from passing judgement or making assumptions.
Instead the focus should be on expressing concerns relative to any work performance issues and referring the employee to appropriate resources for assistance.
Managers may encounter a range of difficult questions around SUDs and it is important that they are equipped with answers and resources.
SUDs present themselves in various ways. It is important that managers are prepared to respond appropriately.
While it is very important not to make assumptions, examples of issues that may be signals of SUDs include:
- Recurrent Tardiness
- Withdrawing from Work
- Less Engagement
- Performance Issues
- Behavioral Issues
As your organization begins to take action around SUDs, educating and engaging managers is key.
It is important for managers to review and understand the company philosophy, practice, resources and techniques for having healthy and helpful conversations with their teams.
A range of manager tools and training will help drive the organizational effort at an accelerated pace.
SAMHSA has developed guidelines to help support supervisors.
Assessing and Engaging the Organization
Understanding the cost implications of Substance Use Disorders within your organization is a great first step.
Developed by the National Safety Council and Shatterproof, this free tool will provide you with a general cost estimate of how substance use (including alcohol, opioids and heroin, marijuana and other drugs) affects your workplace based on your size, your industry, and your state.
The calculator is very easy to use and will provide a report that can be easily emailed and may be helpful to use in a range of presentations.
Regularly track four key data sets to understand the impact on your organization: medical claims, disability claims, leave of absence cases and EAP cases.
Substances to track include:
Use data to determine where to focus your internal communication and education campaigns
If successful, you should see your company's efforts driving more overall treatment but at lower cost (ex. more Rx instead of ER visits) as well as less lost time from work
An effective way to garner employee support and engagement around your program is to ask about employees' experiences and suggestions for improvement.
- Designate a trusted Senior Leader to invite employees to take the survey
- Ensure confidentiality by using a 3rd party research group or tool
- Ensure your survey takes no more than 5 -10 minutes
- Ask employees at the end of the survey if they are open to participating in a focus group, and provide the option to submit contact information
- Report survey results to your organization including themes and potential actions
Conducting focus groups post-survey enables you to dive into key themes and findings from survey results.
Focus Group Tips:
- Invite participants who self identified as interested from the survey and/or who have volunteered to join focus groups
- Conduct several focus groups within 30-60 days of the survey to maintain momentum and ensure thoughts and ideas stay top of mind.
- Include 12-15 participants maximum per focus group
- Use a neutral party to conduct the focus groups to ensure your employees are comfortable and can share freely.
Standard presentation materials can be used in whole or in part in a wide range of meeting settings. For example:
- Kick your SUDs campaign off with a Town Hall Meeting led by Senior Leader(s)
- Share small bits of digestible information throughout the presentation that outline the following:
- Why your company cares about SUDs
- Why your company is taking action (e.g., organizational values, productivity, cost, business case/statistics, etc.)
- Information on the epidemic
- Personal stories
- Ensure that there is ample time for Q&A at the end of the meeting
Aligning and gaining support across leadership is an important step in driving a successful internal SUDs program. It is critical for Senior Leaders to understand:
- The SUD Epidemic
- How SUDs potentially impact the organization
- Why education and support are important
- How and when you provide support
Senior Leadership should be key communicators for your SUDs program. Some activities they can lead around SUDs are as follows:
- Sending an introductory email to the organization
- Presenting at a Town Hall Meeting (see Communicating the State of the Epidemic section)
- Attending Manager Team Meeting(s)
- Participating in Recovery Month
- Utilizing national & local resources to customize support
The establishment of a cross-functional advisory team encourages broader awareness, involvement and deeper engagement across the organization.
- Select your team
- Clearly define your "Why"
- Ask your team to reflect and ask questions
- Determine your Guiding Principles
10 Word Stories Campaign:
BMC captured the impact addiction has had on our 6,000 employees. We asked the BMC community to share their stories with us using only ten words. We wove their stories together, resulting in a powerful three minute short film.
The video had the following objectives:
- Show the impact addiction has had on our community
- Be representative of the community by showcasing our community’s strong diversity and including a range of roles in the organization
- Demonstrate the stigma associated with addiction by representing anonymous stories
- Show that BMC is a stigma-free workplace
Feel free to share this video or perhaps create a similar one for your organization.
Adolescents, Young Adults Not Receiving Medication for Addiction TreatmentDecember 31, 1969
Boston – A majority of adolescents and young adults diagnosed with opioid use disorder are not receiving recommended medication to treat their disease, according to a new study led by Boston Medical Center’s Grayken Center for Addiction. The results show that only 24 percent of youths receive one of the FDA-approved medications – methadone, buprenorphine or naltrexone – within three months of their diagnosis. That gap increases for those under the age of 18, with only one in 21 adolescents receiving a medication. Patients who receive medication are more likely to remain in treatment compared to those who only receive behavioral health services. Given the ever-increasing rate of opioid overdoses, the study underscores the need to address why evidence-based medications are underused to treat adolescents and young adults with opioid use disorder.
Published in JAMA Pediatrics, this study is the first to examine youths with opioid use disorder and how each medication impacts retention in treatment.
The retrospective cohort study examined health insurance claims for 2.4 million youths aged 13-22 years enrolled in Medicaid between January 1, 2014 and December 31, 2015. During that time period, there were 4,837 youths diagnosed with opioid use disorder. Overall, 76 percent received treatment within three months of diagnosis. However, most of those youths, 69 percent, received only behavioral health services, such as individual and group sessions in outpatient and inpatient settings. For adolescents younger than 18, only 4.7 percent received medications within three months, and for young adults over the age of 18, 27 percent received medication within that timeframe.
“Our findings show that a serious gap exists in how we treat adolescents and young adults with opioid use disorder, and that this gap puts them at risk for discontinuing treatment early,” said Scott Hadland, MD, a pediatrician and researcher at the Grayken Center.
The median time that youths remained in care when they received buprenorphine was 123 days; for naltrexone, 150 days; and for methadone, 324 days. For behavioral health services alone, that number was only 67 days.
The recognition of addiction as a chronic disease where patients may relapse is an important aspect of treatment. Recent studies indicate that keeping patients engaged in treatment is critical to their recovery and protects against early death. Even if they do not abstain or reduce their substance use, being in treatment allows them to receive harm reduction services as well as treatment for other medical and psychiatric conditions. However, the authors note, there are too many barriers for youths to access medications to treat their opioid use disorder.
“There are far too few pediatric providers who prescribe medications for addiction, and stigma is still playing a role in deterring many patients and families from using these evidence-based medications,” said Hadland, also assistant professor of pediatrics at BU School of Medicine. Of all addiction treatment programs for youth across the country listed by the Substance Abuse and Mental Health Services Administration, only 37 percent offer methadone, buprenorphine or naltrexone, and of the remaining programs, a staggering 43 percent will deny admission to young people who are already on these medications.
“Recovery is a long journey that is not just about eliminating or reducing substance use, but also about keeping patients engaged in care,” added Hadland. “Providers, lawmakers and researchers must do more to improve treatment for adolescents and young adults with opioid use disorder.”
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Nourishing Our CommunityDecember 31, 1969
With patients at the core of everything, over the years BMC has developed three services to enhance patients’ exposure to foods high in nutritional value. The Rooftop Farm, Food Pantry, and Teaching Kitchen provide patients and employees a way to get and stay healthy while striving to make the city of Boston and its residents among the healthiest in the United States. All three programs work hand-in-hand to ensure patients and their families have access to healthy nutritious foods, sourced sustainably and responsibly.
A growing need for fresh vegetables in the food pantry and kitchen inspired BMC leadership to invest in an urban Rooftop Farm with 2,658 square feet of plantable space on top of one of BMC's buildings. The Rooftop Farm yields 5,000-7,000 pounds of healthy produce each year, with crops such as lettuce, tomatoes, eggplant, kale, cucumbers, peas, potatoes, spinach, peppers, zucchini, carrots, herbs, and others. This produce is given to patients in the Preventive Food Pantry, on inpatient hospital trays, and in the cafeterias.
The Rooftop Farm also advances BMC's goal to be the greenest hospital in the nation by 2020. BMC has already reduced carbon emissions by 50% two years ahead of schedule and just signed a solar farm deal that will make the hospital carbon neutral in two years. This garden adds to our green efforts by reducing storm water runoff, mitigating the formation of urban heat, and deviating waste.
Created in 2001, the Preventive Food Pantry and Teaching Kitchen were the first of their kind in the nation. The Teaching Kitchen provides patients the opportunity to learn how to cook healthy meals at a low cost. This unique space allows the BMC community to come in and view first-hand how to prepare foods they love in a manner that coincides with a healthy lifestyle. Simple, cost-effective recipes are taught while disease and condition specific nutrition education is available for weight management, diabetics, cardiac rehab patients, cancer survivors, pediatric patients and their families, and more. Participants can actually smell and taste the food while learning beneficial nutrition practices. Many of the items used in the Teaching Kitchen are available in the Food Pantry and classes are open daily for patients to drop in and learn new recipes.
When a primary care physician determines that a patient is food-insecure, the patient receives an open-ended prescription to the Food Pantry. The prescription outlines the foods required for the patient to promote physical health, prevent future illness, and facilitate recovery. Families can visit the Food Pantry twice per month and receive three to four days’ worth of food for their household each time. A key feature is the provision of perishable goods, such as fresh fruits and vegetables and meats all year round – items that are often costly and therefore often lacking in a low-income family’s diet.
The BMC Food Pantry currently serves 7,000 people a month; nearly half of whom are children. In 2017, the Preventive Food Pantry provided food to 83,288 patients and their household members (an average of 6,941 monthly).
BMC is committed to providing healthy food options to nourish our community by providing easy access to food for a medically underserved patient population. Many patients experience nutrition-related illness and under-nutrition due to poverty and the limited food choices that come with living in an urban food desert. With a rich history of helping people, BMC’s three key nourishing our community initiatives continue to promote healthy eating and living for a population that is mostly urban and on the go.
Avoiding a Case of the Flu
“Why should I get the flu shot?” is a common question that is often met with varying answers. Anyone can get the flu, which is a contagious respiratory illness, caused by influenza viruses that affect the nose, throat, and sometimes the lungs. While most people recover easily from flu, it certainly is not fun to be very sick for a week or longer, and pregnant women, young children, people with certain medical conditions such as asthma and heart disease, and those over 65 years can have dangerous complications if they get the flu.
That’s why despite studies and predictions surrounding the vaccine, the Center for Disease Control (CDC) does recommend yearly vaccination for people 6 months and older. In addition to the vaccine, prevention is key. Remember to:
- Cover your sneezes and coughs with your sleeve, not your hand
- Wash your hands frequently to reduce the spread of germs
- Avoid close contact with people who have or may have the flu
There is no cure for the flu so the old adage might be worth remembering “an ounce of prevention is better than a pound of cure.”
Contact your primary care provider to schedule your yearly flu shot!
Back to School Health Checklist
Now that summer is unofficially behind us, it’s no surprise that back to school needs are top of mind. While a new backpack, school supplies, and lunchbox may all be at the top of your list, it's important to remember check off important health-related boxes, too!
Schedule a check-up or pre-sports physical if needed
Your child's pediatrician doesn't just focus on one specific issue. Rather, they focus on keeping your child healthy and strong school year after year, all the way through adolescence. They play an important role as the central point of contact for all things related to your child's health.
Stay up to date on vaccinations
Vaccines help prevent thousands of illnesses in the US every year, and it's important to stay up-to-date to protect your children and those around them from serious diseases. Starting in kindergarten and through 12th grade, students in Massachusetts must stay up to date on vaccines for DTaP/Tdap, polio, MMR, Hepatitis B, and Varicella.
Organize medical history and emergency contact information
This may seem like a no-brainer, but be sure to gather all of this information ahead of time to make things easier if an unexpected situation arises during the school year.
Ease back into a normal sleep schedule
Summertime is a fun and carefree time for kids, and although they might argue, it's important that they get plenty of sleep. Keep them active during the day and start bedtime 5-10 minutes earlier each night to make the transition easier come September.
Calm first-day jitters
For lots of kids, especially those entering kindergarten or a new school for the first time, the first day can seem scary. Parents and caregivers can help ease these worries by openly discussing what they can expect on day one, helping to pack their backpack in advance, and reading stories about going back to school. Reassure them that being nervous is normal, and they will forget about it in no time!
To book a primary care appointment for your child, visit bmc.org/pediatrics.