s e t t i n g up a

s t r e s s ma na g e me nt p r ogr am
A CHECKLIST F OR s u ccess
 About this checklist

This publication provides a step-by-step guide to initiate a business strategy to help employees better
manage stress and reduce healthcare costs. No matter if your investment is relatively simple or more
substantial, the key to success is to have long-range strategies customized to your employee population
and that include both organizational and individual approaches. Following these strategies can help
reduce absenteeism, turnover, improve productivity, and help employees better balance work/life issues.

About Health Advocate™, Inc.

Health Advocate, Inc., the nation’s leading independent healthcare advocacy and assistance company,
serves more than 5,000 clients nationwide, providing more than 15 million Americans with personalized
help to resolve healthcare and insurance-related issues. The company offers a spectrum of advocacy,
Wellness, Pricing Decision Support and Human Resources solutions to help save time and money. The
company also offers a direct-to-consumer advocacy service, called Health Proponent ®, to individuals
who are not part of groups.

For more information, contact Health Advocate (toll-free) at: 1-866-385-8033, prompt #2 or via email at
info@HealthAdvocate.com.
 setting up a
s t re s s ma na g e me nt p r og r a m

T
a checklist for success

he price of stress in the workplace has

moved to the forefront of concern for
businesses. Stressed workers are fatigued,
prone to mistakes and injuries and more likely to be absent.
Moreover, even when stressed workers come to work, they do
not function up to par. Most startlingly, stressed employees incur
healthcare costs nearly twice as high than for other employees.
All tolled, the cost of stressed employees to businesses is
estimated to be between $200 and $300 billion dollars a year.
The causes of stress stem from both on-the-job and off-the-
job factors. Long hours, heavy workloads and uncertain job
responsibilities are compounded by work/life balance issues
and worries stemming from the downturned economy, such
as job security and loss of income.
Experts warn that if companies do not address these stressors
wherever possible, they may pay for it later. Workers who are
stressed today can become ill tomorrow, driving up healthcare
costs further.
The encouraging news is that stress can be managed with a
synergistic approach addressing both organizational changes
and individual-based stress management strategies that teach
employees to mitigate stress. Investments can range from the
simple to the more substantial.
Whatever approaches are used, a well thought-out stress
management strategy should be a component of a company-
wide wellness program aimed at all workers, include multiple
approaches and be customized to the needs and resources of
the organization. The following strategies can help improve
productivity and lower costs.
Start with Look at the figures. The scope of stress may be uncovered by
evaluating absenteeism, illness, turnover rates and performance.
Assessment
Form a stress management team. Representatives from
management on down can help identify stressors such as long work
hours. They can also determine if these factors are company-wide or
specific to certain departments.
Survey all employees. Hold discussions and/or design a survey to
assess the stressors that employees face both on-the-job and off.
Offer a Health Risk Assessment (HRA). This online or print
questionnaire can help identify risks for diseases and contributing
lifestyle factors, including stress levels. The HRA can help spur
employees to take steps to reduce or manage their stress.

Encourage Do not single out employees who may be stressed. The goal
is to foster well-being for all employees. Encouraging company-
Maximum wide participation in wellness is acceptable. However, singling out
Participation individuals for participating in stress management, weight loss or
other specific components is not acceptable and is illegal, according
to the Department of Labor and the Health Insurance Portability and
Accountability Act (HIPAA) guidelines.
Implement an incentives system. Incentives can help double
participation in wellness programs, studies show. To be effective,
incentives must be ongoing, offered at different intervals and tied
to the specific activity. For example, employees could be awarded
insurance premium rebates for taking a Health Risk Assessment
(HRA). Or, offering a gift card for a massage could be an incentive
for participation in a stress management workshop.
Distribute ongoing communications. Posters, meetings,
newsletters and the company intranet all boost awareness of stress
management programs.

Apply Here are some organizational changes that can help balance
demand and control, and result in reduced stress levels:
Organizational
Structure jobs with meaning and opportunity for growth. Clearly
Strategies
define workers’ roles and responsibilities. Ensure that workloads are
in line with workers’ capabilities and resources.
Create a collaborative work environment. Making employees part
of the decision-making fosters a sense of control.
Provide opportunities for social interaction. Employees are less
stressed when given the opportunity to socialize with coworkers,
research shows. Options range from the simple, such as the use of
games and contests, to the more involved such as company retreats
with a menu of social activities.

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 Offer Employee Assistance Programs (EAPs). EAPs, typically
offered by the Human Resources department as part of the benefits,
can help employees find professional help with work and/or personal
issues. EAPs can lead to a decrease in worker’s compensation
claims, absenteeism and employer healthcare costs.
Consider changes in environmental design. Stress reduction
solutions can include: natural lighting, noise-masking materials,
ergonomically designed work stations and a designated “quiet”
room to relax and recharge.

Offer Multiple Enlist community organizations. Local groups such as the

YMCA may provide on-site yoga instructors for instance. Mental
Approaches health centers may offer experts to hold seminars on stress and
coping strategies.
Encourage exercise both on-site and off-the-job. Research
shows that built-in exercise breaks at work, such as a 10-minute
walk, may reduce employee stress and increase productivity.
Set up support groups. Enlist a facilitator from Human Resources
or from an outside source to keep discussions on the subject and
focused on solutions.
Think out of the box. Innovative stress management approaches
may include in-house art programs, concierge services that provide
dry cleaning services and grocery delivery, or wall screens depicting
tranquil nature scenes in windowless offices.

Institute Work/Life Give employees flex time. Varying the time when employees
arrive or leave work has been shown to reduce stress, especially for
Balance Strategies employees who are parents, caregivers or have a long commute.
Offer job-sharing, part-time schedules and voluntary reduced
work time. Employees have more time for outside responsibilities
and companies save money.
Allow work at home. This option has been shown to result in higher
morale and to lower stress and turnover.
Extend the lunch hour. A longer lunch time can provide an
opportunity for exercise, relaxation or time for errands.
Install child care initiatives. Options can include offering vouchers
or subsidies that reduce costs for child care services; information
about and referral to child care services; and on-site child care
facilities. Companies can also reserve slots at local day care centers.
Offer sick child care. Contract with a local hospital to provide child
care for employees’ sick children.

Health Advocate, Inc. 3

 Address eldercare. Ideas include: geriatric specialists to address
age-related concerns, workshop education initiatives, support
groups centering on senior issues and extended leaves of absences.
Invest in healthcare advocacy. A health advocacy service
offers employees personalized help to resolve a range of time-
consuming healthcare issues, such as interacting with insurance
companies and providers, resolving medical bills and help locating
caregiving resources.
Implement a return-to-work program. Structuring work with less
responsibility can help the transition after an extended absence for
illness or a family obligation.

Encourage Supply easy-to-read information. Provide educational tip sheets

and flyers about stress, its causes and reduction strategies.
Individual Stress
Give employees access to stress-reducing activities.
Management
Provide encouragement, time and space for yoga or other stress
management activities.
Enlist professional stress management coaches. Wellness
coaches or special counselors can work one-on-one with individuals
or groups of employees with similar stress issues.
Consider mindfulness training. Mindfulness can be a relatively
easy-to-perform and effective strategy. It helps employees focus
their attention on the present moment, and involves stress-reducing
techniques such as meditation and deep breathing, exercise and
cognitive behavioral approaches. Provide employees with materials
on mindfulness, hire a trainer and set up a quiet room for practice.

Evaluate Success Evaluation begins with looking at figures relating to absenteeism,

disability, presenteeism, productivity, turnover, workers’
of Programs compensation and use of medical care.
Track participation rates. Count the number of employee
participants after specific periods of time, such as two months,
six months or a year. Compare the participation against the cost
of incentives. If there is a high drop-out rate among employees,
perhaps goals are set too high or the incentives offered do not kick
in early enough.
Compare Health Risk Assessment results before and after
program participation. This can help gauge the effectiveness of
your stress reduction strategies.

4 Health Advocate, Inc.

“The key to successfully managing workplace stress rests on addressing
both organizational changes and individual-based stress management.”
 1-866-385-8033 (toll-free)
info@HealthAdvocate.com
www.HealthAdvocate.com

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©2009 Health Advocate, Inc. Health Advocate is not affiliated with any insurance or third party provider. Health Advocate
W-B-SWCL0809 does not replace health insurance coverage, provide medical care or recommend treatment.