Friday, May 27, 2011

Wellness Champions

As part of my mission to help 1 million people take good care of their own health, I've been working on an idea I'll call "wellness champion." I want to enable and encourage each individual to become their own wellness champion and learn how to make decisions and choices to improve and maintain their individual health. This is not to say each person is out there on their own without support. This is to stress the importance for every person to take charge of their health. Said another way, each person claims the job of their own primary care provider.

Too often, perhaps, we look for something "external" as an excuse for our weight gain, lack of exercise and inattention to our health. Genetics, time, access, resources are popular reasons. For some people, some of these are valid. For most people, they are excuses. I believe everyone can do something to better their health. The something can, and maybe should be small, to start. The small, positive changes can build over time and crowd out the negative choices.

So, what are the characteristics of being your own wellness champion? My top five:
  1. Empowerment. Each person should take a long, hard look in the mirror and say, "I am responsible for my own health and well-being." For extra reinforcement, write it down and read it everyday. It may sound like a silly, small thing but I think it is important to remember your mission - to take the best care of you.
  2. Individuality. What works for me and my body will likely not work for you. Understand everyone one of us is different; we have different nutritional needs, we have different exercise needs, we have different lifestyles, time, demands, responsibilities, etc. Stop trying to follow somebody else's plan. Learn what works best for you, in your life, at this point and time. Understand it will change over time. Yes, it is an investment but I can't think of a better one you'll make in your lifetime.
  3. Information. Weigh yourself regularly, track your own blood test results, create and maintain a personal health record, keep track of your eating and exercise (getting started requires effort; it gets easier over time). Gather your own data and understand your own information.
  4. Awareness. Learn the signs and signals you get from your body. Try different foods. Exercise at different times of the day. Get more sleep. Know your cravings. Drink more water. Shift your chair or stand up and work. Stretch more often. Turn off the TV/computer. Experiment and keep good notes. Your goal is to discover what you can do to feel your best.
  5. Community. Surround yourself with other people committed to their own health and wellness. If you have people around you who aren't ready to be their own wellness champion, be a leader and model good behavior. Even the smallest thing like drinking water instead of soda, can have an impact on the people around you.
A small idea with a big impact. No matter the level of your health at the moment, there is something you can do, right now, to make it better. The idea is to grab more of those "right now" moments, learn how to make the best choice for you, and be ready to choose well again when the next moment arrives.

Wednesday, May 25, 2011

To Weigh or Not to Weigh

Is that the question? Should you hop on the scale everyday? Should you only get your numbers once per week? The answer is simple.... it depends!

First we'll start with a fact: Your body weight fluctuates each day due to a number of factors:
    • Water intake
    • Dehydration
    • Types and amount of food you eat
    • Temperature
    • Exercise
    • Travel
For me, I know if I eat sushi (the soy sauce makes me retain water) or if I've been on a plane, my body will be 1 to 2 pounds heavier the next day. It is a truth for my body. I'm a daily scale person and there are other options.

Generally speaking, there are four schools of thought on weighing your body:
  • Do so each day
  • Do so once per week
  • Do so once per month
  • Avoid it at all costs
What is best for you depends on your personality and your relationship with your scale. To find your own best plan, you have to ask yourself some tough questions. And, you have to answer honestly.

Count your As and Bs. If you have four or more As, you need to redefine your relationship with your scale. Consider the following:

The scale is a useful tool in your overall approach to your health. To be your own wellness champion, it is important to have a general idea of your weight and to understand how it relates to your energy levels, quality of your sleep, muscle aches (or lack thereof), eating habits and exercise. The decision about how many times to weigh yourself is up to you, but doing so is a tool not torture.

I like to weigh myself each day and I use the number to consider what I did the day before. I also do so first thing in the morning. Consistency of timing is critical. As I shared above, certain foods and certain activities impact my weight. If I hop on the scale and I'm two pounds heavier and I haven't eaten sushi or been on a plane, I look for other hints. If there aren't any, I am likely a bit more careful about my food intake and exercise for that day. A daily weigh in also helps me to identify any trends which is how I discovered the sushi and airplane data.

Based on the quiz answers, here are some ideas.

At a minimum, I recommend a monthly weigh in. Know your weight and get to know your body. No matter how many times you choose (monthly, weekly or daily), remember consistency is key. I think first thing in the morning makes the most sense as it becomes part of your morning routine. You can do so before bed, but understand you're body weight is likely higher in the evening than in the morning.

And, whatever your number, your goal is to identify and understand trends. If your numbers are consisently rising or dropping each day, do you know why? If not, figure it out by making some lifestyle changes and see how it impacts the scale.

Our most important job is to be our own wellness champion. The first place to start is to get back in touch with your body, know how it operates and understand how the choices you make have an impact.

Tuesday, May 24, 2011

Organizational Wellness

Wordle: Mission ClarityWorking with a team of colleagues yesterday to design a new curriculum, the conversation got around to the idea of "organizational wellness." It is all the rage of late to talk about employee wellness and I do agree having healthy, happy employees is important to the long-term success of a company. Perhaps though, employee wellness isn't enough. Let's take it a step further and talk about organizational wellness.

Having worked in consulting for 20+ years, I've had experiences with organizations that I would consider "well" and some I would consider extraordinarily "unwell." I've also worked with organizations over a long span of time that started out well and slid to unwell. Fewer have gone in the other direction. I think it is possible to avoid the slide to unwell and regain organizational wellness if you're in a bad place. To do so, however, requires awareness and effort. Below are my characteristics of a well organization:

1 - Passion
Passion, in the positive sense, is "for the love of" something greater than ourselves. A company with a clearly defined mission the employees truly believe in is a good ingredient of organizational wellness. The missions that focus on altruism and the welfare of the customers typically garner the most passion. Profit is important, but I think passion comes in those organizations that focus on something greater than EBITA.

2 - Leadership
Yes, I had to include leadership. And, I'm raising the bar. In my opinion, we need to start with individual leadership. Individual leadership means each person's ability to make the right choices for themselves so they are then able to make the right choices for the company. A healthy company is one where each person can live both the organizational mission and their personal mission at the same time. This requires a few things: 1 - A clear organizational mission, 2 - A clear personal mission, and 3 - Working for a company where both missions can align. 

Lastly, organizational wellness comes when company leadership encourages people to thrive while pursuing both missions. If neither mission is clear, doing so is the place to start.

3 - Creativity
Everything changes. At some point, even a company which has operated for dozens of years faces a change. Customers change, technology changes, competitors change. A well organization is one that fosters, encourages and expects creativity from its employees. Every single one of them. There are some amazingly talented and creative people hiding in your organization who can see something others can't. Give them a platform, ask for their voice and give them an outlet for their ideas (for example, instead of the annual holiday party convene an annual "New Idea Conference").

4 - Openness
I've been in far too many meetings where there is a "meeting after the meeting" so a smaller group of people can say what they really think. If the people in your company huddle after a meeting, there is something going on you want to know about. Or, you have the wrong people in a meeting. Or, you didn't need a meeting in the first place. Organizational wellness comes from the confidence that the most important thing is honesty, no matter what.

5 - Social Networking
Capitalize on the power of the social networks that exist in your organization. If your company has more than five people, odds are, you have a social network. Use the social network for the good of your team and your organization. Have them start a book club, or an afternoon walking break, or send them to a class together. By building the strength of the social networks you're building the strength of your organization.

Is your organization well? Probably the easiest test is to take a walk around. Are people smiling, energetic and excited? If not, there is work to do be done. In three months, with a concerted effort, you can take your organization from unwell to well. If you're an employee and are living in an unwell organization, your first step is to get really clear on your personal mission. Once there, your next step will be clear.

Monday, May 23, 2011

Wellness in the ACO Ecosystem

An ACO, or Accountable Care Organization, is a new model of coordinated healthcare allowed by the Affordable Care Act (aka health reform). In short, ACOs are one way doctors, hospitals and other healthcare providers can work together to better coordinate care for their patients. From the patient perspective, the goal of an ACO is to eliminate the frustration and hassle that comes with disconnected care. Each of us has some experience with this frustration and having a more user-friendly healthcare experience is welcome.

The goal of the ACO is to improve patient health (called "outcomes" in the healthcare system), improve the quality of care and lower costs. Impressive goals. And, in my opinion, possible if the ACO includes a comprehensive wellness solution within their program.

A comprehensive wellness solution is not to be confused with the old tems of "case management" or "care coordination" or "disease management." Each of those programs did deliver some savings and did improve some patient outcomes. They did not, however, put enough focus on the "whole person." An ACO modeled on the old ideas of disease management is less likely to succeed. Wellness is whole-person centric and is not about whichever diagnosis label appears on the medical record.

None of us are simple, one dimensional beings and our healthcare treatments cannot be one dimensional. We know lifestyle choices cause most diseases (heart disease, stroke, diabetes). When a doctor sees a diabetic patient, the doctor isn't treating "the diabetes" he is treating a person whose lab reports show a high level of sugar in the blood. The reasons for the numbers on the lab report are likely complex and a good outcome requires a whole-person strategy that combines medical, social, cultural and educational components.

Therein lies the challenge for the ACO. An ACO comprised of even the best team of clinicians will miss the opportunity for true improvement in "person health" if they treat based on historical practice and a disease-focused, patient-centric approach. "Person health" improvements demand a comprehensive wellness program focused on the whole person including exercise, nutrition and wellbeing.

A few ideas to consider:

I want to see ACOs succeed because I want people to be more healthy and happy.  Lifestyle choices are eating the healthcare system alive. An ACO lacking a lifestyle program is destined for mediocrity, at best. If you are working on an ACO design, consider comprehensive whole-life, person-centric programs in your design. It matters.