Originally published for www.triskelecollaborative.com
The founder of Triskele Collaborative, Kim Adams, and I met with an astute wellness coach who works for an insurance company this morning, and we spent a good bit of time bouncing ideas around about how, when, and where the tipping point will happen in our country’s health care system when it is able to truly prevent disease and promote “health”. We all understand that the system as it’s currently set up incentivizes medical care and services over preventation. Even if you have zero knowledge on this topic but watch television enough to notice that every fourth commercial is for a pharmaceutical, you already have some understanding of this perspective. Only two countries in the world allow direct to consumer drug advertisements- the U.S. and New Zealand. This is not to say we are against pharmaceuticals or don’t appreciate biomedical innovation; to the contrary. But consider this: 70% of Americans take at least one prescription drug, 13% of our population is on an anti-depressant, and research suggests smarter medication use could save us $213 billion in health care costs. I am remembering a quote by William Osler, Founding Father of Johns Hopkins Hospital: “One of the first duties of the physicians is to educate the masses not to take medicine.”
The founder of modern nursing Florence Nightingale lived and worked around the same time as Osler, reflecting his sentiments on the role of health care: “The very first requirement in a hospital is that it should do the sick no harm.” But harm it has done. In the process of trying to heal, hospital-acquired infections are among the top five leading causes of death in U.S. patients admitted to the hospital. Health care spending exceeds our spending on war and education combined in our country, but we still have some of the lowest health outcomes and the highest infant mortality rate of the 27 wealthiest countries in the world (for these and other curious statistics on health inequality and mortality in the U.S., visit www.infobombing.org).
Clearly, something has to change. And soon.
Well what those outside of the health care industry do about this? Quite a bit, as it turns out. Consider the International Agency for Research on Cancer (IARC) 2014 forecast that cancer cases worldwide will rise by 75% in the next two decades. It is estimated that 90-95% of cancer diagnoses in the United States are rooted in environmental and lifestyle factors, including 25-30% from tobacco use, and 30-35% attributable to diet. Cancer does not happen overnight. In many cases, it is a disease process many years in the making with tumor propagation happening more readily in the presence of chronic inflammation, depression, stress, and lack of social support. For more information, read Cancer is a Preventable Disease that Requires Major Lifestyle Changes.
(University of Washington family medicine professor and pioneer palliative care doctor Dr. Stu Farber died on February 27 of this year after battling acute myelogenous leukemia. His story “Living Every Minute” is a thoughtful account of what it’s like to be a patient catapulted inside medical the system after having served for years from the outside as an end-of-life provider. His words are revelations, offering a new systemic perspective of his life’s work.)
This all brings me back to Triskele Collaborative, our meeting this morning, and the efforts we and other organizations are making to help reach a tipping point in the arena of workplace well-being. As our colleague Chris Free so adequately stated, “To many people a ‘wellness program’ means it’s an app on your phone that if you push the button enough, you get a gift certificate to Applebee’s.” That’s not what Triskele is about, and that was never the intent of all the wellness initiatives being implemented by various insurance companies in response to the Affordable Care Act either. But why are these jokes so prevalent in the health and wellness world? Because artificial incentives and lip service programs are merely an artifact of the strangulated larger system of “profits before people” we often experience in corporate reality. We insert hopeful programs like Michelle Obama’s “Let’s Move” campaign, and the needle has microscopically shifted toward lowering childhood obesity rates. Even still, many are still faced with trending lifestyle norms that encourage us to be sedentary and isolated far more than we’d like on a regular basis (Seattle traffic, ahem!) If we are going to shift this tide, we have to step away from these conversations and wade upstream as far as possible, to collectively envision a different way of being. And a different way of working.
Let’s hold hands Red Rover style as we collectively wade our way up this turbulent stream…
My story is familiar to many in the health care community. The reason I wanted to become a nurse was to help people prevent disease and support the whole health of my patients, however they define optimal health to be. That means I listen and get to know them as a person, stepping away from my human tendency toward judgment and all the “rules” of the system (moderate cardiovascular fitness five times a week, 5-7 fruits and vegetables a day, etc. etc.) as much as possible. I wanted to be able to truly hear patients, to get to know them and connect with them on a human level, and support them in facing an illness or making personal behavior changes they identify as needing to happen.
Unfortunately our medical system does not always support this idealistic notion of patient-centered nursing I embarked on almost a decade ago. I also began under the impression that our evidence based practice research held all the answers, and that being an advanced practice nurse would just be a matter of knowing when and where to identify the best options for patients. But as Dr. Colin Champ says in the introduction of his book Misguided Medicine, “Fifty percent of medicine is wrong.” That’s right, when investigators look at large, rigorous and randomized trials over time, evidence shows that reversals in established medical practices are the norm about half of the time.
Thankfully I was re-aligned with my intention as a nurse when I began working in environmental health with a non-profit called Health Care Without Harm that focused on identifying and preventing the ways in which our health care system causes harm to our patients and planet. My world further opened after following a desire to promote self-care in nursing, so I began wellness coach trainings with Vera Whole Health and the International Nurse Coach Association. It was as if a huge light bulb went off in my head showing me how to integrate everything I’d read and understood about the mind/body/spiritual aspects of health from authors like Dean Ornish, Deepak Chopra, Jon Kabat-Zinn, Candace Pert, and Bruce Lipton. These physicians and medical researchers teach us what we innately know to be true: that genes are not our destiny, that health is intricately connected with environment, relationships, and lifestyle, and that we often underestimate the remarkable capacity of our mind and spirit to promote health and healing.
Then, when I finally met Triskele Collaborative’s visionary founder Kim Adams (also a nurse!), I knew I was in alignment with my purpose. The people and organizations that have been attracted to Triskele’s work finally feel like “my tribe”. We are looking at and health and well-being from a systems perspective and helping businesses re-design the way they do business, from the micro to the macrocosm. This group has waded far, far upstream and joined the movement of edge runners1 who have begun throwing out the life rafts. We can change the system and we are, but we need all hands on deck.
The purpose of Triskele Collaborative is to transform businesses into innovative and thriving entities by modeling living systems. We understand that in order to do this, organizations must invest in the well-being of their people, the chemicals and building blocks of living systems. We understand that when people come before profits- when we are able to identify the unique talent of each individual and care about them as people, this investment in humanity makes employees not only more engaged, innovative, happy, and healthy at work, but the bi-product is a healthier financial bottom line for the business (not to mention it’s great PR and a magnet for Millennials!).
What does this mean? Without getting too detailed, it could mean something different for each organization. As a baseline, it could be a Whole Ecosystem Health Assessment© of your business, measuring individual and group health culture, presenteeism, and engagement to find where your priority interventions lie. It could be a strategic growth plan with the executive team or helping build sustainable stress management into your employee training program. It could be focusing on individual goals with a 1:1 Triskele Catalyst Coach2 or engaging in a self-directed online smoking cessation program. Perhaps you’d like us to co-create standard operating procedures around conducting meetings or setting email boundaries within your business. It could also involve a discussion with Triskele’s insurance consultant to identify whether switching to a self-funded plan is the right strategy for your company.
At the core of Triskele Collaborative is a desire to help businesses do things differently. To shift from the “Predict and Control” machine model hierarchy to the “Sense and Respond” mechanisms inherent in living systems. This means we take your unique situation and priorities into consideration to design a well-being program that fits your one-of-a-kind organization.
Tracking the Return on Investment (ROI) of the well-being investments you make with Triskele is critically important. Another reason why many discussions around workplace health and wellness programs are so limited is that they are often reduced to exclusively tracking savings around reduced health care costs. While this is critically important, Triskele also offers systemic workplace interventions with significant ROI and capacity to improve employee and business health across the board. A snapshot of these include: 1) Emotional Wellness Programs, an estimated 116:1 to 240:1 ROI, 2) Employee Engagement Programs, estimated 300% operating margin ROI, 40% reduction in turnover, improved customer service and innovation, and 3) Process Improvement, Efficiency, Lean Technology, with a wide ROI ranges of 30-900% improvements well documented.
Many Triskele consultants have health care experience, so we look to the most efficient self-managing system the world has ever known as our guide, the human body. Our bodies have the capacity to autonomously and simultaneously perform thousands of tasks daily that keep us alive- converting food to energy, filtering air to breath, warding off harmful microbes and viruses through our circulatory and lymphatic systems, repairing wounds, rebuilding cellular matrix, and mentally responding to the world around us. Without conscious intervention, multiple organ systems function interdependently so that we can breath, move, absorb and release energy, perform cognitive tasks, engage with other human beings, and even nurture new life.
The ultimate goal of a business should be that it is organized in such a way that it can not only nurture the talent and potential of each individual employee, but also be flexible to potential threats and opportunities amidst a chaotic system.
When and how will healthy behaviors and environments become the primary driver of health- rather than what we spend on being healthy?
We are wading our way upstream because we realize we can’t wait for the system to change. We must shift our perspective, leveraging health and well-being from the inside out, rather than the opposite way around. We may also need to shift our value of health care services as the primary driver of “ being healthy.”
Our “health” is all of life as we experience it. It is having friends we communicate with and can confide in when we need to. It’s having jobs and hobbies where we feel like our lives have meaning and we are creating something for the greater good. It is knowing how and with whom we experience energy and actively seeking that joy each and everyday, not just on weekends or on vacation. This means building “health” into our workdays and understanding our well-being to be something that is energetically connected to every other living system we encounter- including the places where we work.
The Law of Diffusion of Innovations seeks to explain how, why, and when new ideas, technology, and movements spread throughout cultures. The theory communicates how new concepts are spread through channels in a social system. In this model:
- The first 2.5% of the population innovators
- The next 13.5% are early adopters (perhaps you could call them “first followers”)
- The next 34% are the early majority
- The next 34% are the late majority
- The last 16% are laggards
Innovators and early adopters are more comfortable making that gut decision based on what they believe about the world. (People will do things that prove what they believe). The law says that if you want mass-market acceptance of an idea, you cannot have it until you achieve the tipping point between 15-18% market penetration.
A few characteristics make adoption innovation more likely within an organization, which is both an aggregate of individuals and its system. They include: 1) tension for change (motivation & ability), 2) innovation-system fit (compatibility), and 3) assessment of implications.
I interpret this to mean that until we have 15-18% of businesses that adopting this living system model of organizational evolution, we may not see the tipping point that makes your workday a life-giving and health promoting experience. Nor will we connect that the health of a business is dynamically interconnected to the well-being of its people. “So how do we measure this movement?” you may ask. Contact us today. We’d love to talk with you more about it.
The time is ripe for a tipping point in health and business. The time is ripe for Triskele Collaborative.
*Disclaimer: I have yet to actually read The Tipping Point…
1Edge Runners, a term coined by Leland Kaiser referring to health futurists who push their ideas forward, often against strong resistance. The momentum and results from these people often lead to necessary and permanent changes in systems and practices. Source: American Academy of Nurses, “Raise the Voice”, (2006).
2Triskele Catalyst Coaches are our combined team of executive coaches, life coaches, and integrative nurse coaches with a collected wealth of knowledge and experience. A catalyst is any substance that helps to accelerate a chemical reaction. The team of Triskele Catalyst Coaches will work with you to target the outcome you want with the timing you need, in an individual or group context.