The modern Canadian hospital is a service-based institution that most of us will interact with at some point in our lives. Hospitals are the research and educational centres of our health care system. In many cases, they are the point of care, although outpatient clinics and various agencies play key roles, especially in primary care.
The modern hospital has its origins in the “hospice” which was a place where people went to , or for palliative care. As medical science grew phenomenally, hospitals became the places of cutting edge procedures, emergency and long term care. Today they continue to be so, and although they exist in a time of constrained resources, hospitals continue to be central to the health care system.
The concept of wellness is somewhat more elusive, but just as important. Wellness is used to describe a state of individual health that is holistic and dynamic. Health can be holistic in the sense that it transcends the physical, and includes mental, emotional, and social dimensions. It is also dynamic in that it can respond to stressors, crises and adapt to change.
The entire notion of health has undergone a transformation in our society. At one time thought of as the absence of disease, it is increasingly being seen as the outcome of processes that enhance optimal structure, function and interaction between human beings, and their environment.
The impact on the treatment of disease, and therefore the hospital, is that a true health care system must consider the factors that generate good health, or contribute to illness. The causes of disease and the determinants of health are essential considerations for a fully functional health care system that is both effective and sustainable.
There is no doubt about it, Canadian hospitals excel at delivering state-of-the-art, timely and compassionate care. But how do hospitals themselves model and exemplify these concepts of wellness? In spite of the fact that some wellness initiatives, such as smoking cessation, have been done in hospitals and that similar good initiatives have been done well, the Canadian hospital cannot at this point in time, really be said to have the kind of leadership position in wellness programing that it does in other areas. What is the reason for this? One reason is that hospitals are primarily concerned with the extremely large task of delivering medical care. Primary care centres might be better suited to health promotion and wellness on a community level. Nevertheless, the hospital is the ideal place for organizational wellness programs to be modelled.
Organizational wellness programs are multidimensional and trans-institutional. They encompass a multifaceted approach to enhancing the wellness of all members of the organization. They might include programming such as diet, lifestyle, stress management, ergonomics, counselling, absenteeism policy and more. Ideally, this should be more than just a “cafeteria style” offering of the most popular initiatives that might interest staff. They should be part of an overarching plan that seeks to create an institutional ethos that is wellness and health promoting. The hospital is the ideal place for this because of its size, its institutional sophistication, and the great concentration of front line workers and researchers in health care.
Mount Sinai Hospital embraces the concept of organizational wellness as being vital to its mission. Recently, Mount Sinai Hospital has made significant strides in developing a wellness strategy and model. Specific components of a wellness program have been launched and a manager of organizational health and wellness has been hired.
An organization is a collection of individuals within a set of institutional objectives, operating procedures, recurrent tasks, policies, and a managerial structure. This organization itself has certain relationships, a position in society, a culture and a certain spirit or Zeitgeist that pervades it. An organizational wellness strategy must fully integrate the various facets of health, with the nature of the organization, and the programmatic methods for achieving increased wellness across the organization.
At Mount Sinai Hospital, a bold new wellness strategy named the “Pillars of Wellness” is underway. These program focal points touch upon many aspects of health, and many facets of the organization. The Wellness strategy is made up of eight pillars, with each one representing a different dimension. The pillars are: Health Promotion, Attendance Management, Disability Management and Disease Management, Health Services and Prevention, Life Balance Programs, Training and Education, Policies/Programs and Benefits and finally Culture and Environment. In conjunction with the various initiatives listed in the Pillars of Wellness strategy a program entitled “The Passport to Health- Destination Wellness” will be implemented and rolled out to all the employees at the hospital. This program will purposely remind all employees of Mount Sinai that they have a duty of self responsibility for their own health. The Passport program will also reinforce the corporate responsibility to provide education, information and new programming with the intent of assisting its employee base in achieving a level of health that is optimal. The Passport to Health program may serve the hospital well by providing a constant reminder that the health of the employee is intimately linked to the overall health of the organization.
What are the benefits for Canadian hospitals? For one, a wellness-based culture produces more, is more efficient, but in a way that is sustainable and builds for the future. Employees who enjoy greater health, more job satisfaction, and are immersed in a wellness-based organization can naturally give more of what they have to offer in their skills, energy and actual output. In 2005, we have come full circle. The hospital is not only an example of the power, speed and effectiveness of biomedical science and technology, but must now evolve into a new organizational focus on wellness. The results for staff, patients and the community will without a doubt be positive.