Sustainability programming isn’t the only healthcare initiative that gets its foot in the door with the promise of cost savings. It turns out that wellness and sustainability programming have a lot in common.

Yes, the route of entry is the same, but so are some of the outcomes. Engaged staff, employee satisfaction,  and doing the right thing lead to a culture of excellence. For the design team, recognizing leadership’s commitment to employee wellness, engagement, and healthy environments can ignite design features that promote healthy environments for all.

Healthcare spending is 10% more for healthcare workers than for the general population, according to "Sicker and Costlier: Healthcare Utilization of U.S. Hospital Employees," a 2011 study released by Thomson Reuters Healthcare.

Nurses are known for taking care of others, but they aren’t as known for taking care of themselves. Often, the reality is that unhealthy lifestyles persist in environments meant for healing. Some of the biggest health issues for healthcare workers include stress, lack of exercise, weight management, and diets lacking in fruits and vegetables.

Tenet Healthcare Corp. is an investor-owned healthcare system with 57,000 employees in 50 hospitals and 100 outpatient centers across the country. For Tenet and other health systems, the value of prevention is clear.

Preventing illness directly impacts insurance expenditures and saves money. For example, Thomson Reuters researchers found that a healthcare system with 16,000 employees can save $1.5 million per year in medical and pharmacy costs for every 1% reduction in health risk, by addressing weight, diet, and exercise, and preventing diabetes and other chronic diseases.

Tenet launched its Healthy at Tenet program in 2006, after three years of providing an outsourced initiative. Tenet felt it had outgrown the contracted offerings, so the company hired Thora Khademazad as manager, health enhancement, to continue the program and take it to a new level.

Tenet connected its wellness program with its health benefits plan, helping staff make the connection between being healthy and taking advantage of healthcare benefits provided as part of their employment package.

“At some point, we need to understand that to truly reduce healthcare costs we need to promote healthy lifestyles to prevent illness—not just focus on changing benefits plan design. A healthy environment is an essential component when pursuing a healthy lifestyle,” Khademazad says.

Tenet’s wellness program strives to engage workers by making it easy to participate and offering a bit of competition and incentive. Through the Healthy at Tenet program, staff receive credits for fulfilling wellness activities and can earn up to $600 individually or $1,200 per family, per year. In order to receive credits, staffers are required to undergo a baseline health assessment followed by an annual physical exam.

Credits can be earned through participating in activities such as stress reduction programs, weight loss, chronic condition support, and exercise.

The health benefits for workers have resulted in cost benefits for Tenet, as well.

“We looked at three years of healthcare costs for our employees who were participating in the wellness program and compared them to those who were not participating. The cost trend was completely reversed—the participant costs, although higher in year one (they were going for annual physicals, taking their medications, and completing recommended preventive care),  continued to decline over the three years. The nonparticipating employees, on the other hand, had lower initial healthcare costs (they were not going to the doctor and incurring any claims), but over the three years their costs rose considerably. Perhaps wellness does pay off—not just for the employee with their improved lifestyle but also for the employer who is paying for a portion of the bills,” Khademazad says.

To further promote wellness, designers should collaborate with staff to create healthy work environments—even in challenging spaces, Khademazad says. In rural environments, grounds can be used for integrating walking trails with physical fitness stations along the path.

One hospital, where outdoor space was not an option, created a walking trail indoors through the use of visuals on ceiling tiles. This walk led staffers through less-frequented hallways and stairwells, and measured the loop distance. Khademazad describes a “stairway to health,” where the use of bright colors, music, and pictures made using the stairs a positive alternative to the elevator.

When designing break rooms, designers should consider features such as yoga space, aromatherapy, music, a connection to nature, or even a treadmill desk.

Tenet has also located its system-wide sustainability initiative in its human resources department, right next to where the wellness program is facilitated. Sustainability picks up where wellness leaves off, with a commitment to protecting the environment and recognizing the link between human and environmental health. Tenet believes that a well-informed employee is more likely to make the right decisions about health and diet, stress reduction, and making a commitment to the health of the environment.

The company has made a commitment to its staff and is committed to continuously improving upon its environmental impact. It’s with this commitment that Tenet became a sponsoring system of the Healthier Hospitals Initiative. As we continue to leverage and identify value streams for healthy environments in healthcare, we can now add wellness, human resources, and employee engagement to the picture.

The sustainability clique is growing—it used to be best friends with cost savings, but its circle of friends has expanded to include community benefit, ethics, quality, safety, and now wellness. Is there a wellness manager on your integrated design team?

For more information on Tenet Healthcare Corp., please visit Janet Brown, EDAC, can be reached at