Presenteeism is a concept many in the field of occupational health consider to be significant but difficult to quantify – somewhat akin to catching lightning in a bottle.
It means being present but not fully productive at work, primarily because of intervening physical and/or mental health conditions.
While there are a number of approaches being used to measure the impact of presenteeism in the U.S. workplace, findings remain inconclusive. In response, the American College of Occupational and Environmental Medicine (ACOEM) and the Integrated Benefits Institute (IBI), an organization that works with employers to demonstrate the business value of health, are preparing to test the reliability of survey instruments used by supervisors and employees to rate productivity.
The ACOEM-IBI study is a byproduct of an investigative process launched in November 2008 when more than 40 leaders from public and private sector organizations convened in Santa Ana Pueblo, NM, for a national summit on health and productivity management (HPM). Summit participants issued 10 consensus statements and a series of recommendations in 2009, including a call to examine presenteeism as a tangible factor affecting the bottom line.
Kenneth Pelletier, M.D., Ph.D., of the University of California, San Francisco School of Medicine, and the University of Arizona School of Medicine, reported at the recent annual American Occupational Health Conference sponsored by ACOEM that study objectives include:
- assessing the reliability and length of survey instruments such as short questionnaires;
- evaluating the validity of specific measures of employee performance;
- identifying factors that contribute to variability in results;
- estimating the cost of absenteeism and presenteeism beyond wage replacement;
- calibrating measurement ranges/scales used in self-report instruments; and
- converting performance measures to ratios such as days lost to dollars lost.
“We have found that some self-report tools work better than others at detecting degrees of presenteeism,” depending on their purpose or application, Dr. Pelletier said. “We need to develop methodologies to determine relationships between scores generated by self-assessed health-related work performance surveys to supervisor evaluations and employee work performance.”
Productivity Measurement Tools
Companies need new and better tools for measuring employee productivity to “highlight important productivity measurement issues for consideration in an overall business strategy,” according to an article by Steve Schwartz, Ph.D. of Health Media, Inc., and John Reidel, M.P.H., M.B.A., of Reidel and Associates.
They outline key issues in the design and use of productivity measurement tools with real-world applications in an article published in the Journal of Occupational and Environmental Medicine. (Refer to Productivity and Health: Best Practices for Better Measures of Productivity, S Schwartz, J Riedel; JOEM, 52(9):865-871, September 2010.)
The ability to identify the “best” tool for measuring productivity depends on how and why the information will be used. “Descriptive measurement” looks at the effects of health on worker performance, while “comparative measurement” examines the impact of various health risks and conditions. A third category, “evaluative measurement,” focuses on changes in productivity over time – a critical consideration in judging the benefits of employee health programs.
Companies need norms or benchmarking data to evaluate health and productivity improvements that can be realistically achieved. In addition, some way of monetizing the productivity impact of health conditions, and the potential for improvement, is necessary to assess the effect on the bottom line, the authors said.
Worker health and productivity data also must be formatted in a way that makes it usable by decision-makers. Dashboard formats are considered a particularly promising approach because they present data in a concise manner.
The authors said they hope their article will help prompt the maturation of high-utility instruments for measuring worker productivity, and for using the information to improve worker health and the financial outlook for employers.
