MEMO

To: Remington Sprague, Chief Medical Officer

From: Summer Pike, ENG 321 student at Ferris State University
Date: July 14, 2014
Subject: A Recommendation Report for Associate Health
Assignment Purpose:
The purpose of this assignment is to explain to the Mercy Health Senior Leadership Team about
how the current associate health practices at Mercy Health present an unmet need that requires
action.
Result Summary:
Currently, Mercy Health Muskegon is lacking a comprehensive associate health program with
the fundamental structure to support and manage their employees, organization, and the
community adequately, due to a lack in ownership for associate health, which currently puts the
organization at risk to pay higher healthcare costs while also suffering from a decrease in
productivity.
It will not come as a surprise as to why the current state of associate health is where it is today,
given the following contributory causes: a poor history of previous associate health ownership by
any one dedicated department, the varying levels of priority and organization around which
departments to merge and when, and the lack of communication about a new Mercy Health
Workplace Health (WPH) endeavor. Understanding the background and reason to why the
current situation is presenting to MH is a vital component to understanding the next steps, as
well as identifying the organizations current state.
In order to effectively address the current associate health unmet need within MH, I recommend
hiring a full time qualified registered nurse to support and re-develop the current associate health
program.

Contact Information:
Summer Pike
O19Summer@aol.com
231-744-5006

A Recommendation Report for Associate Health

Submitted by Summer Pike
Submitted to Remington Sprague, Chief Medical Officer
July 14, 2014

Abstract
This report was prepared to inform the Senior Leadership Team at Mercy Health
Muskegon about an unmet need within the organization. Through various reference materials,
personal communications, and general experience and knowledge regarding associate health and
Mercy Health Muskegon I have identified an unmet need in at Mercy Health Muskegon
surrounding the topic of associate health.
Currently, Mercy Health Muskegon is lacking a comprehensive associate health
program with the fundamental structure to support and manage their employees, organization,
and the community adequately, due to a lack in ownership for associate health, which currently
puts the organization at risk to pay higher healthcare costs while also suffering from a decrease
in productivity.
It will not come as a surprise as to why the current state of associate health is where it is
today, given the following contributory causes: a poor history of previous associate health
ownership by any one dedicated department, the varying levels of priority and organization
around which departments to merge and when, and the lack of communication about a new
Mercy Health Workplace Health (WPH) endeavor. Understanding the background and reason(s)
to why the current situation is presenting to MH is a vital component to understanding the next
steps, as well as identifying the organizations current state.
In order to effectively address the current associate health unmet need within MH, I
recommend hiring a full time qualified registered nurse to support and re-develop the current
associate health program.

Introduction
The American Association of Occupational Health Nurses (2014) stated, Poor employee
health costs business about $1 trillion annually, so business executives look to occupational and
environmental health nurses to maximize employee productivity and reduce costs through
lowered disability claims, fewer on-the-job injuries, and improved absentee rates (History
section, para. 2). In 2008, the only two hospitals in Muskegon, Michigan, Mercy Health Partners
and Hackley Hospital, merged forming Mercy Health Muskegon (MH). During the time of the
merger, both hospitals varied in practices surrounding associate health policies and procedures.
As the merger continued, the lack of structure and inconsistencies surrounding associate health
would become exacerbated, and the inability to properly support the well-being of MH
associates, the organization, and the community would become an unfavorable gap for Mercy
Health. Currently, Mercy Health Muskegon is lacking a comprehensive associate health
program with the fundamental structure to support and manage their employees, organization,
and the community adequately, due to a lack in ownership for associate health, which currently
puts the organization at risk to pay higher healthcare costs while also suffering from a decrease
in productivity. In the following report, I will discuss: background information, the current state
including a conclusion, and a recommendation to support a future business plan for an Associate
Health Program.
Background
During the merger, when hospital departments began to consolidate, associate health
would unquestionably and consequently be overlooked. Throughout my research, I was able to
identify some historically significant factors that would contribute to the lack of oversight
regarding associate health during the time of the merger. The following identified causes will
help to explain why a gap within the organization and associate health has occurred, they are: a
poor history of previous associate health ownership by any one dedicated department, varying
levels of priority and organization around which departments to merge and when, the lack of
communication about a new Mercy Health Workplace Health (WPH) endeavor.
Ownership
A poor history of previous ownership by any one dedicated department in supporting
associate health would become extremely transparent as the merger progressed. Mercy Health
Partners would consist of approximately 2196 associates, and Hackley Hospital would consist of
approximately 1235 associates. Lori Kinder, Infection Control Practitioner for Mercy Health in
Muskegon states that, Prior to the merger Hackley associates would see Joanne Schwalm,
Hackley Infection Control Practitioner, for exposures and immune tracking or go to Workplace
Health but there was never any structure. (Personal communication, June 18, 2014) She then
goes on to explain a similar scenario about Mercy Health Partners prior to the merger, stating

that Kirk Atton, Infection Control Practitioner, minimally worked with associates regarding
exposure and immune tracking, and that the Human Resource department and the Occupational
Health Clinic kept all associate records. Associate health has never been managed or been given
ownership to any one department making it extremely difficult to support and manage.
Merger Planning
During strategy, and other various merger discussions, an implementation plan was made
that separated associate healths three supporting structures; Workplace Health, Infection
Control, and Human Resources. The first of the three departments to merge within the new
Mercy Health platform would be Human Resources, beginning right away in 2008. Next, in
2010, Hackley Workplace Heath and Mercy Occupational Health would merge to form the
new Mercy Health Workplace Health. Finally, in 2012, the Infection Control department
would merge and join as one office, combining their policies and procedures. The varying levels
of priority and organization around the merger would contribute to the loss of attention
surrounding the future of associate health.
Workplace Health a New Endeavor
After the merger, the organization was not only planning the merger between Hackley
Workplace Health and Mercy Occupational Health departments but they were also cultivating a
significant regional strategic plan; a plan that would have WPH serving as a vendor to local West
Michigan businesses, generating revenue by servicing the occupational and environmental needs
of the Grand Rapids and Muskegon workplace market, and specializing in the treatment of workrelated injuries. This type of endeavor would focus more on the outsourcing of their services to
local businesses, and less on a focus for servicing their own internal workforce.
Discussion
Why Now?
As the Partnership for Prevention organization reports, in Healthy Workforce 2010 and
Beyond (2009), The new consensus is that current and future spending in employee health is not
only unsustainable, but also poses a significant threat to the overall competitiveness of American
businesses within the global marketplace (p. 2). Currently, according to Mike Weesies, Director
of Mercy Health Workplace Health in Muskegon, Mercy Health - Muskegon spends
approximately 8 million dollars per year on short term disability (STD) claims and
approximately $800,000 in workers compensation claims per year (Personal communication,
June 20, 2014). If we want to continue to evolve as an organization, the importance of associate
healthcare prevention and management within Mercy Health will need to be addressed. The fact
that we spend an enormous amount of money, 8 million dollars per year, in short term disability
claims without any rational to substantiate the cost, is illogical and unsustainable. By providing
our associates with a comprehensive associate health program we will be able to improve our

productivity and reduce our own healthcare costs. Breedlove (2011) wrote a similar supporting
statement in an article for the Centers for Disease Control and Prevention stating,
When we invest in prevention, the benefits are broadly shared.
Individuals benefit: workers stay productive and healthyboth inside and outside
the workplace.
Businesses benefit: a healthier workforce reduces longterm healthcare costs,
increases stability and productivity, and improves global competitiveness.
Communities benefit: a community that offers a healthy, productive, stable
workforce is a more attractive place for families to live and for businesses to
locate.
Departments, such as Human Resources and Workplace Health, have the potential to
support an associate health position based on their potential to recoup the money that is currently
being spent on preventable cost services and warrant looking into further. For example, if Mercy
Health spends 8 million dollars per year in short term disability claims, and hires an Associate
Health Nurse, at $75,000 per year, to reduce those claims by 5% - 10% or $400,000 - $800,000
then, MH could get a 5% reduction rate on their healthcare expenses. So if MH pays 400 million
in salary expenses and 20% of that is for healthcare expenses (80 million), 5% of that is $4
million!
Cost savings isnt the only advantage to an Associate Health Program. Through
passionate dialogue Weesies and I were able to brainstorm some of the pros and cons an
Associate Health Program may present. Below is the list of possible opportunities that present a
low risk when considering the employment of an associate health nurse to develop a
comprehensive managed Associate Health Program.
PROS

Appropriate triage to Emergency Department, Urgent Care, and Primary Care.

An extension of Mercy Primary Care (rotating office)
Increase associate satisfaction (priority scheduling for our own associates, family
services, phone triage, immediate nurse visits, etc.)
Building of physician relationships through Patient Centered Medical Home
Build relationships/supports department/office managers.
Help increase/maintain capacity within the county as the shortage of primary care
providers increase.
Increase in-network referral opportunities.
Large decrease in healthcare cost/premiums (primary prevention, triage of appropriate
care)
Increase productivity (supervised on the job assignments vs. being at home, oversees the
return to work process Family Medical Leave Act and STD).

Potential big impact proposition low risk

Compliance with Joint Commission, Center for Medicare and Medicaid Services, HFAP,
or Michigan Occupational and Safety Health Administration standards.
CONS

Director/manager buy-in for a no charge for departments accepting transitional duty

associates.
Union bargaining issues
Department allocation and funding
Conclusion

It will not come as a surprise as to why the current state of associate health is where it is
today, given the following contributory causes: a poor history of previous associate health
ownership by any one dedicated department, the varying levels of priority and organization
around which departments merge and when, and the lack of communication about a new
Mercy Health Workplace Health (WPH) endeavor. Understanding the background and reason(s)
to why the current situation is presenting to MH is a vital component to understanding the next
steps, as well as identifying the organizations current state.
Currently, Mercy Health Muskegon is lacking a comprehensive associate health
program with the fundamental structure to support and manage their employees, organization,
and the community adequately, due to a lack in ownership for associate health, which currently
puts the organization at risk to pay higher healthcare costs while also suffering from a decrease
in productivity.
Recommendation
In order to effectively address the current associate health unmet need within MH, I
recommend hiring a full time qualified registered nurse to support and re-develop the current
associate health program.

References
American Association of Occupational Health Nurses. (2014). Careers. Retrieved from
http://www.aaohn.org/careers/profession-of-occupational-environmental-health-nursing.html
Breedlove, B. (2011, May 16). Investing in Prevention Improves Productivity and Reduces
Employer Costs. Retrieved from: http://www.cdc.gov/policy/resources.html
Partnership for Prevention. (2009). Healthy Workforce 2010 and Beyond: An essential health
promotion sourcebook for both large and small employers. Retrieved from
http://www.prevent.org/Topics.aspx?eaID=1&topicID=52