The Personal Path to Wellness: Why choice architecture is essential to good wellness programs

Words by Mitch Martens

Imagine you’re the administrator of a wellness program at a big hospital, like I am, and an employee comes to you requesting resources to help reduce his foreign accent. This employee is overweight and has high blood pressure, but his priority is clearing the roadblocks in his career created by the way he talks.

What do you say? As someone in the healthcare field, your instinct may be to tell the employee that he really ought to take fitness classes and antihypertensives instead of enrolling in elocution classes. That seems like the obvious priority to you. But if you really want to meet the employee where he is, the only correct response is “thank you for inviting us onto your wellbeing journey.”

Meeting your employees where they are is foundational for any wellness program that really puts them first. Too many companies do things to their employees as opposed to for their employees. And acting for your employees means traveling with them on their diverse journeys toward improved wellbeing. This approach is based on “choice architecture,” which basically means allowing your employees to choose the meaning and goal of their own paths toward wellbeing.

At Cedars-Sinai this is how we’ve been approaching wellness for our approximately 15,000 employees since 2012. We’re focused not on hitting biometric targets or financial savings goals, but on building positive experiences for our workers so they feel good working for us and are as productive and happy as they can be. Where others might talk about ROI, we talk about VOI — Value on Investment. Are we impacting the culture? Do people feel seen and cared for? Does our program help attract and retain good talent?

Building good experiences for employees requires a program with six essential components. Successful programs are empathic; they meet people where they are. They’re personalized–participant-driven, not one-size-fits-all. They’re empowering; they celebrate little wins. They simplify, with low barriers to entry and pared-down rules of engagement. They’re transparent, offering clarity about why data is collected and who will have access to it (hint: It should be a third party only). And finally, they’re situational; it’s important to recognize that “life happens” and goalposts sometimes need to shift.

Ultimately, it’s an emphatically human-centered approach to engagement, recognizing people in all of their messy, hesitant, inconsistent, striving glory. As healthcare providers, we need to remember that our business is not just “patient caring,” but “human caring.” So it follows that we care for our employees as human beings, not simply as employees.

If you’re looking at the whole human, your wellness program has to go beyond addressing only physical health. Traditionally, wellness programs provide a turn-key menu of health-related resources: a couple workout classes, fruits and vegetables in the cafeteria, a smoking-cessation program and so on.

But humans have many dimensions of well-being, and those dimensions are interrelated. At Cedars-Sinai, we account for seven in our wellness planning: emotional, spiritual, environmental, physical, social, intellectual, and occupational. For us, it’s all fair game, and we’re happy to help each employee prioritize whichever aspects of wellness will most help them achieve their life goals.

Those goals and priorities run the gamut. Here’s what we might hear: I want to go back to school. I want to get out of credit card debt. I want to learn to play the piano. I want to cut back on sugar. I want to get a divorce. I want to lose weight. I want to travel.

Our program is designed to be open, transparent, and collaborative. We want a relationship where we toss info or resources to employees, and they can feel comfortable saying “no, that’s not what I was asking for”, or “yes, good start, and here’s what I need next.” Our initial goal is to build a culture of trust and empathy; to have people thinking, “Cedars does care, and there are solutions out there. There is a place I can go to find some help.”

As a way to open the door to these types of relationships, we’ve created a website that hosts a huge array of tools and ideas for everything from men’s health to ergonomics to meditation. This platform allows employees to explore and easily tap into our resources. We’re hoping in the future to leverage technology to build a picture of what services people are looking for, perhaps even one day algorithmically tailoring content for them. But for now, we’re more focused on simply raising awareness and providing straightforward access to wellness resources, all under one roof.

The website and our other efforts in the early years of our program have focused on increasing the visibility of the program within our large organization. Success in this first stage means more and more employees being aware of the program, more and more leaders asking us to engage with their teams, and a growing feeling among staff that the hospital administration is in employees’ corner.

Once we’ve built a culture of open-ended engagement, it may well be that we guide some patients onto more structured programs that tackle common issues like back pain, weight loss, chronic conditions, and smoking cessation. These programs will still be part of a highly personalized approach to wellness involving pathways that employees choose, rather than the typical forced, carrots-and-sticks approach.

I’m often asked about how we measure ROI of our wellness programs. Of course, there are lots of ways we can do this, but at Cedars-Sinai we’re more focused on VOI or ‘value on investment’, which naturally involves more qualitative feedback. We believe wellness is not about hitting artificial milestones that the company has created to help its bottom line, but about creating a space for individual experiences, goals, and paths to better wellbeing.

I’m reminded of the old story about the girl and the starfish: A little girl is walking along a beach among thousands of starfish washed up during a storm. As she walks, she throws them one by one back into the water. A passerby says, “you can’t save them all!” The little girl pauses, thinking. “You’re right,” she says, then picks up another and throws it in the water. “But I sure made a difference for that one.

Mitch Martens is the Employee Wellness Administrator at Cedars-Sinai Medical Center. With 24 years of experience in wellness, Martens designed the Cedar-Sinai wellness program from the ground up starting in 2012. Thanks to his leadership, the program has received various awards, including the Wellness Council of America (WELCOA) Well Workplace University Certification and the American Heart Association’s Platinum Certified Fit-Friendly Certification. Cedars-Sinai was recently selected as a Work@Health worksite under a CDC-sponsored program, and Martens was named to WELCOA’s list of Top 10 Health Promotion Professionals.