1. Expanding More than a name change
Hello, I’m CDR Brenda Ross, Chief of Operations and Customer Services. Thank you for participating in our FedStrive Advantage training.
I’m going to go ahead and take roll call.
Thank you. Go ahead and put your phones on mute, by hitting “star 6” or pushing the mute button on your phone.
Area Nurse Managers are expected to learn this information and disseminate this training to the local sites by the end of the. The training will be pre-recorded and provided to the ANM’s for their use in training health center staff.
Now I’m going to turn it over to the Director of FOH, Dr. Gene Migliaccio who will providing welcoming remarks.

2. Welcome Gene Migliaccio, Dr. P.H. Director Federal Occupational Health
In September, we retired our BOHCS service package. In its place, we’re implementing FedStrive Advantage, as an extension of the brand of our integrated health program.
On January 1, we will begin the actual rollout of Fedstrive Advantage. This is not a simple renaming of BOHCS. Instead, FedStrive Advantage is a reinvention of how we prioritize and deliver our services.
FOH is full of many talented, hard-working people. But in many ways, our competitors in the private sector have gotten ahead of us in terms of providing integrated occupational health care and focusing on prevention and wellness. As a Federal agency serving Federal employees, we must lead those efforts.
That's the purpose of today's training - to move FedStrive forward. And that’s why we’ve made the training mandatory for all health center staff who will be delivering FedStrive Advantage.
This has been a collaborative effort, and I commend the people who have come together today to share information with you – that includes CDR Brenda Ross, your Chief of Operations and Customer Service; CDR Tom Hochberg, our FedStrive Director; and staff from the Center for Health Promotion and the Center for Health Communications. 
You're going to hear a little more from them about why we're making changes and how these changes will affect you. We have the ingredients for success, but we need your commitment to work with us in order to succeed.
The FedStrive bus is continuing its journey. We need to know that the people who are on the bus with us are committed to going where we want to go. Now is the time to get onboard, commit to this program, and understand where we're going. But be assured that you won’t be alone. Throughout 2013, we'll be helping you, with additional follow-up training and tools.
I know I can count on you to rise to this challenge. Thanks for your hard work.

3. Following this training, all health center staff will be able to:
Objectives
Following this training, all health center staff will be able to:
1. Explain the FedStrive philosophy and brand experience, and the rationale for the transition from BOHCS to FedStrive Advantage
2. Recognize the four service categories included in the new FedStrive Work Order and provide 1-2 examples from each section.
3. List the service elements associated with the S.T.R.I.V.E. acronym and perform these service elements with each health center end-user.
Thanks, Gene. Following this training, CSMs, AMAs, and ANMs will be able to: 1. Explain the FedStrive philosophy, brand experience, and the rationale for the transition from BOHCS to FedStrive Advantage.
4. List the three core health risk categories that constitute a completed Health Risk Appraisal (HRA).

4. Objectives
Following this training, all health center staff will be able to:
1. Explain the FedStrive philosophy and brand experience, and the rationale for the transition from BOHCS to FedStrive Advantage
2. Recognize the four service categories included in the new FedStrive Work Order and provide 1-2 examples from each section.
3. List the service elements associated with the S.T.R.I.V.E. acronym and perform these service elements with each health center end-user.
2. Recognize the four service categories included in the new FedStrive Work Order, and provide 1-2 examples from each section.
4. List the three core health risk categories that constitute a completed Health Risk Appraisal (HRA).

5. Objectives
Following this training, all health center staff will be able to:
1. Explain the FedStrive philosophy and brand experience, and the rationale for the transition from BOHCS to FedStrive Advantage
2. Recognize the four service categories included in the new FedStrive Work Order and provide 1-2 examples from each section.
3. List service elements associated with the S.T.R.I.V.E. mnemonic & perform these service elements with each health center end-user.
3. List the service elements associated with the S.T.R.I.V.E. mnemonic tool, and perform these service elements with each health center end-user client.
4. List the three core health risk categories that constitute a completed Health Risk Appraisal (HRA).

6. Objectives
Following this training, all health center staff will be able to:
1. Explain the FedStrive philosophy and brand experience, and the rationale for the transition from BOHCS to FedStrive Advantage
2. Recognize the four service categories included in the new FedStrive Work Order and provide 1-2 examples from each section.
3. List the service elements associated with the S.T.R.I.V.E. acronym and perform these service elements with each health center end-user.
And 4. List the three core health risk categories that constitute a completed Health Risk Appraisal (HRA). We’ll have a question and answer session once we’ve covered all this material, so please save any questions you may have until the end of the presentation.
4. List the three core health risk categories that constitute a completed Health Risk Appraisal (HRA).
Please hold your questions until the end of the presentation.

7. What Is FedStrive? Some history:
FedStrive was a by-product of a meeting hosted by President Obama in May of 2009 with several leaders of major corporations. The goal was to share best practices and the business case for worksite wellness and to reverse the prevalence of chronic disease and the impact of rising healthcare costs. The result was the Federal Employee Worksite Wellness Initiative which charged three federal agencies, including the Department of Health and Human Services with developing pilot programs to improve federal employee health. And thus FedStrive was born.

8. What Is FedStrive? FedStrive’s mission aligns with the President’s
wellness initiative:
Goals of the
FedStrive program
Keep the low-risk population at low risk
Reduce major behavioral risk factors among the moderate to high risk population
Provide evidence-based health promotion programming
Contain costs and effectively allocate resources
The mission of the FedStrive pilot program was to improve the health and wellness of the targeted federal workforce with the programmatic goals you see listed here. As you can see these are population based and preventative in nature.

9. Success of Pilot Program
What Is FedStrive?
Success of Pilot Program
Highlights: FedStrive Health Status Improvements (n = 444)
Body Mass Index – changes in overweight (- 9.4%) and obesity (- 2.1%)
Physical activity - participation in physical activity (≥ 3 times/week) increased from 56.1% to 63.0%.
Total Cholesterol % of individuals with high cholesterol levels (≥ 200 mg/dl) subsequently reduced their total cholesterol below 200 mg/dl.
Cholesterol lowering medication adherence improved by 60.8%.
Nutrition - Increases in daily breakfast consumption from 79.2% to 84.0% and overall nutrition status from 60.7% to 78.3%.
Decreases in excess stress from 18.1% to 14.9% and self-reported negative overall health effects from stress from 13.7% to 8.1%.
After only two years we’ve began to see dramatic results. In this table you see improvements in BMI, physical activity, total cholesterol and adherence to cholesterol lowering medication, nutrition, and stress reduction. We look forward to seeing similar improvements and employee engagement as we rollout FedStrive Advantage nationwide. That’s why we’re here today.

10. Expansion of the FedStrive Brand
What Is FedStrive?
Expansion of the FedStrive Brand
NOT just a renaming of BOHCS; BOHCS is dead
FedStrive brand becomes the face of integrated care at FOH
Rolling out FedStrive Advantage is NOT just a renaming of the old BOHCS program, it’s creating a new “brand experience” for end-user clients. BOHCS is history. We’re here to talk about the FedStrive brand. So what does it mean to expand the FedStrive brand? Well, let’s start with what it DOESN’T mean. It is NOT just a renaming of the old BOHCS program. What FedStrive expansion DOES mean is that FedStrive will become the face of integrated care at FOH.

11. Expansion of the FedStrive Brand
What Is FedStrive?
Expansion of the FedStrive Brand
NOT just a renaming of BOHCS; BOHCS is dead
FedStrive brand becomes the face of integrated care at FOH
Reflects the adoption of the integrated care philosophy throughout FOH
When the FedStrive brand is applied to an FOH service or product, we are telling the consumer that it incorporates our integrated care approach.

12. Expansion of the FedStrive Brand
What Is FedStrive?
Expansion of the FedStrive Brand
NOT just a renaming of BOHCS; BOHCS is dead
FedStrive brand becomes the face of integrated care at FOH
Reflects the adoption of the integrated care philosophy throughout FOH
That means our potential customers and end user clients can expect a consistent “brand experience” that separates FOH from its competitors.
When potential customers/end users see the FedStrive brand on any FOH product or service, they will know:
- What kind of brand experience they can expect
- The difference between FOH and its competitors

13. Brand Experience Prime Example: Apple When Steve Jobs returned:
“By re-establishing the core values
he had established at the beginning,
Apple again pursued a direction which was clear and different from any other companies.”
Apple Corporation is a prime example of a company that has clearly defined its brand experience. According to Jonathan Ive, a Senior Vice President at Apple, that was a key element in the success that Steve Jobs attained when he returned to take over the struggling company in As you’ll see, that brand experience applied to every facet of the way Apple does business.

14. Brand Experience Prime Example: Apple - Product Experience
- Functional attributes of the product
- How well the thing works
- Experiential features
How the production technology works
Aesthetics (design, colors, shapes of the product)
- Product Experience
- The Look and Feel
- Communications Experience
- Customer Service
It had to do with the “product experience” – how the products look and feel, and quality of production. For example, taking a holistic approach at all points of care; even during a simple blood pressure check or a flu shot. We want our end user clients to feel just as cared for whether they come in for a band-aid or a preventive health screening.

15. Brand Experience Prime Example: Apple - Look and Feel Name Logo
Signage
Packaging
Store design
Web sites
- Product Experience
- Look and Feel
- Communications Experience
- Customer Service
It has to do with the look and feel of everything from the company name and logo to the packaging and design of its stores and web sites. We want our clinics to have the FOH Mission, Vision, and Values posted. We want FedStrive and FOH materials to be displayed prominently so our end user clients can make the association between the quality of service they are receiving and the “brand experience.”

16. Brand Experience Prime Example: Apple - Communications
Advertising, B2B, & B2C
Must provide value
Must inform the customer
Must entertain the customer
- Product Experience
- The Look and Feel
- Communications
- Customer Service
It also has to do with communications that provide value, while both informing and even entertaining customers, in order to better engage them. To support you in communicating the FedStrive message; we’ve created a wealth of downloadable flyer templates that are form fill-able and easy to use. We’ll talk more about other available tools and resources later on.

17. Brand Experience Prime Example: Apple - Customer Service
“It is important not to forget the aspect of customer service in the overall brand experience. Specifically, the cradle-to-grave aspect of the customer chain should not be broken – this ensures that the “brand promise” is not broken.”
- Product Experience
- The Look and Feel
- Communications Experience
- Customer Service
Excellent customer service ensures that FedStrive clients will always experience its “brand promise.” As the public face of the FedStrive brand, all FOH health professionals play a critical role in delivering the FedStrive “brand experience.”
Now Tomas Bonome will take a few minutes to talk about exactly WHY we’re expanding the FedStrive brand, and why FOH needs you to help us provide the FedStrive “brand experience.”

18. Why Expand FedStrive? Our HRA data demands it Leading Risk Factors
For Federal Employees:
BMI
Physical inactivity
Weight
Stress
Thank you, Tom. In short, there are several important reasons. For one thing - Our HRA data demands it - BMI, physical inactivity, weight, and stress are the leading health risks faced by Federal employees across our book of business. Addressing these risks must be the focus of our services. FedStrive is designed to tackle health risks, track them, and identify new ones overtime. It's public health in action....

19. Why Expand FedStrive? Our services need to work together
Integrated Health:
“The seamless coordination
of comprehensive services
using a data-driven approach
that assists agencies in
achieving a culture of health
and high performance.”
- Our services need to work together - If challenging employee health risks are the bad news, the good news is that we already have an arsenal of staff and services to address them, but we have to talk to each other to make this work and our services have to be focused on addressing actual client health risks. 
So, what do we mean when we say talking to each other and having services work together? For example, if you're delivering a brown bag seminar on Stress Reduction, you would coordinate with the Fitness Center Staff and onsite EAP Counselor to deliver the session. The fitness center staff member would have an opportunity to introduce themselves and highlight the relevant classes like Yoga or Pilates that could help address this health risk. Likewise, the EAP counselor would be able to highlight services they provide as well. This requires proactive engagement and coordination among staff members and integration of additional services available to the specific agency. Of course, not all agencies have a complete set of services from us, but they should be included whenever possible. 
All in all, FedStrive is about proactive integration that connects services, staff, and the clients/customers we serve. It's how we translate integration into a brand experience and a value-added service delivery model.

20. Why Expand FedStrive? Delivering value for our customers
Shrinking federal budgets mean our customers must
do more with less.
- Delivering value for our customers - One of the most important reasons. In today's economic environment Federal budgets are shrinking, forcing our customers to do more with less. Less funding, less staff, and less ability to choose vendors as they look to control costs. For us to create a return on value requires driving utilization, increased utilization addresses core health risks, and reduced health risks improves employee performance. And increased performance is what they truly care about. 
Helping keep employees on the job and focused while they are there allows us to directly support their efforts to overcome the resource and staffing limitations they face. From the perspective of our customers, FedStrive will help ensure FOH services are not a "nice to have", but a "need to have".

21. Why Expand FedStrive? Because FedStrive works!
- And finally, - FedStrive works - FedStrive already has documented evidence showing it can reduce health risks for Federal employees and now is the time to take it to scale.
Now Brenda Ross will take some time to describe how the Clinical division will be doing at the ground level to help make the FedStrive brand a success for FOH.

22. How Does This Affect YOU?
Thank you Tomas. At this point, you’re probably wondering: How does all this affect me, and how will it change my day-to-day operations? I’m going to guide you through some of the answers to those questions.

23. Refocusing Mostly a change in priorities Prevention
Population-based health
Partnering with FOH staff
First, let me reassure you that we are not changing everything. In fact, we’re mostly just re-prioritizing the services that you already provide. You’ll continue to perform the services that you’ve been trained to deliver, but with a heightened emphasis on prevention, on population-based health (such as data provided through the HRA), and on partnering with other FOH (and in some cases non-FOH) health professionals at your location.

24. Refocusing Mostly a change in priorities Prevention
Population-based health
Partnering with FOH staff
Clinical will not be the only division that will be going through this training. But we’re starting with Clinical because it is the largest division within FOH, and it is the division with which our end user clients have the most personal experience.
Clinical not doing this alone
Every division will be trained to “own” the brand experience

25. New Work Order Priority Items Get the “Green Light”
We have created a new statement of work based on FedStrive Advantage priority areas. You should have received a draft of this document in the invite. I’ll give you a moment to refer to it now.
The items in green are a priority. Special focus should be paid to these services. Items in yellow are second priority, and items in red are the lowest priority. Let’s take a closer look at the top priority items in green.

26. New Work Order - Health counseling based on HRA and biometrics
- FOH3 is also being revised
Consistent with our goals of stressing prevention and population-based health, our highest priority is given to conducting a Health Risk Appraisal, gathering biometrics, and using that information to guide individual education, coaching, counseling, and referrals.

27. Referrals Expanded on new work order
Promote all services lines when appropriate / available
Referrals are another priority area in the new Work Order. By looking for opportunities to educate, counsel, coach, and refer clients based on their needs, you will be improving customer service and helping to provide a quality “brand experience.”
Again, the items in green are the first priority bundle of services to emphasize.

28. Health promotion classes/webinars
New focus
Consistent content
Partner with other staff on-site
Health promotion classes or webinars are still available to help clients stay healthy or change risky behaviors. However, these classes focus on NCQA wellness and health promotion health risks that are also are of greatest impact on health and productivity among the population we serve.
Standardized content will be developed and utilized for all of these classes to help maintain the “brand experience” and may be offered on-site or on-line. In addition, the scope of practice covered within these topics is varied. For example, risky drinking and depressive symptoms. Utilization of subject matter experts for these classes is still appropriate.

29. QA tracking
A chance to get credit for many things you’re already doing without getting any credit
Look at metrics and accountability
Will translate well to EHR
We know that many of you are already doing a lot of what has been outlined in the WO. This new WO provides you with the opportunity to document much of the work you’ve been doing already. In addition, we are working to capture programmatic metrics so that we can measure the success of the FedStrive Advantage program; similar to the FedStrive pilot program highlights described by Tom. QA tracking will assist us during the transition to an Electronic Health Record that will be coming in the near future.

30. What’s Going Away Deprioritizing — Based on national guidelines:
Prostate Surface Antigen (PSA) screening
Pulmonary function testing (PFT)
Auditory testing
TB screening
Reprioritizing – Focus on population-based health
So what is going away? Based on national guidelines, CDC and U.S. Preventive Task Force, we have deprioritized PSA, pulmonary function testing, auditory testing, and TB screening. These screenings are still available via fee-for-service. Clinical Service Managers can arrange for the provision of these services.
Again, the focus of FedStrive Advantage is on population-based health!!
Now Tom is going to cover the FedStrive Advantage rollout timeline.

31. Timetable
FSA – Overview Training)
FSA – Training(all HCs)
Thank you CDR Ross. The timetable for the roll out of FedStrive Advantage is illustrated here.
December 31st is when all initial FedStrive Training should be completed. A recording of this presentation will be available for Area Nurse Managers to ensure that all clinical staff under their purview receive this training by December 31st. You have flexibility to accomplish this in a way that works for you and your staff.
January 1st is the official launch and the rollout will continue through Fiscal Year There will be more trainings throughout the year as deliverables and capabilities are developed.
FSA – Training (all HCs)
FSA – Training (all HCs)
Jan – Sept 2013: Ongoing FedStrive Advantage Training

32. Support Online toolkit at: fedstrive.foh.hhs.gov/toolkit
To support your transition to FedStrive Advantage we created an on-line toolkit that includes downloadable materials such as the ones listed here. Let me walk you through the four sections of the toolkit.

33. Toolkit Information on FedStrive Expansion and Integration
The “be informed” section provides you with important materials to further explain FedStrive. These include answers to Frequently asked questions, talking points for the nurses to use with end user clients and agency points of contact, as well as steps to integration.
Also, this presentation will be posted within this section of the toolkit.
Information on FedStrive
Expansion and Integration

34. Toolkit Materials to help you Plan and run events
The “be prepared” section offers all of the resources you will need to plan and manage FedStrive events. I would especially encourage you to become familiar with the event planning guide.
Materials to help you
Plan and run events

35. Toolkit Materials to help you disseminate information
The “be ready to share” section provides materials to help disseminate information with important stakeholders; for example, the wellness committee guide you see here. It also includes a guide to using FedStrive social media resources.
Materials to help you
disseminate information

36. Toolkit Presentation materials
Lastly, we have a section dedicated to presentation materials. These materials will be invaluable in delivering the health education seminars and other health promotion activities.
Presentation materials

37. S.T.R.I.V.E. Survey client health risks
Apply this tool with every client to guide you in “owning” the clients’ brand experience.
Survey client health risks
Talk about results and concerns
Recognize willingness to change behaviors
Integrate services towards a measurable goal
Validate the plan, address interests and needs
Encourage return for follow up
Thanks Tom. We've shared a lot of new information with you and to tie up I want to let you know that we're not asking you to learn a whole set of new tasks and procedures, but rather to re-prioritize some of the work you already do and focus on how it is delivered. That's the power of a brand and the surest way to develop brand loyalty among our clients and customers. And don't worry we're going to help you with training along the way.
To start we've develop a short pneumonic device. It's called STRIVE and each of the letters stands for a critical step in delivering the FedStrive experience to our clients. It also ties into the elements of the revised work order shown earlier.

38. S.T.R.I.V.E. Survey client health risks
Apply this tool with every client to guide you in “owning” the clients’ brand experience.
Survey client health risks
Talk about results and concerns
Recognize willingness to change behaviors
Integrate services towards a measurable goal
Validate the plan, address interests and needs
Encourage return for follow up
S - Survey client health risks.
Survey the risks using the HRA and biometric tools as part of the "Annual Awareness Assessment". You may already doing some these tasks for clients on a routine basis. When you do, be sure to include the other annual assessment elements for them and proactively encourage their participation.

39. S.T.R.I.V.E. Survey client health risks
Apply this tool with every client to guide you in “owning” the clients’ brand experience.
Survey client health risks
Talk about results and concerns
Recognize willingness to change behaviors
Integrate services towards a measurable goal
Validate the plan, address interests and needs
Encourage return for follow up
T - Talk about results and concerns
These are the items listed under the Individualized "Education, Counseling, and Coaching Section". You have objective evidence of a health risk and their attention. Now is the time to discuss what the results mean, their concerns, and challenges they face.

40. S.T.R.I.V.E. Survey client health risks
Apply this tool with every client to guide you in “owning” the clients’ brand experience.
Survey client health risks
Talk about results and concerns
Recognize willingness to change behaviors
Integrate services towards a measurable goal
Validate the plan, address interests and needs
Encourage return for follow up
R - Recognize willingness to change behaviors
Is there an area they are most interested in or perhaps they have some sensitivities? If you know their concerns it's easier to select a course of action. For example, if a client has a high BMI and a high stress level, but doesn't warm up to the idea of going to the fitness center to address their weight, change the course of action. We know that weight can be a polarizing issue, but something like stress is a common risk we all experience. In fact, the monthly health campaigns targeting stress and overall mind/body well being consistently have the highest number of website page views. Generally, clients are interested in reducing stress. Would stress reduction be a good way to promote physical activity? 

41. S.T.R.I.V.E. Survey client health risks
Apply this tool with every client to guide you in “owning” the clients’ brand experience.
Survey client health risks
Talk about results and concerns
Recognize willingness to change behaviors
Integrate services towards a measurable goal
Validate the plan, address interests and needs
Encourage return for follow up
I - Integrate services toward a measurable goal
Integrate the services based on willingness to change that are contained in the "Referrals" and or "Health Risk Reduction Seminars" section of the work order . Considering the example that I just mentioned, you could advise the client to attend a yoga class at the fitness center to help reduce stress levels. It's focused on an area of interest, yet addresses two health risks at the same time. There may be other seminars, webinars, or resources that you could introduce as well. Finally, suggest a goal they can realistically achieve. This could be simply enrolling in a fitness class, or loosing 15lbs. It all depends on them.

42. S.T.R.I.V.E. Survey client health risks
Apply this tool with every client to guide you in “owning” the clients’ brand experience.
Survey client health risks
Talk about results and concerns
Recognize willingness to change behaviors
Integrate services towards a measurable goal
Validate the plan, address interests and needs
Encourage return for follow up
V - Validate that the plan addresses interests and needs.
This is just providing solid customer service. It's making sure they are satisfied with the outcome of the consultation.

43. S.T.R.I.V.E. Survey client health risks
Apply this tool with every client to guide you in “owning” the clients’ brand experience.
Survey client health risks
Talk about results and concerns
Recognize willingness to change behaviors
Integrate services towards a measurable goal
Validate the plan, address interests and needs
Encourage return for follow up
E - Encourage return for follow-up.
That could be for their next annual visit, for questions or encouragement, or for other work related health needs. Again, it's good customer service that helps support the brand.

44. S.T.R.I.V.E. Survey client health risks
Apply this tool with every client to guide you in “owning” the clients’ brand experience.
Survey client health risks
Talk about results and concerns
Recognize willingness to change behaviors
Integrate services towards a measurable goal
Validate the plan, address interests and needs
Encourage return for follow up
 In delivering this approach the objective is not to define exactly how you address their risks or needs, but to define the sandbox. You are all highly trained health care professionals and we want you to own your client's experience, and commit to resolve their health risks to the very best of your abilities. In doing so you have our trust that you'll make the best decisions possible.

45. Thank you Tomas. This concludes the presentation.

46. Housekeeping Location of recorded training
Fedstrive.foh.hhs.gov/toolkit
ANMs will be provided an template they can use to inform clinic nurses about how to take their training, how to access today’s presentation, and how to take a short follow up quiz.
For future questions about FedStrive Advantage, staff should be directed to follow their chain of command.
Before we start our Q&A session we have a few housekeeping topics to discuss.
As you know this training was recorded and will be posted for your use on the FedStrive toolkit page. We will also provide a survey for your use while training health center staff. This quiz will assess the ability of participants to meet the learning objectives outlined by this training and will verify that it has been completed.
For future questions about FedStrive Advantage staff should be directed to follow their chain of command.

47. S.T.R.I.V.E. Survey client health risks
Apply this tool with every client to guide you in “owning” the clients’ brand experience.
Survey client health risks
Talk about results and concerns
Recognize willingness to change behaviors
Integrate services towards a measurable goal
Validate the plan, address interests and needs
Encourage return for follow up