EAP impact on work, relationship, and health outcomes.(Research Report)(Employee Assistance Programs)

Abstract

The employee assistance program (CAP) at Federal Occupational HeaLth (FOH) gathered outcomes data from almost 60,000 clients during the three-year period 1999 2002. Measurement of outcomes at pre- and post-EAP use was incorporated into fine standard clinical process for all clients. Outcomes included (1) work productivity as affected by the client's emotional problems, (2) productivity as affected by the client's physical health, (3) the interference of physical or emotional issues on work and social relationships, (4) perceived health status, (5) job attendance/tardiness, and (6) global assessment of functioning (GAF).

Results found statistically significant improvement from pre- to post-EAP intervention for all six measures. Unplanned job absence and tardiness in the previous 30 days decreased by an average of 1.5 days pet case, and line average GAF rose by 10 percent. Outcomes improvements were evident to a similar degree across clients with different kinds of assessed problems.

Background

Every sector of the healthcare profession must assess and evaluate whether it is providing the best care possible and producing optimal client outcomes, client satisfaction, and return on investment. The healthcare community continues to focus on outcomes measures as a means of ensuring quality of service and demonstrating value. For example, hospital and medical surgery clinic "report cards" are becoming more available to the general public; many are on independent Web sites that compare similar procedures.

In contrast, the behavioral healthcare field generally does not collect large-scale outcomes data or make such data available. Perhaps this is due to the multiple variables and difficulties in the collection, study, and reporting of outcomes information in a naturalistic environment such as an employee assistance program (EAP). These limitations, however, should not deter EA professionals from sharing outcomes evaluation methodology and data.

Federal Occupational Health (FOH), a service unit within the U.S. Department of Health and Human Services' Program Support Center, has almost 60 years of occupational health experience. Its mission is to work in partnership with its federal agency customers to deliver comprehensive occupational health services to improve the health, safety, and productivity of the federal and military workforces. Although a federal agency, FOH competes in the market for federal agency business.

FOH's EAP provides services to more than 3.3 million federal employees and family members. In an effort to evaluate and improve services and outcomes, the FOH EAP routinely assesses client health status and outcomes before and alter the use of the service.

FOH uses health status measures recommended by the Health Outcomes Institute and InterStudy (1992), which advocate assessing, tracking, and analyzing outcomes as a result of health treatment interventions. Review of client outcomes and client satisfaction responses are two of several data-driven quality monitoring processes used by FOH to expand its understanding of program strengths and weaknesses.

In evaluating client outcomes information, FOH's goals are to learn the extent to which clients show improvement, are satisfied with services received, and report increased productivity after using the EAP as well as to gain a better understanding of what activities lead to improved outcomes. The data also allow FOH'S EAP counselors to know each client's health status, available social supports, and individual situation so they can help provide better, more focused care.

This study updates and replicates an earlier FOH study that discussed aggregated health status and outcomes for clients of FOH's EAP (Selvik and Bingaman 1998). The earlier study used the same measures as the current study; but on a smaller sample and over a shorter period of time. This is a large-scale study representing a diverse range of EAP clients from across the nation over a three-year period.

The goal of the current study was to explore the extent of EAP client improvement in major outcome areas relevant to workplace performance and overall health and functioning. Data were collected over a three-year period using a standardized procedure that involved validated self report instruments and counselor-assessed measures.' The study is of …