Ruby Savage, BSN, RN, COHN-S, an alum of the Colorado School of Public Health Total Worker Health® certificate program, reflects on her work to integrate TWH concepts into health and safety strategies as an occupational health nurse at a heavy industry worksite. Her approach emphasizes active worker engagement and cross-departmental collaboration, creating a cohesive and supportive environment that promotes the overall well-being of the industrial workforce.
As an occupational health nurse at a heavy industry worksite, I know that worker health and safety are at the heart of every interaction. In many organizations like mine, key departments such as benefits, safety, industrial hygiene, and occupational health are tasked with managing the health and safety of employees. However, despite our shared goal of ensuring the health and safety of our workforce, our efforts often remain siloed. This can lead to duplicated efforts that waste time and resources, delays in solving cross-departmental challenges, and inconsistent or even conflicting approaches among departments, ultimately hindering the effectiveness of our programs and limiting their positive impact on workers.
Over the past year, I completed the Total Worker Health® certificate program through the Colorado School of Public Health at CU Anschutz Medical Campus. This program, a collaboration between the Center of Health, Work & Environment, and the Department of Environmental and Occupational Health, equips participants with the tools to implement Total Worker Health (TWH) concepts in the workplace. TWH approaches include policies, programs, and practices that aim to holistically identify and address worker needs, integrating occupational safety and health with overall worker well-being.
This educational experience has deepened my understanding of how to enhance worker quality of life. By expanding our focus beyond traditional occupational health and safety, we can incorporate broader organizational strategies that promote meaning, fulfillment, and positive health outcomes for employees. This holistic approach underscores the interconnectedness of work factors and the collective effort needed to implement effective company programs. While I am just beginning to introduce and integrate TWH concepts at my worksite, I am eager to share my experiences during these early stages.
Engaging the Worker Population
One of the foundational elements of implementing TWH is engaging with the workforce. To truly understand and address workers' needs, it is essential to involve them in identifying their health concerns and developing practical and effective solutions. This engagement ensures that the programs we design are relevant, accessible, and beneficial to all employees, regardless of their role or work environment.
Workers are uniquely positioned to understand the relationship between work and personal needs and to express their interests and preferences. For example, while office-based staff might prefer single large events like a health fair, shift or field workers in heavy industry may benefit more from alternative events or activities accessible at various times and locations. Incorporating worker feedback is crucial in designing programs that workers will actually use and benefit from.
At my organization, we have several avenues to facilitate discussions between frontline workers and leaders, including a health and safety committee and toolbox talks. Onsite medical personnel also utilize individual-level opportunities, such as during routine medical appointments, to discuss the use of existing programs and workers’ ideas for new ones.
Leaders also play a central role in TWH by demonstrating engagement, modeling desired behaviors, and encouraging worker participation. By continuously seeking and incorporating worker feedback, leaders can support follow-up efforts to assess what is working and what can be improved. It is important to remember that leaders themselves are employees with specific needs. Therefore, targeted communication, resources, and programs to support them should also be included in the TWH approach. My organization is implementing training to empower leaders to utilize available resources and better support their teams and themselves. My role involves conducting thorough needs assessments for occupational health programs and developing and delivering a plan to ensure efficiency and clarity for program users.
Operationalizing the Approach
Turning TWH concepts into tangible actions requires a thoughtful and strategic approach. The key to success is integrating these concepts gradually, using existing platforms and processes to introduce meaningful changes that resonate with employees and leaders. By focusing on incremental improvements, we can build a solid foundation for a more comprehensive and effective TWH program.
In my role as an occupational health nurse, my approach to integrating TWH concepts is to implement small changes rather than attempting to introduce new programs rapidly. By leveraging existing programs and interconnected areas of work, I have begun to introduce TWH practically. For example, I’ve taken immediate steps to improve and expand health communications by targeting specific audiences, seeking feedback for clarity and relevance, and ensuring that messages are delivered through channels that effectively reach frontline workers and office-based staff. Occupational health department communications are now being integrated into broader health and safety communications, including those from leaders, to demonstrate cohesiveness and support.
While my organization excels in some areas of worker health, particularly in offering supportive benefits programs, there are always opportunities for improvement. For example, I am now partnering with our Benefits team to align my department’s health education material with a new company benefit program. When the Benefits team announces a new resource related to nutrition, the occupational health team will provide educational materials that highlight this program, creating a coordinated effort that reinforces the importance of this topic, empowers workers to action, and encourages broader collaboration in the future.
I am also actively seeking opportunities to better understand other departments’ processes, needs, and barriers within my heavy industry worksite. My focus is on closing knowledge gaps for all parties involved. This includes attending departmental meetings for focused discussions and initiating interactive, end-to-end process reviews across departments for optimization. Strengthening this foundation will position the organization for more interconnected approaches across departments and foster alignment for improvement initiatives or new programs.
Expanding the Traditional Focus
Integrating Total Worker Health approaches at a heavy industry worksite involves expanding the traditional focus on health and safety to embed worker well-being into policies and practices. It requires active involvement from all levels of the organization, cross-departmental collaboration, effective communication, and continuous improvement. By applying the knowledge gained through the Total Worker Health® certificate program at the Colorado School of Public Health, we can create a healthier, more fulfilling work environment for all employees.
