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Worksheet to Help You Get Started on Program Design, Implementation, and Evaluation

This worksheet was adapted from The Whole Worker: Guidelines for Integrating Occupational Health and Safety with Workplace Wellness Programsby Commission on Health and Safety and Workers' Compensation in the California Department of Industrial Relations.

  1. What are the issues at your workplace?

    Conduct a Workplace Health Assessment, gathering information from various sources:

    • Site visits
    • Employee surveys
    • Health benefits
    • Health care claims
    • CDC Health Score Card
    • For more information about how to conduct a workplace health assessment, see the CDC National Healthy Worksite Program
  2. Choose the issue (or issues) to be addressed
    Why was this issue selected?
    • High interest to your workforce?
    • Shown to be a high impact factor?
    • Other?
  3. Who will be involved?
    • Management
    • Workers
    • Benefits & human resources
    • Workers’ compensation
    • Employee health
    • Occupational safety and health
    • Other?
  4. Brainstorm options:

    • How can we make our jobs, including how work itself, safer and healthier?
    • How can our organizational policies, programs, and practices support the safety and health needs of workers?
  1. Prioritize options from the organizational categories, then consider options for supporting individual health efforts.
    Criteria to consider:
    • Cost-effectiveness of the option
    • Staff commitment necessary
    • Length of time needed to implement
    • Evidence base behind the option
  2. Identify resources

    What resources are available? What resources are needed?

    What are the barriers, and how can they be addressed?

    • Funds
    • Personnel
    • Buy in
    • Partners

    What are the barriers, and how can they be addressed?

  3. Set up a workplan and timeline

    Does everyone involved in the workplan have a clear idea of their role and expectations?

  4. Evaluation

    How will we measure success?

    • Participation rates
    • Engagement or retention rates
    • Injury/illness rates
    • Workers compensation costs
    • Medical costs
    • Turnover
    • Sick leave, etc.
    • Worker satisfaction, engagement
    • Community, family impacts

View PDF Version of Planning Worksheet

  • Page last reviewed: November 6, 2015
  • Page last updated: November 19, 2015
  • Content source:

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