Quest Diagnostics Case Study

Quest Diagnostics, one of the world's leading clinical labs, runs about 150 million diagnostic tests each year, including cholesterol tests, Pap smears, HIV screenings, and drug screenings. Quest Diagnostics also performs genetic screenings and anatomic pathology testing and works with drug companies to perform clinical trials. The company employs approximately 43,500 people in the U.S. and has more than 2,100 patient service centers where samples are collected, along with about 30 primary labs and 150 rapid response labs throughout the U.S., Mexico and the U.K.

Key Observations

The leadership of Quest Diagnostics made a commitment, as a healthcare company, to "walk the talk" when it comes to the health of its employees. In 2005, the company launched its health and wellness initiative, known as HealthyQuest, which included promoting a new tobacco cessation program and phasing in tobacco-free campuses. The tobacco cessation component of HealthyQuest has been so successful that since the program's inception, the company has seen the initial 16.5 percent of employees who used tobacco decrease by one percent annually, and more than 2,800 employees have joined their tobacco cessation program since it was launched.

One of the distinguishing features of Quest Diagnostics' health and wellness initiative is that it taps employee talent to help promote the program. Each business unit has its own health promotion team with volunteer leaders assigned to address each initiative, one of which is tobacco cessation. The volunteer program is popular with former tobacco users and with those who want an extra incentive to quit by serving as a leader for their colleagues. There are now approximately 400 health promotion team leaders of all specialties throughout the company, all volunteering varying amounts of their time to improving the health of Quest Diagnostics' employees. Click here to see the HealthyQuest Leader job description Quest Diagnostics shared with potential volunteers.

Employee communications played an integral role in the success of Quest Diagnostics' program implementation. Brochures on tobacco cessation were distributed to employees at each location, and the company provided a wealth of program information through the intranet. A national voicemail went out to all employees, and articles about the program were included in newsletters and the company magazine. Some locations also held "lunch and learns" featuring presentations from organizations like the American Heart Association. The company also began promoting its health risk assessment (HRA), called Blueprint for Wellness™, as a means of getting people involved in their own health management, including understanding the effects of tobacco use. As a result of their promotions and a newly implemented incentive, over 29,000 people took an HRA in 2005 — up from fewer than 11,000 in 2004, the highest participation amount prior to the launch of HealthyQuest.

Through HealthyQuest, employees can access an array of programs designed to help them move to a tobacco-free lifestyle, including services provided through Free & Clear^®, the company's tobacco cessation vendor partner. Quest Diagnostics pays for 100 percent of the cost of counseling and nicotine replacement products such as gum and patches to both full-time and part-time employees, their spouses and domestic partners, and their eligible dependents. Employees who prefer to use a prescription cessation medication must discuss this option with their personal physician and have the medications prescribed by their physician. They are then responsible for any applicable copayment or coinsurance amounts. Additionally, employees who call the employee assistance program and express a desire to quit tobacco can be soft-transferred to the tobacco cessation vendor. Quest Diagnostics' tobacco cessation vendor estimates that employers can expect to pay between $300-$400 per enrollment for services including telephone counseling, Web site use, communication materials, and medications.

In addition to adding their tobacco cessation program, Quest Diagnostics took a two-phased approach to implementing tobacco-free policies at its 32 business units. Phase I involved locating any designated smoking areas at least 50 feet away from an entry or walking path. Phase II was the implementation of a 100 percent tobacco-free policy. The goal was for 80 percent of business units to reach Phase I by the end of 2007. Not only was this goal met, but many of the locations chose to implement the Phase II tobacco-free policy instead. After less than two years, 16 of 32 business units are now 100 percent tobacco-free. Phase II is not mandated on a national level, but has been implemented on a site-by-site basis due to word-of-mouth among location leaders and a positive response from employees. The Tobacco Cessation Leaders have been very effective in providing support and leadership on the company's behalf as the tobacco-free policies have been implemented. According to Ms. Bontempo-Ziegler, "If you're updating policies, you have to provide communications and support to employees to help them adapt."

Measuring Success

Aside from seeing a one percent reduction in tobacco users each year since the start of the program, or about 1,000 people, Quest Diagnostics has also experienced positive feedback from program participants. The company has received a number of moving testimonials. One employee wrote:

"I just wanted to send a quick note with a positive outcome from the new smoking policy. I have smoked on and off since I was 19 (I am now 36). I stopped for 2.5 years to get pregnant but started again six years ago. I have wasted thousands of dollars on cigarettes and get sick at least once a year because of my smoking. I always plan on quitting, but never get around to it. There is always some stressful life event coming up and I needed a smoke. The new no smoking policy forced me to make a choice. In late January I handed over my last pack of cigarettes and lighter to our pathologist, and have been smoke-free ever since…THANK YOU! I owe you a huge debt of gratitude."

Testimonials like this one are shared with employees to help reinforce the positive effects of the company's tobacco-cessation program.

Additionally, the tobacco cessation leaders receive a weekly report from their tobacco cessation vendor that tracks the number of people who sign up for the program specific to each business unit. Seeing weekly spikes in registration allows them to flag best practices, such as the announcement of a new tobacco-free policy. By tying the report to Blueprint for Wellness results, they can easily see the number of tobacco users for each site as well as the percentage of users registered for their tobacco cessation program, providing insights on a local and national level regarding how well employees are taking advantage of the services Quest Diagnostics offers.

The Next Generation

Quest Diagnostics leaders are currently discussing how best to move their tobacco cessation initiative forward. Now that the program has been in place for some time, the company is currently researching approaches such as premium penalties for tobacco users, incentives for non-users, and mandated tobacco-free campuses across all business units. (The company has long had in place differential premiums for smokers and non-smokers for optional life insurance, but believes it has had little impact on discouraging the use of tobacco.) The company is also always looking for ways to keep interest alive.

Lessons Learned

Quest Diagnostics has coupled participants educated on their own health risks through the Blueprint for Wellness offering with a well-researched and behaviorally sound tobacco cessation program implemented by committed, local employee leaders. The tobacco cessation leaders at the business units encourage local support groups and help educate coworkers on the side effects of tobacco use and potential withdrawal symptoms when quitting, as well as the effects of secondhand smoke. These leaders champion and represent the unique value that HealthyQuest brings to the improvement of employee health.

Quest Diagnostics' goal was to roll the program out from the company's leadership, rather than from the benefits or human resources departments. And, says Ms. Bontempo-Ziegler, as a result, people from all departments became highly engaged, volunteered to work on the program implementation, and were extraordinarily passionate about what they were doing.

Quest Diagnostics understands that cultural change and improved health does not happen quickly. It is not easy for people to quit and so they developed company messages that were supportive rather than judgmental.

Employers can make a difference in employee health. The HealthyQuest initiative at Quest Diagnostics has done much more than help employees quit tobacco and prevent coworker, friend and family member exposure to second-hand smoke. It has also helped the company address rising health care costs by targeting specific risk factors associated with cancer, heart disease, and other illnesses. Most important, Quest Diagnostics has helped empower its employees to improve their quality of life.

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