Healthcare organizations are in the midst of a chaotic time. Practices are moving from traditional fee-for-service toward value-based care, while complex regulations continue to evolve. The pace of change is staggering. Trying to keep up can force attention away from a practice's main goal: delivering high-quality patient care.
In this new healthcare environment, compliance is critical. It impacts patient safety and reimbursements. Meanwhile, regulatory scrutiny has increased. But compliance should not be something practices look at solely as a task they have to check off. Instead, to be effective and successful, an organization must ingrain compliance in its culture—from executive leadership to doctors, nurses, and other front-line staff.
The Changing Compliance Environment
Over the last decade, there has been a significant shift in healthcare as practices put more focus on meeting the expectations of others, whether from regulators, payers, or patients. A large part of this focus requires staying current on laws, rulings and regulations governing the healthcare industry.
Healthcare providers not only have to recognize what these requirements demand, they also must understand how to move their businesses forward and improve patient care within parameters defined by regulatory bodies. To do so requires an integrated risk approach. In other words, they must realize the risks impacting the entire organization and the steps they can take to mitigate those risks—not only for the business, but for patients as well.
Creating a culture of regulatory compliance requires more than just reading regulations and putting internal policies in place. The entire practice must embrace compliance, as it is critical to protecting providers and patients. Most importantly, compliance must be embodied in everyday activities. Instead of simply saying "we have a compliance policy and this is what we do," healthcare providers must ensure everyone within the organization shares the same mindset and continually does the right thing. In addition, providers should know how to address concerns and who they can work with to affect positive change.
Building the Foundation
To build, or strengthen, a culture of compliance, there are three main steps healthcare practices should take:
- Survey employees to get a sense of what compliance means to them
Understanding the current culture is key to making changes that ensure compliance stays top of mind. Start with an anonymous survey, asking if employees have witnessed code of conduct or regulatory violations. Find out if they feel they could express concern about violations to others, and if not, why they do not feel comfortable. By shedding light on some of the perceived and real barriers that exist within the practice, you can discover opportunities for education and training.
2. Educate and train employees on compliance
To achieve the culture of compliance you desire, employees at all levels of the organization must share common goals and exhibit buy-in. Educational videos on healthcare compliance awareness and training courses designed for your particular type of practice are great places to start. It’s important to know that the compliance culture will not take hold and blossom without support from middle managers who are crucial to demonstrating it to front-line employees every day.
In our work with practices, we have found that great success comes from training middle management about how to set the proper tone at their level, express what they are receptive to, and handle any compliance concerns that employees identify.
3. Launch a practice-wide awareness campaign
Hand in hand with training should be an awareness campaign that clearly states the practice's compliance policies, employee expectations, and proper steps to take should concerns arise.
Awareness campaigns may include posters, interactive microsites, regular email communications, and other types of targeted materials to remind employees about key compliance concepts. Always include details about who to contact if there are compliance concerns. Videos and all-hands meetings can be leveraged to introduce new concepts or further increase awareness and commitment to compliance.
Additionally, you should keep on top of current trends and regulations, and offer ongoing training and educational sessions for staff members. Staff should review and sign off on compliance policies on an annual basis.
Providers who transform their practices today will reap the rewards of satisfied patients, increased profits, and improved control over their practices. While it’s important for practices to take these three initial steps to build a culture of compliance, it’s just as important to ensure the team is working with partners that practice compliance as well. With a holistic, team-centered approach to compliance, practices can truly succeed in the era of healthcare reform.
Susan Kohler is the chief compliance officer at Greenway Health, a health information technology and services provider
