The odds are high that there is someone in your organization who is seething at the perception that their boss is allowing, or even encouraging, improper behavior.
A client recently asked me to review one of the longest documents I’ve ever seen. It was written by a nurse who believes that her supervisor is trying to skew quality data.
This offers several lessons.
First, I really wish confidentiality didn’t prevent me from naming the client, because they’ve handled this remarkably well and deserve credit. The complaint was the length of a dissertation. It was also quite emotional. I have no doubt that in many organizations, those characteristics would have caused a quick dismissal of the merits of the complaint as the ramblings of a disgruntled employee. Instead, my client saw the meritorious matzo balls of the individual’s concerns buried in the emotional soup.
Too often, lengthy, emotional, or disorganized complaints are dismissed as meritless simply because of their style. That is very, very dangerous. One of my compliance mantras is that a stopped clock is still right twice a day. In this case, I don’t think that the employee is a stopped clock. Stretching the clock metaphor, they’re just wound too tightly by a supervisor who, over a couple of years, has incorrectly dismissed legitimate concerns. Because they were so tightly wound, they snapped. For people looking for a reason to ignore a complaint, the tome offered excuses. But there were true insights contained in the nearly 100 pages.
A second problem is that it’s much easier to create financial incentives that reward fishy behavior than incentives encouraging compliance. Let’s say your organization awards bonuses to people for achieving safety or quality goals.
That bonus will incentivize both legitimate and illegitimate methods of meeting the metrics. In the quality context, it will incentivize quality improvements, but it will also reward people who can rig the numbers. I am not suggesting that paying a bonus for quality improvements is unwise, or that the client’s system was poorly designed; it’s just impossible to develop any metric that can’t be gamed. It is, however, much harder to develop any really effective compliance-oriented metrics.
One of the few truly effective bonuses I can think of is a bonus linked to the percentage of supervisees who, in an anonymous survey, say that their supervisor encourages them to raise compliance concerns.
Another thing to be wary of is inconsistency. One of the employee’s legitimate beefs is that the organization limited their ability to document certain conditions without the approval of others. The only time such limitations existed was when the relevant documentation could hurt the organization. The same employee was freely permitted to document, without any review, characteristics that could help the organization. That double standard is low-hanging fruit for a government regulator.
Now, the good news is that the employee did bring the concern to compliance, rather than reporting to an outsider. But the concerns had festered for nearly two years. And the trigger for the complaint is my final point. The employee bringing the complaint was disciplined by their supervisor, who felt that the employee’s continued efforts to document in the record constituted insubordination because the supervisor had issued a directive to limit documentation. Honestly, I’m not quite sure what the lesson is here. On the one hand, I’m glad that something finally broke the logjam and brought the topic to compliance. But I wish the “something” hadn’t been what the employee understandably felt was a retaliatory act.
Song lyrics don’t always translate well in an article, but this is a possible exception. In any organization with 100 or more employees, it’s hard for compliance to know everyone. But it’s good for compliance to take the words of Keri Noble’s 2004 Talk to Me to heart: ”There you are again. I see you all the time. We haven’t really met, but you know I know I don’t mind because I think today’s the day, I’m going to go right up to you and say ‘Would it be alright if I called you up sometime.’”
Having compliance professionals doing affirmative outreach to as many of your employees as possible is time and effort well spent. If you can’t do it in person, do it via email or a survey. But in person is far superior.