Compliance Motivation – Is It Possible?

by | Aug 11, 2011

Compliance Motivation – Is It Possible?

I talked a couple of weeks ago about leveraging the culture of compliance in your hospital to encourage WFM process compliance. It is certainly interesting how compliance plays a running theme through all of healthcare and up into government and overseeing bodies.

Joint Commission, of course, has patient care-related compliance rules. (And when you are a patient, you are very thankful for them!) How does the Joint Commission enforce compliance? Through the use of accountability. For a typical hospital administrator, the primary interaction with the Joint Commission is to suddenly be fielding an audit and providing data and reports as requested, and then be questioned about events or activities that fall out of the norm of Joint Commission rules or guidelines.

In other words, the body in authority ensures compliance by enforcing accountability for actions with consequences.

Now let’s talk workforce management: You & your hospital have compliance rules related to workforce management. Do your staff follow them? It probably depends or varies manager to manager. Hopefully yes, but probably not 100%. That’s why we talked about leveraging an overall culture of compliance for WFM.

The problem is, just like for patient care, the bodies of authority (DOL, state laws, labor unions, finance & HR depts, etc.) aren’t happy with “not 100%”. If it wasn’t important, it wouldn’t be a rule, right? And so how do you get from a state where, as a commenter on my previous blog entry noted, managers “are not focused on compliance” to a state where they are motivated to be compliant?

The answer is the same as it is for the Joint Commission: You enforce accountability.

Accountability is a popular word these days. The healthcare industry is learning about a new acronym this year: ACO. It stands for “Accountable Care Organization” and, while you can read more than you’d care to know about them, in a nutshell they are an attempt to create a structure to pay physicians (and maybe even hospitals) reasonable amounts for appropriate care. The goal is to keep the providers accountable for the care they give. Financially.

Back to WFM: If a manager or an employee is determined to be responsible for something, anything, including compliance, that individual probably won’t truly consider themselves responsible for it unless they are held accountable. Going back to that comment on my previous blog entry, the point is made and accurately so that if a manager is “so-so” on compliance today and there is no direct follow-up with them about it, then they will continue to have other, higher priorities.

So, without spiraling downward into the very negative topic of “consequences,” how do you hold staff accountable for compliance? How do you motivate them to be compliant?

When it comes to workforce management, I have one suggestion that brings out the big stick in healthcare and almost any other organization: Transparency. And specifically, transparent reporting.

Transparent reporting is a way to make public the actions of everyone who is responsible to perform tasks or make decisions that are compliant. As a result, if a person in a position of responsibility has done things appropriately, the public knows it. And if they haven’t done things appropriately, the public knows that too! And trust me: No one – at least no one that you should want to be in a position of responsibility! – wants their dirty laundry aired in public. Basic human nature to avoid public shaming becomes the catalyst for how accountability is driven by transparent reporting.

Most WFM systems provide audit trails of activities. And the WFM data itself can be a giant billboard about behavior. Reporting behavior in the form of auditable data out to the public – and the public can be defined as peers, leadership, etc – is a powerful way to provide visibility for actions performed or decisions made. Compliance comes right along behind that, pulled along by the natural desire to avoid embarrassment over being called out for failure to perform correctly. That’s also known as: Being held accountable!

Do you need to help encourage compliance in your hospital? Use accountability for responsibilities. How do you hold people accountable without focusing on negative consequences? Transparent reporting. Motivate people to be accountable in completely objective way.

War stories of this transparent reporting welcome! Post them in the comments or email me.


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