Compliance Survey Best Practices

Tips to reduce survey fatigue and improve results

In its Compliance Program Guidance documents, the HHS OIG recommends surveying employees as one method to demonstrate the effectiveness of a compliance program. The agency has specifically called for the use of “questionnaires developed to solicit impressions of a broad cross section” of the workforce. This recommendation is reinforced by further guidance suggesting that organizations evaluate all elements of their compliance programs through employee surveys. Similarly, the Department of Justice has highlighted the benefits of surveying employees to assess the compliance culture.  As a result, many healthcare organizations have conducted employee compliance surveys. However, most internally developed surveys are not professionally designed, tested, or validated, leading to results that may be unreliable and potentially misleading. Over surveying can also be a problem. Frequent or repetitive surveys often lead to employees becoming tired, disengaged, or indifferent. This survey fatigue can also arise when employees don’t understand the purpose of the survey or see the same types of questions repeatedly. When this happens, consequences may include low response rates, inaccurate or dishonest answers, and reduced data quality. Many employees also distrust the intention of internally generated and administrative surveys and are not honest in answering questions. Weary and suspicious respondents may be inclined to rush through surveys, giving uniform answers such as selecting “Yes” for every questions. To minimize this problem, it is advisable to include reverse-scored statements and mix them in other survey statement questions. It’s worth noting that developing, administering, and analyzing an internal survey can be more expensive than using a validated vendor solution. If using a vendor, the vendor should provide detailed analysis of results with actions to address weaknesses, and not just charts and numbers. Below are some tips for conducting effective employee compliance surveys:

1. Explain in advance the reasons, objectives, and uses of survey results.
2. Reduce frequency of surveys to only one compliance-related survey a year.
3. Don’t wear out respondents with too many questions, limit them to forty or less.
4. Using professionally developed/tested questions can avoid misunderstandings.
5. Identify survey types that best meet needs (e.g., compliance knowledge or culture).
6. Alternate formats, between Dichotomous (Yes-No for compliance knowledge and understanding); and Likert scale (compliance attitude and culture degree of agreement).
7. Use validated surveys that are tested for reliability.
8. To improve quality responses, ensure responses are anonymous and untraceable.
9. The independently administered survey provides better assurance of anonymity of responses.
10. Survey analysis should identify result significances for Compliance Officer and leadership.
11. Surveys with only statistical results are of limited value without knowing the significance.
12. Ensure there are means to determine the significance of the results.
13. The best surveys can benchmark results against other organizations using the same questions.
14. Benchmark results can also be compared between an initial survey, and one conducted at a later stage.
15. Provide feedback to participants on how the information was used.

Interested in learning more? Please contact Richard Kusserow at [email protected].

About the Author

Richard P. Kusserow established Strategic Management Services, LLC, after retiring from being the DHHS Inspector General, and has assisted over 3,000 health care organizations and entities in developing, implementing and assessing compliance programs.