How to find an inexpensive solution to measure and benchmark compliance culture
TheÂ U.S. Sentencing Commission Guidelines for OrganizationsÂ note the importance of organizations to develop institutional complianceÂ culturesÂ that discourage criminal conduct. They note that an effective compliance and ethics program must â€œpromote an organizationalÂ cultureÂ that encourages ethical conduct and a commitment to complianceâ€ and encourage compliance assessments that identify the presence of aÂ cultureÂ that discourages wrongful conduct.
TheÂ OIG Compliance Program Guidance for HospitalsÂ stresses similar points by stating that compliance efforts need to be designed to establish aÂ cultureÂ that promotes prevention, detection, and resolution of instances of conduct that violate applicable laws, regulations, health care program requirements, and ethical business practices. The OIG also calls for usingÂ benchmarksÂ that demonstrate implementation and achievements as being essential to an effective compliance program. They further advise that consideration should be given to usingÂ questionnairesÂ that solicit impressions of a broad cross-section of employees and staff. This is only one of three methods the OIG notes for evidencing program effectiveness. In the OIG Compliance Program Guidance for HospitalsÂ Â it states that â€œfundamentally, compliance efforts are designed to establish aÂ cultureÂ within a hospital that promotes prevention, detection and resolution of instances of conduct that do not conform to Federal and State law, and Federal, State and private payor health care program requirements, as well as the hospitalâ€™s ethical and business policies. . . the compliance officer or reviewers should consider techniques such as. . . questionnairesÂ developed to solicit impressions of a broad cross-section of the hospitalâ€™s employees and staffâ€ and should evaluate all elements of a compliance program through employeeÂ surveys. In theÂ Compliance Program Guidance for Nursing Facilities,Â the OIG recommends evaluations of compliance programs through the use of employeeÂ surveys, internal assessments, periodic review ofÂ benchmarks, and feedback from employees.
TheÂ DOJ â€œEvaluation of Corporate Compliance Programs,â€Â published last year, notes that an effective compliance program includes â€œ[t]he companyâ€™sÂ cultureÂ of compliance, including awareness among employees that any criminal conduct, including the conduct underlying the investigation, will not be tolerated.â€ The DOJ calls for their prosecutors to assess whether the company has established processes that incorporate theÂ cultureÂ of compliance into its day-to-day operations. They also note that it is important for a company to create and foster aÂ cultureÂ of ethics and compliance with the law, and executive leadership needs to implement aÂ cultureÂ of compliance from the top.
Measuring and Benchmarking Compliance Culture
The biggest challenges in creating or using a benchmark survey are determining (a) how to evidence aÂ culture of compliance; (b) what credible method to use to measure an organizationâ€™sÂ cultureÂ of compliance; and (c) how toÂ benchmarkÂ progress in the organizationâ€™sÂ culture? In theÂ 2020 SAI Global and Strategic Management nationalÂ Healthcare Compliance Benchmark SurveyÂ of compliance programs, respondents indicated that one-third of organizations use surveys on compliance issues with their work force, with most organizations relying upon internally generated and administered surveys. Only 8% of respondents reported using professionally developed and administered surveys, which are far more reliable and have greater credibility with executive leadership, Boards of Directors, as well as outside authorities. TheÂ OIG Compliance Program Guidance for HospitalsÂ also calls for â€œthe existence of benchmarks that demonstrate [that] implementation and achievements are essential to any effective compliance program.â€ Compliance culture surveys can be used to meet that standard.
Solution to Measuring and Benchmarking Compliance Culture
Since 1993, Strategic Management has been employing aÂ Healthcare Compliance Culture Benchmark Survey (Survey)Â on behalf of hundreds of health care organizations with a surveyed population of more than three quarters of a million. This has created a huge database of users that permits organizations toÂ benchmarkÂ their results against that universe. Many use the Surveyâ€™s initial results as a baseline from which future surveys can be used toÂ benchmarkÂ change in the compliance environment over time. Results from a survey report should provide great value in identifying an organizationâ€™s strengths as well as opportunities for improvement. This can help ensure that the organization in on track towards creating aÂ compliance cultureÂ of the highest quality. It can provide great insights into how effective the compliance program has been in changing and improving the compliance of an organization and signal not only the strengths in the compliance program, but also the areas of potential weakness that may warrant attention.
Employing this tool isÂ surprisingly inexpensiveÂ and costs only a small fraction of a full compliance program effectiveness evaluation or even a gap analysis. They are also less costly than developing and delivering a survey in house. Reports from the Survey are about 30-50 pages and include tips for addressing any weaknesses. They benchmarkÂ results against the huge universe of those who have used the same Survey in three ways: (a) overall results; (b) by category; and (c) individual questions. The results provide invaluable metrics of program effectiveness.