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Organizations Should Evaluate All Elements of a Compliance Program Through Employee Surveys

OIG Compliance Program guidance calls for effectiveness benchmarking of compliance programs and advises organizations to evaluate all elements of a compliance program through the use of “employee surveys”.  Further, the OIG states that, as part of the review process, compliance officers should consider techniques such as “using questionnaires developed to solicit impressions of a broad cross-section of … employees and staff.”

A professionally developed and independently administered compliance knowledge survey can provide powerful empirical evidence of compliance effectiveness for oversight committees and outside authorities.  This survey tests employee understanding of the operation of the compliance program, including: (a) structure and operations of the compliance program; (b) role of the Compliance Officer; (c) how the hotline functions; and other key factors for an effective program called for by the OIG.  Survey results can signal not only strengths in the compliance program but also areas of potential weakness warranting attention.  This survey has the added benefit of: (a) signaling to employees that their opinions are valued; (b) underscoring the organizational commitment to employees as individuals; and (c) signaling that employee input is used to make positive changes.

For optimal results, survey completion times need to be kept to no more than 20 to 30 minutes. Anything longer risks employee apathy and the potential for careless responses. A properly designed survey is able to:

  • Identify areas of strength upon which the Compliance Program can be anchored.
  • Identify areas that warrant attention in improving the overall compliance environment.
  • Establish a benchmark against which progress of the Compliance Program can be measured.
  • Measure employee perceptions and morale related to management and leadership.
  • Gathering employee perspective on the effectiveness of meeting Compliance Program goals.
  • Identify issues affecting attitudes and morale.
  • Permit comparison to the survey universe comprised of all organizations that have employed the survey.

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Anyone can draft a survey in a matter of hours but that does not mean that the survey will produce reliable, valid and credible results, especially to an outside party.  Internally developed and administered surveys could be questioned in regards to potential bias or reliability both in its preparation and administration.  The best practice is to employ a valid and independently administered survey tested over many organizations. Further, using a firm specializing in health care compliance is surprisingly inexpensive.  There are a number of advantages in employing a professionally developed and administered survey including:

  1. More credible and reliable results;
  2. Confidence that instruments have been professionally validated and tested;
  3. Coverage of areas the OIG states employees should know about the compliance program;
  4. Guaranteed confidentiality of respondents (critical to reliability);
  5. Ability to benchmark results against universe of others that used the same instrument;
  6. Additional validity and credibility in the results; and
  7. Less costly than developing and administering a survey in-house.

A compliance survey may be the least expensive means to have an independent evaluation of the compliance program.  However, organizations should remember that surveys should not be employed more than annually.  Conducting surveys too frequently will lose the effect of buy-in, support, and could prove to be counter-productive.  When all is said and done, a properly developed and independently administered compliance knowledge survey should provide detailed analysis of the individual questions and overall results that include comparison to how the organization compares with others who have employed the same survey.  If done properly, it is reasonable to expect more than just numbers.  The textual analysis should easily run 25 pages or more in length.

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