Trinity Hospice

Communication: From Contempt To Collaboration, Punishment To Partnership

The hospice audit process can be a source of significant stress and anxiety for all involved. For hospice owners, audits represent a substantial financial and operational risk, often tied to the fear of financial penalties, repayment demands, or exclusion from Medicare participation. These audits can also impact their reputation and the trust of their patients and families.

Clinicians have long received feedback from “Compliance” regarding their documentation, work product and care provided for patients. Historically, these audits lacked emotional consideration and failed to address personalized care and patient quality of care. Clinicians often worry that their clinical judgment and patient care decisions are being scrutinized, potentially leading to professional repercussions. This fear can breed contempt, defensiveness and reluctance to fully engage with the audit process.

As the bearer of the “Compliance” title, I approach audits with a blend of apprehension and frustration, rather than fear. My role as a detective is to uncover potential noncompliance issues. Understanding the severe repercussions for the program if compliance isn’t ingrained in our culture, I emphasize the critical need for hypervigilance. It’s essential to safeguard the integrity and standards of the program, underscoring the vital importance of our collective commitment to compliance.

However, there was a time when the Compliance department’s mission was clouded by a contentious atmosphere, driven by an “aha, got you” mentality. This approach fostered mistrust and fear, creating barriers to open communication and collaboration. It’s essential to recognize the importance of compliance nurses not just as enforcers but as protectors and allies, working alongside the team to ensure the highest quality of patient care and ethical practices. By shifting the focus from punishment to partnership, communication naturally evolves from contempt to collaboration, leading to a culture of compliance.

It’s Essential To Recognize The Importance Of Compliance Nurses Not Just As Enforcers But As Protectors And Allies, Working Alongside The Team To Ensure The Highest Quality Of Patient Care And Ethical Practices

How To Reset The Culture Of Compliance In A Hospice Program?

Culture

• Showcase a firm dedication to compliance and actively endorse ethical behavior across the organization by clearly communicating its significance and ensuring that leaders set a positive example.

Communication

• Ensure that feedback is framed not as a matter of assigning blame but as part of a collaborative effort to maintain compliance.

• Address any personal feelings clinicians may have about being singled out by reassuring them that these reviews are a necessary part of everyone’s role in compliance.

• Train compliance leaders to present feedback in a constructive and positive manner to ensure it is well-received and productive.

• Clearly articulate policies that have stringent requirements, explaining the “how’s” and “why’s” behind our actions.

• Follow up with team members to ensure and confirm that they have completed their assigned tasks continuously from day one of the hiring process.

Partnership

• Embrace feedback and diverse viewpoints to foster an inclusive and collaborative environment.

• Allow leaders the freedom to explore and create their own path, keeping compliance program requirements in mind.

• Secure stakeholders buy-in for the compliance process to achieve a higher level of commitment, especially given our reliance on accreditation organizations and CMS as our primary payer source.

By adopting these principles, hospice programs can reset the culture of compliance, turning it into a positive and collaborative effort that enhances the quality of care and ensures adherence to regulations. How do you plan to implement these strategies in your organization?