2022 Healthcare Benchmark Report Deep Dive

August 29, 2022

Ethico was founded to uphold the highest standards of healthcare compliance and we continue to elevate the quality of healthcare E&C worldwide, which is why we brought you the 2022 E&C Hotline Benchmark Report: Healthcare Edition. Still not sure what it means for your program?

Enter the EthicsVerse! We’re digging into the report to pull every action item, insight, and integral statistic so you can build a better program. See where the future of healthcare compliance lies, and future-proof your organization. To get a copy of the 2022 Ethics & Compliance Hotline Benchmark Report: HEALTHCARE EDITION for yourself, download it here.

Transcript for 2022 Healthcare Benchmark Report Deep Dive

Nick Gallo: Hello, everybody. Welcome to the “EthicsVerse.” We’ve got a great show for you guys today. We are gonna just start introductions now as everybody starts to file in. We are here with Ellen Hunt. Ellen, one of our favorite ethics and compliance thought leaders. Super excited to have you on. We’re gonna do a deep dive on the Healthcare Benchmark Report. This is the first healthcare benchmark report ever put out in our industry. We have a deep healthcare concentration, so we have enough statistically significant data to draw some really great insights for you to benchmark against.

And we have Ellen Hunt who’s got a ton of great experience to help us walk through it. If you’ve attended some of our other ones that have been benchmark deep dives, I wanna encourage you to stay because the insights that Ellen is gonna be bringing while talking sort of primarily about the healthcare industry are absolutely applicable to every single industry and every single company because it’s really gonna be focused on organizational justice which we’ll get into more in a second.

As always, welcome to the EthicsVerse. This is the coolest place to be at 12 Eastern, every Thursday. We want to bring you high-quality content that’s gonna help you elevate your program, gives you some actionable tips and techniques to make a bigger impact in your organization. So, why don’t we… everybody jump in and say where you’re from? As always, we want this chat to be very lively. Ask your questions along the way. We’ll do our best to incorporate those into our discussion. So I’m here with Gio, my brother and partner at ComplianceLine, and Ellen Hunt. I’m gonna do my screen share guys, and we can just kind of start diving in here.

Okay, so “2022 Healthcare Benchmark Beep Dive.” Like we said, it’s the only one in the industry. So, Ellen, if you don’t know her, you don’t follow her on LinkedIn, you really should. She’s active on there all the time. And I got to tell you, Ellen, I’ve never been to a talk of yours or a conversation of yours where I don’t get a little nugget that I can steal and apply somewhere else. We were at the Compliance Week, and it was at like the woman’s brunch that I snuck into and someone was complaining about, “You know, I don’t feel like I get paid enough.” And you stood up and you said, “You know what? Unicorns should get paid more.” And that has stuck with me. I’ve said that a thousand times since. I don’t think I’ve credited you every single time, but so glad to have you here.

Ellen Hunt: I’m thrilled to be here. It’s just an honor to talk about this report. I think there’s a tremendous amount of great data here, not only just for healthcare professionals but really for all ethics and compliance professionals. So, thank you so much for inviting me.

Nick: Here we go. And everyone, the man who needs no introduction, Gio Gallo, my brother, and partner. All right, let’s dive in. Quick commercial. ComplianceLine we have a suite of corporate integrity products that are listed here. We’re an alternative to some of the other mainstays in the industry. If you’d like to learn more, please reach out anytime. We’d love to help or just give you some tips on what you should be looking for, how to optimize a program. That’s in place if you’re locked in a contract or something like that.

So, here’s our 2022 Hotline Benchmark Report. If you don’t have this report right now, please drop your email in the chat, and someone from our team is gonna send this out so you can follow along the way. Okay, so go ahead, drop that in. People on our team are monitoring that chat right now, and we’ll try to get that to you during this conversation. As always, world-famous. ComplianceLine EthicsVerse book giveaway. We’re gonna be giving away five more books this time.

We have a cool library of books written by ethics and compliance professionals or that are kind of ethics and compliance books, HR-driven human behavior books that can make your program better. We are big book nerds. Readers are leaders, as we like to say. So, please participate in the chat. Add your own tips, your own techniques. Like, we like to say on every single “EthicsVerse episode,” we are at an interesting point in our industry. There is an inflection point that me, and during our show flow Ellen, we were talking about. There’s an inflection point in our industry that we’re approaching. The next 10 years is gonna be extremely exciting as we, you know, pull our chair up to the grown folks table, away from the kitty table that a lot of us feel like we’ve been trapped at for the last, you know, 15 years or something like that. A lot of things are coming together for us and it’s our time now to really shine. It’s our time to sharpen our saw and to really elevate our program. So, we want to help with this book giveaway and the kind of content we’re putting out.

Also, we’re gonna be giving away five custom benchmark reports. So, if you’re a healthcare company and you would like to enter yourself into the drawing, let’s go ahead and drop a two in the chat right now and you’ll be entered into the drawing and this will be a great report. This is something that’s a PDF. You can take to your boss, you can take to the board to show how you stack up against the industry, against other healthcare organizations, and also get a bunch of actionable techniques and actionable tips that you can start implementing right away. So, drop a two in the chat if you’re interested in that, and let’s get moving.

Here’s our methodology. The point is that this is a statistically valid approach to doing this. We don’t use a lot of rounded numbers. We don’t do averages of averages. We try to present the raw values for you so that you can get the clearer picture of what’s going on out there. So, we’re presenting information over the last four years, and we try to preserve outliers, but we limit it to organizations that have had 10 or more reports. If you just have one or two reports, we go ahead and exclude those, but those are the only alterations to the data that we do. Gio, talk to us about this framework. We talk about this kind of thing all the time and how these three things come together to really drive forward the pace closure time.

Giovanni “Gio” Gallo: Yeah. As Ellen and I were discussing in the pre-show in the green room, there are a lot of different ways to look at these data. “Do these apply to me? Does someone else do something different? Does an organization in another state or another specialty, or another size apply to me?” And largely, getting more data is helpful. And, you know, at the core of this is one data point that you might use to kind of define the health of all these other things. This close cases faster. If you’re able to close cases faster, it means you’re probably doing a bunch of things right. You’re probably getting good information, you’re probably following up in a consistent way and things like that.

Well, to get that, that’s really the overlap of these three things. This good employee engagement means that employees are speaking up and they’re being transparent and they’re being engaged in your program, and they’re giving good information and giving things that can be substantiated and identifying themselves. It really starts with that speak-up culture to lead to the listen-up culture. So, then, you know, if you have that right, your employees are doing their part.

Well, then whoever is managing your hotline, your web form, your mobile app, your texting whatever that is. If you have that adaptive intake, the Compliance 3.0 version of the adaptive intake is being empathetic, right? Whether that’s asking the right questions. Not boring people with, you know, too long of an automated greeting, not making them wait too long or just, you know, understanding how to get through that elicitation, that interview in order to get to the good answers.

Well, if you have that involvement from your employees and your intake is adaptive and empathetic, and then you follow that up with systematic follow-up so that you can actually kind of take consistent action, follow up on things, get things to the right people in the right order with the right priority and triage and things like that. When all of those three things come together, you’re gonna see your performance, you know, be rated pretty well against the benchmark in a bunch of different areas. And one of those areas will be that speed to which you close cases.

And, you know, we’re really proud of the excellent ethics experts we work with who do work on our software platform, and we see them closing cases and many times on average almost twice as fast as organizations that do it other ways. And that’s because, you know, they’re focused on all three of those things as these things happen. Just doing one of those really well and the other ones poorly is probably not gonna get you as far down the path.

Nick: So, Ellen, we were talking in the show flow and we kept coming back to this refrain about moral injury and more broadly, organizational justice. I love your thought leadership in general, I love your spirit and I love what you bring to this conversation and I’m really interested to see how we can weave this through all these different data points so that we can kind of humanize this process more. But where do you see organizations fall flat on their process relative to the organizational justice opportunity?

Ellen: Yeah, so I think there’s a couple of areas. And just in general, you know, organizational justice has three or four prongs, depending upon which researcher you’re following. But generally, it’s, “Am I compensated fairly, right? Is there equity in pay? Is there procedural justice? Do I feel that the organization has processes and procedures that are gonna treat me fairly, right?” And then there’s the inner relationship which is, “Do I have a boss that I think has integrity? Do I think that the people that I work with are honest, transparent, and are gonna do the right thing?”

I think it’s critical when we look at the great resignation and where our workforce is going and where ethics and compliance will be in the next 5 to10 years. Because it is to me, the absolute core, if not the heartbeat, of every ethics and compliance program. Because if you can’t accomplish organizational justice and if you are not knocking it out of the park in regards to your hotline and investigations with procedural justice, you’re really never gonna have an effective program. And we know that people are walking out the door because of moral injury or because they’re ethics refugees. We talked a little bit about the war on talent, but it’s really a war on opportunity. People have decided, “Now, I have other opportunities, and I’m not going to settle to work for a place that I don’t think treats me with justice, whether that’s fairness in pay or fairness when I raise the concern.”

And so we talked a lot about Speak Up campaigns, but one of the things we don’t do is tell people what happens when they do. We’re not utilizing our hotline portals and our other communications to tell people about the process. We’re not following up and we’re not being transparent about some of the results. And so, we can say, speak up all you want, but if we’re really not talking about what happens when you do, you’re not gonna get to that nice diagram that Gio was talking about, right? When you’re able to have empathy and you’re able to treat people, go fairly and close those cases and resolve those concerns. Because when you get back to the heart of it, the ethics and compliance program is there to find and fix.

Nick: That’s right. And so, I think that’s a good transition into this next slide where we’re talking about reporting channel usage. And I think the big takeaway from this slide is that particularly during the pandemic, we saw a pretty big pop in hotline usage, right? That went from about 60% and it’s sort of stayed here and the new normal, but something that I think… so if you’re looking at your own, you know, we’re gonna talk about a lot of these different factors. What you need to recognize is that while this benchmarking is helpful to see what other folks are doing, the best benchmark is yourself and where you’ve come from.

So, comparing your data to last year or two years ago or to whenever normal was and being able to explain differences and see is there a systemic problem here? Is there something I can explain away from an anecdote or from a story? And what can I do to kind of get that process going better and better? That’s really gonna be the best place to start. But you, Ellen, just mentioned something about the process. And I think when we see people who are coming over from somewhere else or they have a relatively lower, you know, reporting rate than other than what they would like, let’s say, so much of what we end up like advising folks on is what kind of campaign can you push forward to drive more information into the minds of these human sensors that are inside of your organization? Gio, you talk to us a little bit about how we can turn these people on by building trust in that process to Ellen’s point.

Gio: Yeah. I mean, I kind of think of three or four points of influence and, you know, increasingly, we’re coaching compliance officers and ethics experts across all layers of the organization to think of these different points of influence. I think a lot of times we might get a little bit too focused on, “Hey, this is what I’ve done, and I need to fix this thing,” and zooming out might help you do that. So, those four are like the pre-message that you give to employees.

Like the first point of engagement. What happens when they hit your web form? What happens when they’re looking up to find out where to go? What is the experience like when they call the hotline? So, that’s first point and then it’s the follow-up, and then it’s the wrap-up. So, all four of those points are ways that you can influence, you know, I think we need to realize that each employee is like a prism. Each employee, the interactions that you have with them refract out and they’re gonna have a bunch of other interactions with other employees and say, “Hey, that was great.”

And point number two, “I just called the hotline, not sure what they’re gonna do about it, but it was a really good experience. They heard me out and I feel like this is probably gonna go well.” Or you have that interaction on the wrap-up and you say, “Hey, we can’t divulge everything we did in this entire investigation. We want to let you know that we’ve substantiated this and we’re taking action on it or whatever.” That interaction becomes a ray of light that hits the prism that’s that employee and they change the way that they shine on your culture.

They change the way that they might encourage someone else to call their hotline or to engage, to walk into the compliance office, you know, and report something or whatever it is. And that’s kind of what we’re seeing in this healthcare space. I think there’s some interesting dynamics. You see kind of a diversion 2019 to 2021 kind of across that pandemic, you know, where reporting has gone up, you know, compared to things in the traditional comparison going down and also just the engagement in that hotline. Obviously, a large proportion of the healthcare companies that are in the sample, these are essential services and us and our team and our employees were staffed and working through this and you can see that those things were changing. And each of these points of interaction are kind of a flashpoint for you to make an impact in a really important situation.

Ellen: The best reference you can ever get and the best campaign is when somebody who’s gone through the process or has interaction with your office gives you a reference. And I don’t think we think about it as a net promoter score, but when somebody says they’ll refer you because what do people do when they’ve got a concern? They go to somebody they trust and say, “What should I do?” And when that person says you should call ethics and compliance or you should call the hotline or you should go talk to somebody on the team. As you said, it’s that prism of light that shines through the culture and really helps you establish that organizational justice throughout the organization.

Gio: Thanks, Ellen.

Nick: So, we were talking, Ellen, about design thinking and how that seems to sort of fall short and many of us who are so heads down in our work that we’re just trying to process these cases and we’re trying to just close them. Talk to us about that design thinking and how that integrates with the, you know, reporter experience or the customer experience. And I’d love you to kind of touch on this abandonment rate if you can.

Ellen: Yeah. So, one of the things that we do in ethics and compliance is get very focused on the message we want to push out and we don’t think about why it’s relevant or important to our audience or more importantly, to the organization. So, one of the things that I’ve done in a couple of circumstances is utilize the design thinking methodology to apply it to the investigation process and the hotline process. And the reason being you really need to put yourself in the shoes of the user. And we don’t often talk about our clients or our customers, but every ethics and compliance program has clients and customers. If people aren’t using you, then what value are you bringing to the organization, and what’s their experience?

Saying something and raising a concern takes a tremendous amount of courage. And we can talk as much as we want about don’t have a fear of retaliation or we have zero tolerance, but the truth is those people are taking a risk, and we have to do everything we can to make that as safe for them as possible by informing them along the way. Do you buy something off of Amazon without looking at reviews?

Nick: Right. Exactly.

Ellen: Yeah. Do you decide to go to a course or enroll in something without not knowing the syllabus? Do you…? Of course not. We’ve all become very educated consumers because we can do everything online. You want your employees or whoever’s calling and raising a concern to buy, to buy into your process and to buy into the fact that you’re going to treat them fairly and objectively and timely. And so, when you get turned off quickly, right? We’ve all had this experience. You’re online, you’re filling out the form, it takes forever. What do you do? You give up. You give up because already I’m doing something that’s hard. It’s probably taken me a couple of weeks, maybe even a couple of months, a number of conversations with people for me to decide, “I’m gonna raise my voice.” And now you want my zip code or you want my credit card or you want me to agree to advertising or whatever.

We all know that the more easy and convenient this can be and the more comfortable, the more effective it’s gonna be. And so when you have people who are hanging up the phone, not only is it that you didn’t get that concern, they’re left with, “I’m never gonna do this again.” When somebody says, “Oh, I have a problem. What do you think I should do?” They’re not gonna say, “I had a great experience without ethics and compliance.” They’re gonna say, “I had a horrible experience with them. Don’t do that. That’s the last thing you should do.” So it has that prism effect, that trickle effect that Gio was talking about. The light shines further and further if it’s a good and positive experience and it darkens when it isn’t.

Gio: Yeah, you got some antimatter going through that prism and darkening everything. But I love you bringing up that give-up, Ellen, I think a lot of us are looking to drive engagement and figure out how we can get people to call and how we can get people to go to the web form and stuff like that. How we can get people to engage with our investigation? But as you do a Pareto analysis or your 80/20 rule around, “Hey, where can I have a big impact without a lot of effort?” Those people who are giving up, they already followed this whole path of adoption, right?

They found out about it, they know about it, they know when to speak up, they know what matters, they know where to call. And they’re almost at that finish line and then they say, “You know what? All of my fears are probably more true than I thought. I’m just gonna stop.” If you can troubleshoot that piece, then you’re gonna get all of those people who were so close to participating, you’re gonna get them over that finish line and hopefully, they’re gonna have a great experience after that.

Ellen: Absolutely.

Nick: So, Ellen, we were talking about issue of anonymity and how this can be such a signal for the health not only of your broad program, especially to the extent that your speak-up, listen-up solution is an indicator, a canary in the coal mine, if you will, of your broader compliance program and culture of integrity. But we’re talking about how issue of anonymity can be a great indicator of how people understand the process. And the thing that you kept saying over and over again was like, the number one thing you can do is just explain the process to people. Talk to us some more about that and how that’s such an easy hack.

And again, let me just pause and let me interrupt you before you start. What we’re gonna keep talking about as we hit this inflection point into Compliance 3.0 is that these are gonna be small tweaks to our mindsets, small tweaks to our program, small tweaks to the tools in place, small tweaks to the way that we interact with the humans in our organization that are going to create those points of leverage. The machine is built. We’re just gonna be changing the air inflow a little bit so that engine of ethics can combust a little bit better. Talk to us about, though, Ellen, how we can communicate better that process and how that can ultimately feed into the experience and the issue of anonymity.

Ellen: Yeah. So, continuous recalibration, I think, is really where when we think about where is ethics and compliance gonna be in the next 10 years, to your point? We’ve got the machine built, but we just have to make it a higher-performing machine. Being anonymous is just a fascinating issue. And I think one of the things that I have always focused on and I kept track on my own because there were no reports that did that is how many reporters came forward originally as anonymous and we were able to get them to identify themselves?

To me, that’s a huge compliment to the investigative team in building trust. And as we all know, when you have the ability to talk to the reporter, you have a much better chance of getting to a good resolution in a timely and effective way. We’ve all had those cases where somebody calls and the information is so cryptic, it’s really very hard to figure out what is the problem, how do you even approach it, can you even investigate it? But I think the other thing we have to think about and Nick and I talked a little bit about this yesterday, I ran across a statistic from another benchmarking report, primarily in Europe, where the numbers of the people who are more comfortable going out to an external source versus internal increased by 5% from 2017 to 2020.

And this is really problematic, I think. Now, you know, all these numbers you have to take with a grain of salt. They’re benchmarks. But if people feel more comfortable going to the news reporter or going on Facebook or going to your regulator than to you, you’ve got a problem. And I think it shines some darkness on our Speak Up campaigns. We’ve spent a lot of time and money on Speak Up. Speak Up, Speak Up but yet more people feel, “Well, sure. I’ll do that, but not to you. I’m going to go outside.” And so I think what’s key on this is we can’t just stop talking about zero tolerance of retaliation because that’s after the fact. You’re telling me that after…and being tolerated, right?

We have to talk about how we prevent retaliation, right? And we have to tell people what we do. And this gets back to that procedural justice piece, right? Are you tracking, are you following up? Do you have that connection with your HR folks so that once somebody is part of this, whether they’re being interviewed or they’re the manager or they’re the reporter or the wrongdoer, are you watching them? Because if you’re not, then frankly, all you’re doing is after retaliations happen, is punishing people.

So, I think we’ve got to change the narrative and what we’re talking about in retaliation. And I think we also really have to be very clear with people, what’s the process? How does this work? Remember, how often do people go through this in their career? Some only once, some never. The managers aren’t familiar. The people being interviewed aren’t familiar. Your reporter probably isn’t familiar, and your wrongdoer, you hope, isn’t familiar, because if he or she is, then you’ve hired somebody who’s a wrongdoer twice, right? But I think as we look at this with ESG and DE&I and some of the other things that are going in our organizations, transparency is the name of the game. And the other piece that we really have to work on, I think, is to tackle this issue where people believe nothing has gotten done.

We have to be more clear with people about what the issues are, whether they were substantiated or not, and I like to say they were found truthful or not truthful because substantiated is such a big word. Right? And what do we do about it? What do we do about it? I think people really have an extreme frustration with their organizations when you say speak up, speak up. speak up, right? And they never know what happens. We see this with employee surveys, right? People are just over it. “Stop asking me if you’re never gonna do anything with the information.”

So, we have to delve into the root cause, not only just with the individual actors, but the organization, right? If you have 50 cases in a year about your gift and entertainment policy, you ought to be out there saying, “We’ve received feedback that our policy wasn’t serving your needs. We’ve changed the policy.” You just have to show that you are customer-centric and you’re listening to what your customers need.

Nick: I mean, there’s so much in what you just said. We could have a whole episode just on that last talk track that you had because there’s so many different things that we can take from it and so many different hacks from it. What you talked about, you know, so what I like to tell people to do is on your ethics portal page, and if you don’t have one, you should get one. This is not really that expensive to do, and it makes a world of difference, especially as you’ll see a little bit later. Everyone’s accessing this information through the web now. They’re not going to the code of conduct on their desk anymore. They’re doing a Google search and they’re finding it.

So what a great opportunity to put an interesting link up there to say, changes made by you. And people click on it and see, these are all the policy changes that we’ve made based on your Speak Up, you know, people like you or these are all the people that have spoken up recently and these are the heroes. These are the people that we’re gonna celebrate. Yes, we can sort of like drive Speak Up by hiring whistleblowers, but we can also drive Speak Up by promoting the people inside our organization who are willing to raise their hand and who are willing to, again, be that canary in the coal mine to say, “This is not what I signed up for. This is not an exhibition of the values that we espouse.” Those are the people that we want to reinforce, and those are the people we want to frankly give more power to and you can give some kudos to in some really easy ways. Ellen, go ahead.

Ellen: To your point about the portal, right? Maybe I don’t want to have to go ask somebody. Well, if I raise a concern, what happens?

Nick: Exactly.

Ellen: Right? Let’s let people self-serve. We know they’ve gotten very comfortable with that and make that information available so that, you know, if I’m thinking about raising a concern, I can research this myself and I don’t have to go talk to somebody and out myself ahead of time, right?

Nick: Exactly.

Ellen: I mean, what a valuable tool.

Nick: Angela just brought up a great point in the chat, and she just talked about how a lot of execs are overly focused on the bottom line and they’re not concerned about the employee experience. And what’s kind of baffling to me is how that thinking ends up rearing its ugly head in the ethics and compliance department insofar as we get overly focused on the numbers and we’re not focused on the reporter experience. So, you brought up this net promoter score concept that is such an easy thing to embed in your overall process, whether you’re doing it on the hotline side or you’re doing it on the investigation side, when you actually end up talking to that person but getting some sense in some pulse.

Look, you should obviously be testing your line, but if that’s only gonna take you so far, an aggregation of a statistically significant sample of employees who have engaged in this process and getting some sense of how they’ve enjoyed that process or would they recommend this process to somebody else is gonna give you some really quick insights on tweaks you can make to that particular experience to make sure that the compliance tail isn’t wagging the employee experience dog.

Ellen: Well, and the employee experience is your bottom line. I mean, the great resignation has told us that, right?

Nick: Great. That’s a great point.

Ellen: If I don’t like working for this company because I don’t think that you live your values, I don’t think you fulfill your mission. “Oh, and by the way, when I did raise a concern, I didn’t like the way I was treated.” I’m shopping with my time, right? And my career somewhere else. I’m just gonna go buy from somebody else. I don’t have to work with you. But the other thing that I think we really need to think about when we think about all of this is how this really does impact our ability to live our values and the number of people who are leaving our organization because we say one thing and do another.

When I look through my crystal ball the organizations that really do the deep dive and do the tweaks and the hacks to get their program working more efficiently, are the ones that are gonna have the competitive advantage. So, the days of thinking that ethics and compliance is not related to talent and employee engagement is just over. Of course, it is.

Gio: Yeah. I would just add to that, Ellen. I love that line that your employee experience is your bottom line. I would add to that that we’re just making the job harder for ourselves if we’re not supporting this reduction in turnover and reduction or improvement in employee engagement because we’re making the jobs harder. If you’re not running not just an actually ethical organization, but one that is perceived as ethical, then the ethical people, they’re gonna leave. You’re gonna have a brain drain of the people who have standards, and it’s always gonna follow this power rule of the people who care most about this thing that you’re underperforming on are gonna leave first.

If that’s pay, the people who care about pay, they’re gonna leave. If it’s ethics, the people who care about ethics, if they don’t perceive your program to be ethical, your company, your values, your executives, well, then the most ethical people are gonna leave first, and you’re gonna be left with the people who are like, ‘Who cares about values? Who cares if a few people…every now and then?” And you’re gonna have that kind of that type of thing that we’ve seen as like, brain drain in cities and regions and stuff like that. That’s gonna happen within your company, around your ethics.

Ellen: Well, and the person who is disengaged is never gonna be the person who raises their voice. They’ve already decided they don’t care. You know, I mean it really doesn’t matter what your campaigns are because you have to get them emotionally. You have to figure out really what is gonna bring them back to loyalty and commitment to the organization. Otherwise, why would I bother? Why would I bother to raise my voice?

Nick: So, we’re talking a lot about employee engagement, and we’re jumping ahead a little bit, but the point is on this slide. This blue triangle represents the level of employee disengagement in your organization. And to the extent that there is any person in your organization that doesn’t have to pedal all the way down, that isn’t earning the whole salary that the company, in theory, is expecting to get from their efforts, then this blue triangle exists. And to Ellen’s point, these things go hand in hand. Employee engagement goes with ethical behavior. It goes hand in hand with willingness to speak up, and it goes hand in hand with the extent to which somebody has ultimately bought into this culture of integrity that Gio was talking about.

And, you know, we may have a session at some point that kind of dives into the full econ of this. But the point is that Frank doesn’t like the econ classes. Buckle up, Frank. I’m always gonna weave in a little econ here because at the end of the day, we’re talking about ROI. At the end of the day, we’re in businesses that need to be going concerns that have to continue to make money. And the point is that many of our organizations, to Ellen’s point, you can see it here. I’m gonna circle back here. I know I’m jumping around a little bit.

Sixty-five percent of people are looking for a new job, and 62% are quitting because they don’t believe in the company’s mission. So, you get this ethical brain drain. You get this drain of talent. Again, this is not a linear change that’s happening in our organizations. We’re hitting tipping points left and right and the full cost of the great resignation, as I say, has not crashed across our economy yet.

We’re just starting to see the early stages of it. But if this large percentage of people don’t believe in the mission, and 82% are experiencing actual retaliation, whose responsibility is that to fix and to address? It’s obviously ours. It’s our responsibility, and it’s our opportunity, frankly, to start to attack this head-on. Not to say there’s no retaliation, we won’t, you know, stand for it, but we’re gonna be taking active steps that resonate that people believe in terms of preventing it. Talk to us, Ellen, about this opportunity, this ROI discussion. I mean, there’s a lot in everything I’m talking about here.

Ellen: So, I think there’s a couple of hacks, right? And one hack, absolutely is when you close an investigation to do a customer service study or survey, and it doesn’t have to be 20 questions, but do you feel you were treated fairly? Do you feel the investigation was timely? Do you feel it was objective? And in studies regarding procedural justice, people who will say, “Yes, it was fair, it was timely, objective,” will say that even if they don’t like the results, right? We’re often sometimes so afraid to say, “Hey, how did that work for you?” When we know people got answers they didn’t like, but that’s the real key. People can live with an answer they didn’t want or don’t like if they think it was fair and objective and timely, right?

And I think the other thing is, we the ethics and compliance field, we do not do enough with exit interviews or exit surveys. We need to be asking people, “Why did you leave?” And we need to ask it from the ethics and compliance perspective. When people have just already decided they’ll walk out the door, they’re gonna be a lot more candid, right? And you don’t know. How many people who have left your organization are ethics refugees, right? That’s a whole data point you don’t even know, right? Because if there is that bad stinky manager, right? And he or she is a bully, and people don’t feel they can even raise their voice, right, so, they vote with their feet, how are you ever gonna mitigate that risk? Because you just don’t have the data.

Nick: Right. And as that turnover happens, you’re getting a bunch of other ethics refugees that are relatively more jaded from their bad experience, from the other side of the fence that they jumped over, that are coming into your organization. So again, you can look at that either as a threat to the ethics of your organization and frankly will manifest as a real threat if you don’t do something about it or you can recognize it as an opportunity because, look, there’s a lot of psychology behind a pattern interrupt. when you’re expecting one thing and you get something else that has a deep impact on your memory, on your mind, and you have an opportunity, as these new folks have turned into your organization, to show them that the culture that they’re stepping into is different from the one that they left. The bet that they made is a good bet. And if you can do that, you can start to get those ethics ambassadors in your organization that can really start to transform your culture.

Ellen: Absolutely. And really, ethics and compliance should be positioned as a resource, right? And a place for people to go to help resolve their issues. And what you want is people coming in and talking to you rather than reporting concerns. It’s all about getting to the place where you’re preventative rather than detective.

Nick: That’s right. And so you talked about exit interviews. We’re talking about employee disengagement, which is a massive silent killer. Like I said, that Econ 101 graph that Frank in the chat loved so much, it gave him flashbacks to his horror days in undergrad. The fact is that that exists everywhere. And the fact is the ethical desire of employees to have an actual ethical culture that they’re a part of that actually lives out its values authentically is higher than it’s ever been. So, that creates the biggest opportunity for ethics and compliance. The people that are maintaining these lines that to Ellen’s point, are the sort of outward manifestation, the outward, you know, interaction point with the organization to really prove their worth in a different way.

Ellen: This is a phenomenal opportunity for anybody in ethics and compliance, regardless of what organizations be talking about, how you contribute to the bottom line versus talking about how you’re preventing the parade of horribles, right? It’s a completely different narrative, right? And for some of us who have been doing this for more than a decade or two, right? It was, “Oh, the orange jumpsuit is a suit, and let me make sure you don’t have terrible fines and horrible regulatory findings, or you don’t get excluded and debarred by Medicare or Medicaid.” Hey, we’ve all hollered that refrain, and frankly, following the law and being compliance is table stakes. Folks, that’s table stakes.

Nick: It’s table stakes.

Ellen: Every organization needs to do that. Ethics is the ceiling, though, right? This is where we can go with this. And when you can say, this plays a key part in your employee engagement, where you want to be as an organization, how you position yourself in regards to ESG, you’re now talking about that real ROI, and it’s a completely different narrative where you are contributing to the bottom line and not just being a cost center or the department of no.

Nick: Me and Gio were just talking about this the other day. Everyone cares about this now. Everybody cares like, we now can affect this thing that everybody at the board level cares about and at the C-suite cares about, because it’s affecting this thing that they care about first and foremost, which is the bottom line. Talk to us Gio about how we can tie this employee engagement and cost of turnover into the ROI discussion that we can point to directly by our, you know, hotline performance and investigation performance.

Gio: Yeah, I just want to set the stage here that someone, astutely pointed out in the chat that GEICO started speaking up culture in 2002 or something, right? Like, we’ve been talking about this in healthcare for a full two decades. So, none of this as a concept is new to us, but also what have you been frustrated by over the past decade or however long you’ve been in this? Is it that you’re not getting the budget that you want? Is it that you’re overstressed and overstrained and your whole team is stressed out? Is it that you’re worried because you have to make do with an under-resourced program or you can’t get the software that you need or you can’t staff up like you need?

Is it just that you don’t have the respect in the invitation to the discussion or the budget or the strategic table that you want? If that’s you, if any of that has resonated with you, this stuff that we’re talking about, in case you think, “Oh, you’re talking about employee engagement, you’re talking about all this, you know, fancy flowery stuff, it’s not relevant. We got to run a program.” I know that there are some people in this market that feel that way. I just want to encourage you that this tide is shifting and you have an opportunity to take advantage of the shift, this kind of decrement or, you know, the fall-off in employee engagement and stuff like that, and the uptick in the interest that your owners and executives and board having these things.

As that gap widens, you can come in and be the hero and say, “Hey, you know what? I’m a compliance hero. I’m an ethics expert. I know how to solve this problem that you care about. So, people care about it now and in case you didn’t before, you didn’t realize that this was your path to getting that respect and involvement and budget that you need, you can funnel all of this into your ROI discussion. So, I know a lot of us are not comfortable talking numbers and speaking GAAP accounting statements with the CFO and stuff like that. That’s fine. You got to realize that the real return that’s gonna get people excited about this is not the, “I’m an insurance salesman and I can make sure that you’re protected if things go terrible.” No one’s excited about that.

What’s the biggest insurance company that advertises across the country? It’s GEICO, and they’re not talking about insurance. They’re talking about a GEICO, because that, like, “I can make sure you’re protected if everything is gonna fall apart.” It’s not romantic. It’s not exciting. You got to talk about the thing that is exciting and say, “Hey, you know what? We’re gonna keep you protected. We’ll keep you out of jail. We’ll block some fines, but we’re also gonna run this efficiently, and we’re also gonna help this thing that is this great resignation.

And you should be talking about all three of those things in your ROI and say, “We’re gonna help block some fines. We’re also gonna run our program efficiently. We need to upgrade our software platform. We need to get a compliance portal. We need to be doing some exit interviews. We need to add these things to our program.” And also when we do those and do them well, instead of just check the box, right? No one’s making a pitch and saying, “Hey, let’s check the box on this thing.” Well, when we do this actually well when we do this authentically because ethics is the team, compliance is the team that actually cares about these things. Doing those well, that’s gonna help move… Like, if you join one of our ROI sessions, you’ll see that if you move employee engagement up 1% or 2%, which leaves another 38% to go if you move your turnover down half a percent, which obviously you can get a ton better from that. Just those small changes can make a huge impact on the bottom line.

You don’t have to wait until your tone at the top, right? Like, raise your hand if you’re sick of hearing about tone at the top. You don’t have to get the tone at the top right to do this. Appeal to the things they care about. They care about the bottom line and say, “Hey, you know what? Here’s your path to the bottom line.” It’s not, well, let me find a few more regulations that we cannot fine for. Where’s the progress? Where’s the excitement? Where’s the romance? Your GEICO on your insurance ad is you talking about employee engagement and turnover.

And when you say, hey, when people stop feeling so disappointed in their leadership and the fear process and the justice in this organization, then these things are gonna go up. And then instead of that brain drain, you’re gonna be attracting people to say, “Hey, this is actually a great company to work for. Hey, you know what? The leadership in this team, the leadership of this company is actually authentic and they actually care about integrity.” Then you’re gonna be getting great employees that not only are not doing terrible things, right?

You’re not just like, “Hey, we might be able to hire fewer felons who are gonna be feeling medicine, but we’re gonna be hiring people who are engaged and care about us and are gonna help move our whole mission forward.” That’s the pitch for a compliance budget. That’s the modern-day 2020 pitch for a compliance budget and that’s where we all need to level up into. And you can make the case with the data we’re presenting today, with these benchmarking data, and with these principles that Ellen is bringing up in these hacks. And when you make that, you’re gonna start seeing all those things that have been weighing us down for the past 10 years start eroding away and people saying, “Hey, you know what? This is a team that can not just solve the ethics problems, not to solve the compliance problems. They are actually serving the entire organization.”

Ellen: Well, I would just say look and think about the evolution of the care market standard for the board of directors, right?

Nick: Perfect point. Exactly.

Ellen: Let’s think about Boeing and the Blue Bell Creamery case, right? And it’s very clear that the courts are very tired of shareholder derivative cases where the board claims they didn’t know what the major red flag risks were. And there isn’t a board of any organization now that doesn’t have employee risk or employee talent as one of their top five risks. So, it’s right back to the risk assessment and dealing with what is an important operational risk to the organization, and that is keeping the right talent, retaining the right talent, but also knowing what the issues are. And your right talent is gonna raise their voice and let you know.

So, I think there is a tremendous message to your executive team and to your board that if you are not paying attention to this risk, then you are ignoring a red flag, which is not in line with your oversight duties, your fiduciary duty as both a board member and as an executive. You’ve got to know what the risks of the organizations are. And if you don’t have an effective ethics and compliance program, you just won’t. So, that’s I think it goes to.

Nick: Yeah. I think that’s spot on and I’m also kind of like getting tired of hearing about, “Well, the board just doesn’t get it. The CEO, the C-suite just doesn’t get it.” As if these are like coded automatons who just have no way to comprehend a new idea. All these ideas lattice works in their minds aren’t crystalline. They’re not just gonna shatter. It’s your job to turn those light bulbs on and it’s our job to take advantage of the opportunities that Ellen is talking about and Gio is talking about. Those opportunities are tying the ethical workplace that we are kind of arbiters of, at least at some level, to these things that they care about so that we can turn ethics into a strategic competitive advantage in our marketplace. But it’s only gonna work if it’s authentic.

If you just have a bunch of boring posters up of people from the ’90s with shoulder pads in terms it’s not gonna be a competitive advantage. If people feel different in their organization, if they feel different in your company because their voice matters because they understand the process because they feel like they can turn on this, you know, they can be an actual human sensor for your company, there’s a ton of magic that’s gonna rock it forward and it’s not turning a battleship, as I say, it is lighting a match and, you know, there’s a kindling potential within our organizations, but we have to like that match and we have to take hold of the steering wheel that is our lives and is our jobs.

So, we were talking about this slide yesterday, Ellen, and you said, you know, everyone is just like… What did you say? “We don’t look for insights in the data. We’re just looking at the numbers.” And talk to us about how issue substantiation can give us some clues and how we can fix it if that substantiation level isn’t where we want it to be.

Ellen: Yeah, so I think there’s a number of things and a number of dynamics. And one of the things and I know there’s been some stuff in the chat that I often hear from my clients and experienced in the organizations in which, you know, I was the chief or part of the compliance team is that’s an HR issue. That’s an HR issue, right? Or that person is a bad performer. They’re a frequent flyer.

So, we engage in this conversation about demasking and discrediting not only the reporter but also the allegation. And I think we’ve got to stop kind of using that language because I think we have to think of every issue as something that impacts the organization. HR issues impact how employees feel about the organization, whether they think you’re living up to your values, your mission, and your purpose. And they’re not disconnected. We always want to put things in silos, but the fact of the matter is our worlds are becoming more and more connected with one another all the time. And so, yes, it may be that HR is handling it because they’re the subject matter experts, but it has an impact on your ethics and compliance program because it gets back to that organizational justice piece.

If I don’t feel that I’m being treated fairly, either by my boss or by my opportunities or whatever it may be, it impacts how I feel. And, you know, when we think about how… and we have to rely on other areas for their subject matter expertise. Maybe it’s your HR folks, maybe it’s your auditors. Maybe you don’t have an investigative team, so you’ve got to rely on others to do that. It is how are people being treated, right? And I think we’ve all been in that situation where, you know, somebody’s a star performer, has been for years, but the boss doesn’t like that person that much, then they’re afraid they’re gonna get a bad performance review. They raise a concern, and all of a sudden, right? As the concern has hit the door, the preemptive strike, oh, now they’re gonna get a bad performance review, right?

And so my conversation with those managers, “I’m sorry, where have you been?” How does somebody go from being a four and a five to a two and a one? What happened? And you haven’t documented anything in the file. So, this is let’s use ethics and compliance to get rid of the employee that I couldn’t get rid of otherwise. But I think when you think about substantiation and the issues, I think it’s really, really important to have a way, whether you’re using your portal or you’ve got something else on your internet or maybe it’s gonna be your sustainability report. Because if you’re looking at some of those people who are reporting some really significant numbers on the issues that have come in, the place closure time, and the substantiation. It’s really important for people to know, was it or wasn’t it true?

I mean, sometimes you interview 10 or 20 people on a concern, was it true? Was it not true? And you should see, even if you’ve got a really strong culture, you’ve got lots of people raising their voice, right? But that doesn’t always necessarily mean that everything’s true. It means if they think there’s something wrong, they say something, and that’s okay. That’s okay. So, I think, you know, we look at substantiation rate sometimes as if we have to keep raising the grade, right? Every case that comes in should be substantiated.

No, no, no. And I think it’s just as important to tell people when things haven’t been substantiated, right? And to do it in a way that acknowledges, it was a valid concern. “We were really glad it was raised. Even though we didn’t find any wrongdoing, we might be modifying our policy.” And that gets back to my conversation about the root cause, right? Maybe this time there wasn’t misconduct, but boy, could happen next time so what are you gonna do to prevent that going forward? And so when you think about that, you know, we all suffer, I think, from that belief in the organization that nothing gets done. It’s like the employee survey. And if you can be giving some real numbers and talking about what is and isn’t substantiated, it’s gonna give a lot of credibility to your program.

Nick: Yeah. And this talk track I’m about to share with you is the same thing that I would say about your sanction screening and your sanction monitoring. We get overly caught up with type 1 errors. Type 1 errors are, of course, false positives. So, what you’re talking about an unsubstantiatable case or something that you can’t substantiate or that maybe it’s somebody raising their hand about something that they think is wrong. That’s not something that we should be concerned about. We should be more concerned about the false negatives. The ones where people aren’t speaking up when they should speak up. That’s really where the game is. That’s where the battle should be fought.

So, a couple of things you said, Ellen, I’m gonna have to watch this back because I’m gonna… A couple more of your talk tracks and your little lines, I will be stealing. You’ll be hearing about them all over LinkedIn. I forgot to do this earlier. Everybody who’s attending, drop your LinkedIn contact information into the chat so that you guys can all connect with each other. The number one opportunity we have in this game, because it’s a unique time in our lives, because it is a unique industry that we’re in where you can reach across the aisle, you can really reach across, you know, the middle of the street to a competitor even, and get tips and techniques is this community that we’re all a part of.

And it’s not just the “EthicsVerse,” there’s a bunch of people who are fighting the same battle in different corners of the world. And the more interaction we can have, the deeper we can build our network and the more touch points we can have to reach out and say, “Hey, what are you doing with this? Hey, do you have any tips about this?” Those are the things that are really gonna move the needle for us. I cannot believe we are going… This should have been a 90-minute one. Listen, this really should have been a little bit longer.

So, I’m gonna blast through a couple more of these and really get to your big takeaways, Ellen, because I thought they were great. So, the big takeaway here is for reporter types. We saw a pretty significant pop in 2020 when COVID started, and again, it carried forward into 2021, and that was about related parties. These were people calling on behalf of their spouse and saying, “Hey, I have this concern about personal protective equipment,” or things like that. At the end of the day, we as ethics and compliance, we’re only getting somewhere between one and four reports per 100 when there’s probably 40 or 50 reports available per 100 in our organization over a 12-month period. We should be willing to take reports from anywhere we can. And this opens up, at least to turn light bulb to you, on maybe other campaigns you can run to spouses or to other people, or to external parties.

We want to root out wrongdoing in our organization. We want to reinforce our culture of integrity and we want to sell, so to speak. We want to convince all the people that are within underneath the umbrella of our company that we’re taking a concerted effort to reinforce this thing that we think is important. So, that’s my big takeaway from that one. Gio, talk to us about reporter awareness. I can’t believe we’re getting so close. This is so fun. This is so fun today. Gio, talk to us about reporter awareness. And again, the opportunity here, maybe tie that into the portal or something like that.

Gio: Yeah, so big surprise, guys. I don’t know if you guys heard about internet and computers and mobile phones, but people are using them. You know, Nick was talking about earlier. Someone probably doesn’t have a code of conduct printed out in their desk at home and they’re flipping through it to page 47 to type in the URL for your web form or to call a hotline. You got to make this available everywhere. And just like, you know, there are a lot of things that Ellen has been bringing up about user behavior from customer satisfaction reports or from other ways that people engage with their employees.

What people do for that is it’s on Google, it’s on the website. It can show up in a search result. It’s on your internal portal. But if you’re not on the VPN, it might show up somewhere else that’s, you know, about us on your website or the employee section of your public website that customers go to or patients go to, or whatever. So, you know, the big story here is that internet is ticking up and printed materials are coming down and word of mouth is still stable. So, I think the two big things are upgrade where you’re putting your phone number and explaining the process and things like that on the internet, in people’s emails.

Just think about what is someone gonna do if they say, “Hey, I’m gonna report.” They’re probably gonna maybe look through their email and search compliance. They’re probably gonna go on the website and say hotline for insert company or hospital name or whatever. And then also, that word of mouth is still happening and I would encourage you even and as you address the internet piece, figure out how you can improve that word of mouthpiece because that’s a small percentage, but those are really high-value connections where someone says, “Hey, you know what, take it from me, I did this.

And for that internet piece, if you don’t have a compliance portal, if you don’t have a landing page where someone can say, “Hey, where do I get to my training? Where are these policies? Hey, I’d love to find out… you know, let me just… you know, instead of searching through my email and going back to my training, is there one place where I can get a bunch of information about our ethics program, including the web form link and the hotline?” It’s not that hard to spin up and you can get a lot of these things that we’re talking about in one place and you don’t have to manage a bunch of it. You don’t have to be a techie to be able to offer that to your team and your department.

Nick: I’m shocked that it’s 2022 and people still are debating on whether more reports are good or aren’t good. We had a conversation at a large healthcare organization with someone who was like, “We’re not getting a lot of reports.” I hope they’re not on this. If they are, I love you. But they’re like, “We’re not getting a lot of reports.” And we think that that’s fine. And I’m just thinking, like, “I am on the other side of the spectrum with this.” There are 30, 40, 50 reports, reportable instances per year. And you know, I’m glad these numbers are healthy relative to other benchmarks that are out there, but they’re such an opportunity to actualize and start to crowdsource risk management at scale.

It’s right there for us, but we just have to have to do something thing about it. So, Ellen, you had so many great takeaways. We recrafted this whole slide from other presentations we did, and I’d love for you to just kind of walk us through these big takeaways. And if everybody wants to stay on for literally two more minutes, we will go over the upcoming EthicsVerse sessions next week. It’s gonna be really good. It’s all about ROI. It’s gonna be bringing together a lot of the concepts that we’ve talked about for the last few weeks together in something that’s really actionable, and it’s gonna be a really fun case study. So anyways, Ellen, talk to us about the health of your program and how this can really be an opportunity for us.

Ellen: Yeah. So, I mean, it’s all about those preventative steps, right? I mean, when you think about your investigative function and your hotline, it’s the heart of your ethics and compliance program, right? It’s the heartbeat. Everything flows from there and it is where you add value to the organization by identifying risks. So, when you think about how are you gonna keep yourself healthy, you’ve got your diet, your exercise, and your sleep. And when you think about that, you got to think about that with your program as well. How are you feeding your program? How are you making sure that it’s getting out there and being seen? And how are you getting feedback back and how are you resetting and thinking about it?

You do have to recognize that things don’t sit in silos anymore. An HR issue is an ethics issue, and engagement and turnover is key. And, you know, the issue about retaliation, we just have to change the narrative there and do a lot better at actually protecting people before it happens, instead of saying we don’t tolerate it after it does. And just think about the organizational justice piece. Nick and Gio have talked about the ROI and the return. If you can just change engagement by one or two points, the effect on the bottom line isn’t just dollars. It’s productivity, it’s innovation, it’s commitment, it’s loyalty and it’s people who are gonna speak up and think about that feedback loop. You know, tell people what’s happened, but also ask them, how did it work for them? They are your customers.

Nick: Right. They are phenomenal points. Round of applause for Ellen. Ellen, thank you so much. I had high expectations and you surpassed them once again. If you guys love this, drop a nine in the chat for Ellen because she is phenomenal. One of my all-time favs. Here are a couple of our upcoming “EthicsVerse.” Again, it’s every Thursday at 12 Eastern. Next week, Gio and I are gonna be doing a case study on ROI. This is a really fun talk that we do. It’s a really fun exercise, and I think it’s gonna turn on a lot of light bulbs as we start to talk about the motivation triad, Aristotle’s rhetorical triangle, and how to pull different aspects of our indirect impact in our organization into that numerator of our ROI to really unlock a lot of budget.

We’ve had a ton of success in helping and coaching people on their ROI discussions before they go to the board or before they go to the budget committee, and we’re gonna share some of those things with you now. We have the EU Whistleblower Directive Part 2 coming up. This is the 201 class that you guys asked for. We’re gonna be doing performing risk assessments, and we’re gonna be diving into empathetic workplace investigations with Katharine Manning, who’s one of the authors. If you win the book today, maybe you want to pick out Katharine Manning’s book about Empathetic Workplace investigations.

And then my good friend Christian Hunt is coming on for a couple of episodes before we get to the end of September. So, we are super excited about the “EthicsVerse.” We love your input. If you have ideas for other areas, if you have pain points, our team is gonna be reaching out to you to get some more input on the types of topics you want us to bring to you every Thursday. So, thank you all who stayed to the end. Looking forward to seeing you next Thursday, and until then, we’ll see you on the next “EthicsVerse” webinar. See y’all.

Ellen: Thank you. Bye.

Gio: Thanks, Ellen. Nine, nine, nine, nine. Lots of nines for Ellen.

Nick: Yeah, lots of nines for me, Ellen.