The healthcare industry needs whistleblowing more than any other sector. Why? Because when malpractices go undiscovered, the consequences directly impact your patients and your business.
A strong whistleblowing policy can help spot and prevent violations of laws and rules, corrupt practices, instances of fraud, and any wrongdoing that may cause serious damage to your patients’ safety. Here, we’ll explore what whistleblowing in healthcare is, why it’s critical for your business, why it directly impacts patient safety, and how to investigate a whistleblowing complaint.
What is Whistleblowing in Healthcare?
According to the National Whistleblower Center (NWC), a whistleblower is “someone who reports waste, fraud, abuse, corruption, or dangers to public health and safety to someone who is in the position to rectify the wrongdoing.”
In a healthcare setting, this translates to someone who reports any reasonable suspicion of healthcare fraud, criminal activity, corruption, or risk to patient safety. When healthcare businesses build a whistleblowing culture, they avert issues such as:
- Unsafe patient treatment
- Use of research or studies for corrupt practices
- Unsafe dispensing of medications
- Unethical billing methods
- Unnecessary (expensive) treatments
- False diagnoses
- Toxic workplaces
- Financial fraud
- Patient data theft
For someone to be able to “blow the whistle” or report a suspicion, healthcare businesses must establish anonymous systems of reporting and protect their whistleblowers from retaliation.
Why is Whistleblowing Important?
Those working in healthcare have an obligation to put patients’ well-being first. The code of conduct of every healthcare business should outline the importance of ethics in healthcare. So, when wrongdoing emerges, people within this setting are obligated to report it. Here’s why whistleblowing is vital for healthcare businesses:
- Stops minor issues from translating into serious damages. Whistleblowing uncovers an early warning sign of misconduct that could potentially escalate into legal, financial, and reputational catastrophes if not addressed. By starting an immediate investigation on a whistleblower report, healthcare businesses can avert this serious damage.
- Keeps fraud at bay. A solid whistleblowing culture allows people to unmask instances of fraud, unethical behavior, and corruption. In fact, the very presence of a whistleblower system is enough to discourage most perpetrators from engaging in unlawful activities.
- Prevents financial, reputational, and legal losses. When wrongdoing goes unreported, it transforms into a full-blown scandal for all the world to see online. Legal and reputational damages soon follow once the word reaches the public. This later drains the business of financial resources. Immediate tackling of a whistleblower complaint can also prevent similar incidents from happening again. This further mitigates damaging legal and financial losses.
- Increased awareness. An absence of whistleblowers would cause unlawful activities to unfold more frequently. But when whistleblowers do get a chance to report issues, the information can later be used to educate other team members. A strong whistleblowing system and training can further educate your teams on whistleblowing best practices.
- Creates a positive culture. When employees are encouraged to “speak up,” the business gains more trust. The result is an open and positive culture.
How Does Whistleblowing Impact Patient Safety?
The National Institutes of Health (NIH) and National Center for Biotechnology Information (NCBI) outline “four common situations in which a clinician may consider raising concerns:
- Reporting on the systemic failure of a trust to provide adequate nursing resources
- Requesting a review of the clinical outcomes of a whole department
- Reviewing poor clinical outcomes involving a single individual over a period
- Anticipating and reporting a single catastrophic event.”
These situations may inevitably overlap in certain cases. For instance, a shortage of resources is a surefire recipe for poor clinical outcomes.
Take the widely publicized case of Stephani Hohman and Lisa Lippert, for instance. When they were employed by the University of Texas Medical Branch emergency room, they noticed how patients under the care of Dr. William Mileski were increasingly sent for “trauma evaluation,” where they underwent unnecessary, unwanted, and painful procedures.
This is just one example of how unethical healthcare practices can impact patient safety. With lives on the line, healthcare workers must be trained to blow the whistle if they see anything that may be harmful to the patient’s health and safety.
Whistleblowing and Fraud
Whistleblowing isn’t just limited to patient care. Healthcare facilities also see many cases of fraud, such as billing for services or procedures that were not performed and improper use of laboratory tests to get more payments. While they don’t necessarily affect patient safety, they must be reported to protect the business from legal and financial pitfalls.
How to Investigate a Whistleblowing Complaint?
So, you’ve received an anonymous report. Now what? Here are a few steps to investigate it:
Document All the Information
Record every piece of evidence and interactions related to the report. Make sure all your notes are objective. Store this information both digitally and in physical form.
Select the Team for Investigation
Every whistleblowing situation should be handled with care and confidentiality. This is why it’s critical to choose your investigation team carefully. To ensure maximum confidentiality and objectivity, it’s often best to work with a trusted third party.
Set Clear Expectations
Setting an estimated timeline and clear expectations ensures the whistleblower isn’t under the impression that the investigation is going nowhere. Let your whistleblower know how information is being managed and assure them the process will remain confidential.
Plan your Feedback
Keep the whistleblower informed about the way the investigation is unfolding. Go into as much detail as possible about the action being taken. This ensures the whistleblower knows their complaint is being investigated and avoids any long-term grievance.
Aftercare
Don’t forget to check in on the whistleblower once the investigation is complete. This is a necessary step to identify any potential retaliation before it causes serious damage.
A Final Word
Building a whistleblowing culture starts with establishing an anonymous reporting framework and developing a compliance training system for your staff to use it in time of need. Your people must feel safe to do the right thing. Educate them on how your anonymous reporting tools can protect them from retaliatory actions. When an anonymous complaint does knock at your door, be sure to take prompt action and take steps to ensure similar incidents don’t repeat down the line.
