Preventing Harassment Depends On Your Organizational Culture

Individual behaviors do not present as much of a risk factor for harassment as does the organizations' culture

Sarah was surprised when Mike came into her office to file a harassment complaint. Everyone within the organization had just completed Harassment Training the previous week, but yet here is Mike sitting in Sarah's office. Mike is complaining that he is being bullied in the office by multiple staff members. Sarah is very aware that this is covered within the organizations Harassment Training, so why was it happening? This situation has the potential of getting messy and dragging on for quite sometime.

Harassment is a decision made by an individual when his or her 

work environment allows for it.

Yes, the above statement is a hard fact to face. When an individual decides to take action in an inappropriate manner, that decision was made using various factors:

• What is the character of the individual in question?
• Does he or she have a history of inappropriate actions or words, but not held accountable for those actions or words?
• Did the individuals' supervisor report any suspicious activity, words, or mannerisms?
• Is there motivation behind the individuals actions or words?

All of the above questions do not necessarily point to the individual, but rather the organization and the culture that lives within that organization. Harassment thrives in organizations that lack respect, a healthy culture, and accountability.

Victoria Lipnic of the Equal Employment Opportunity Commission (EEOC) stated the following:

"Too much of the effort and training to prevent workplace harassment over the last 30 years has been ineffective an focused on simply avoiding legal liability. In simplest terms, training must change. That does not mean we are suggesting that training be thrown out - far from it - but training needs to be part of a holistic, committed effort to combat harassment, focused on the specific culture and needs of a particular workplace. Above all, employees must have faith in the system." (1)

Simply having a reactive system in place that responds to harassment claims is not enough. Out of fear of retribution, employees may not report the harassment when it occurs. It is becoming vital for organizations to lessen the opportunity for harassment from happening so significantly, that it is nearly non-existent within the organization. This type of harassment free environment is created from the culture that exist within the organization. Here are some suggestions to help create a harassment free culture:

• Hire not just for skills and knowledge. The character of the individual must be a top priority when considering who to bring into the organization.
• When an individual does act inappropriately, they must be held accountable. A slap on the wrist or a simple "tongue lashing" will not deter the individual or others from inappropriate actions in the future.
• Effective supervisor training is a critical component. Supervisors must receive proper training that enables them to identify strange behaviors, words spoken, or mannerisms. When something odd occurs, it should be documented and monitored.
• Create an environment of positive thinking, mutual respect, and support for fellow co-workers.
• Ensure that your harassment policies are equal for everyone within your organization. One classification of worker should not have an advantage over another or receive special treatment.
• Be sure everyone within the organization (at all levels) receives harassment training and this training is acknowledged through documentation. As part of your harassment training, ensure that all members of the organization understand what is considered harassment.
• False harassment accusations should not be tolerated. A growing number of employees have been falsely accusing their co-worker of harassment in order to gain a competitive advantage over that co-worker.

Creating a "harassment free" culture within your organization will never completely eliminate harassment from occurring. However, it will greatly reduce the opportunity for it to occur.

Don't put your organization at risk by having a reactive approach to harassment. Take measures to be more proactive in your approach. Your employees will be grateful for the safer work environment that will be created and it will reduce the liability risk to the organization.

Individuals will be who they are. Try to ensure that you have the best people within your organization who, through their character, actions, and words are representatives of an organizational culture that you can be proud of!

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Your Biggest Liability Is Standing Right Next To You

The greatest risk to any organization comes from within

Donna felt confident that she had terminated Kate's employment with just cause. Within a week of Kate's firing, Donna received notice that Kate filed for unemployment insurance. Donna was surprised with the news. Kate was let go because she was doing something that was against company policy. She was, in the eyes of the organization, steeling and falsifying documentation. Donna thought that not doing these things was simply common sense. During Donna's conversation with the unemployment representative, he asked her a question that stunned her. He asked, "do you have documentation that you trained Kate in these matters?" Donna's reply was very similar to how many others might have replied in her situation, "why would I need to do training on something that is common sense?" Kate began receiving unemployment benefits.

An organization relies on its employees and their productivity. Close relationships are sometimes formed. Even the occasional lifetime friendship is created. Employees are one of the greatest resources to an organization. It is for all of the reasons listed above, and many others, that an organizations biggest liability comes from its employees.

Yes, the statement above is cold and harsh, but so are certain workplace realities. Employees present the biggest risk to an organization. Here are some examples where employees are a liability:

• Compliance (HIPAA, Medicare, etc) - Employees are human and sometimes their curiosity gets the better of them. They also tend to say or do things that could get an organization in trouble or audited.
• Harassment - Employees have a bad history of being mean and spiteful to each other. If an employee enters a department where they are either not liked or resented, the other employees will make the unwanted employee's work environment unbearable until they are no longer there.
• Social Media - People love to vent their frustrations. As it turns out, people now have a way to vent their frustrations about their jobs to the entire world. Employees of any organization are no different. If an employee feels slighted at their job or does not like their job, the world will hear about it.
• Employment Termination - There is always a level of risk when an organization has to terminate an employees employment. Although the supervisor feels that he or she did everything right, there are times when something unexpected comes back to bite the organization right in the bank account. Here are two facts to remember: 1. some employees will lie and 2. unemployment officers and the courts tend to lean in favor of the employee (particularly if the employer has little or no documentation to back up their side of the story and it boils down to a "he said, she said" situation).

What has been said here is just a taste of reality. However, with that reality, there are things an organization can do to lessen its liability:

• Training and Documentation - It is vital that an organization deliver training on every topic that is relevant to that organization. No matter how trivial it might appear. Do not assume that people will just know stuff because it's "common sense". In addition, it is critical that there is documentation of any given training. Include the names of the attendees, date, and the topics covered.
• Policies and Procedures - Having established, written, and communicated policies and procedures will help an organization protect itself from employees who claim that they had no idea this or that was against the organization's policies. Having written policies and procedures will also protect an organization if an audit should occur.
  
• Organizational Culture - What does the culture within an organization say about it? For employees, the culture of an organization says a lot. Having an organizational culture where the employees are supportive of one another, where there is a positive attitude, and where new ideas and thoughts are free to flow, helps lessen negative attitudes and bad feelings within the organization. It helps to bring in the right type of person who would fit the culture within an organization.
• Employment Termination - This goes back to the idea of having effective policies, procedures and documentation in place. For example, if an employee quits, do not ask him or her to come back to the office to train another employee. When an employee quits, there IT access should be cut and they should not be doing any more work for an organization. This should be a written policy and followed the same way every time. Avoid showing favoritism towards employees and be sure that managers/supervisors know to avoid getting too close and personal with their employees. Managers and Supervisors should stay objective and focused on developing the employees in order to help them become more valuable within the organization.

Employees are a vital component to the success of an organization. Your employees will have diverse backgrounds, skills and personalities. However, they are still employees of an organization. Any organization who looses sight of this fact is putting itself at risk.

Organizations should treat their employees well and give them every opportunity to succeed in their position of employment. However, it is up to the organization to protect itself from the liability that comes with employees being imperfect people.

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Ethics Training in Healthcare

Having no ethics training within the organization, will put any healthcare professional at risk!

I received a call from a client who was attempting to dispute an Unemployment Claim stating that the employee was terminated for an unethical situation. I asked if the employee ever received documented ethics training, specifically in the particular situation at hand. The client's response was no. As many healthcare professionals do, this client assumed that ethical situations should be understood by all without documented training being necessary. With the requested documented training, this healthcare professional will most likely loose their Unemployment Claim dispute. This entire situation could have been avoided by having ethics training in place.

Ethics is defined as: moral principles that govern a person's behavior or the conducting of an activity.

In the past, moral principles were assumed to be standard among most people. In today's ever changing social world, this is no longer the case. It can no longer be assumed that all employees have the same, or at least, similar moral principles and standards.

There are two major factors that are creating this new dynamic for employers:

• New Principles/Standards For a New Generation - Baby Boomers and Generation X's have, for the most part, bring a similar set of principles and standards to the workplace. This is not always the case with Millennial's. Many of the Millennial Generation have similar principles as the the previous two generations, however, there is a significant number of the Millennial Generation who do not hold to the same principles and standards as the Baby Boomers or Generation X's. These particular Millennial's have their own set of ethic principles as they see the old ones as "dated" or "behind the times". When they act outside of the assumed principles that have been recognized by previous generations, they do not understand why what they did was wrong. Their actions follow their own set of principles and standards.
• Dramatic Influx of Unique Cultures - With the recent influx of refugees and immigrants from places that have cultures most people are not familiar with, new challenges will arise within the workplace. Some assumed principles and standards could be unfamiliar with people of various backgrounds and cultures.

Due to the two major factors listed above, and the other factors not listed, it is strongly recommended that all healthcare professionals have established and documented ethics training within their organization. Do not assume anything is "just understood" without formal and documented training. Ethics training should be created based on the culture the organization is attempting to establish or has already established. In addition, having ethics training as part of an organizations' already established compliance training, will only strengthen the employees understanding and desire to follow compliance regulations.

Some employees may feel that ethics training is unnecessary and is a silly waste of time. However, by not having established and documented ethics training in place, an owner is putting him or herself at risk of monetary loss, a damaged reputation, and a decrease in employee moral.

It is the simple things that make a big difference in the success of an organization. Ethics training is one of those simple things that will make a big difference.

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Compliance Essentials: Training

Training is one of the essential cornerstones of any effective compliance program.

Training is an investment for any organization. That investment pays great dividends in the form of liability protection when it comes to compliance. However, with that being said, some organizations are still hesitant to train their employees or outright refuse to make this very important investment.

When it comes to Federal and State compliance, the decision to train employees has been taken out of the hands of the organizations. For example, with HIPAA compliance, the Office for Civil Rights (OCR), states:

"§164.530(b)(1) Standard: Training. A covered entity must train all members of its workforce on the policies and procedures with respect to protected health information required by this subpart and subpart D of this part, as necessary and appropriate for the members of the workforce to carry out their functions within the covered entity."

In the event of a HIPAA audit, the auditor will ask him or herself a discovery question:

"Does the covered entity train its work force and have a policies and procedures to ensure all members of the workforce receive necessary and appropriate training in a timely manner as provided for by the established performance criterion?"

In addition, the auditor will take the following action:

"Obtain and review such policies and procedures. Areas to review include training each new member of the workforce within a reasonable period of time and each member whose functions are affected by a material change in policies or procedures. From the population of new hires within the audit period, obtain and review a sample of documentation of necessary and appropriate training on the HIPAA Privacy Rule that has been provided and completed."

And finally, the auditor will:

"Obtain and review documentation that workforce members have been trained on material changes to policies and procedures required by the HITECH Act."

What is the above patter of the auditor?

1. As a mater of policy, require that all employees are being fully trained
2. Ensure that each organization has established policies and procedures
3. Verify that training is being done by obtaining documentation on training and policies/procedures

This similar pattern is followed by other government organizations. Documented compliance training is required in the areas of OSHA, Medicare, and other various areas where compliance is required.

When organizations give their employees the resources and information they need to be compliant with these various regulations, they begin to establish a culture of compliance within the organization. 

Compliance training is not a request or addressable, it is REQUIRED!!!!!

Employee training is an investment worth making. However, compliance training is not just a good investment, it is liability protection that any organization cannot be without.

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5 Pioneering Changes to Healthcare Compliance Support

Excessive weight of compliance regulations has necessitated the need for more guided compliance support

Dr. Paul was just wrapping-up the recent OSHA audit. He was very frustrated as he was found to be in violation of more than a dozen OSHA regulations. Following the completion of his OSHA audit, he called the company he had entrusted with his compliance, Healthcare Compliance Solutions, Inc. (HCSI). After some discussion between Dr. Paul and the representative at HCSI, it was discovered that after Dr. Paul had purchased the HCSI Compliance Program, he did not fully incorporate the program into his seven locations that he was trying to support with the single compliance officer. Dr. Paul and HCSI worked together to ensure that the next audit, OSHA or HIPAA, would have a much different and positive result.

The case study described above really happened. It was this very situation that made it clear to everybody at HCSI that something different needed to be done in compliance support. Major changes were needed to the compliance industry and HCSI has taken it upon themselves to be the pioneer in the reformation process of healthcare compliance support.

Below is the list of the areas identified where changes are necessary:

• Training - It was previously thought that all an office needed was to train their employees once a year (if that) on compliance regulations while having a pizza party. Once the information was distributed, the employees would go about their days, having learned very little about the organization's procedures or the compliance regulations, and putting the organization at risk of a breach.
• Policies and Procedures - This is an issue that has proved to be very costly. The federal regulations require effective and written policies and procedures . For too many years this requirement has been taken lightly. Ineffective or incomplete manuals have become a plague on the healthcare industry. Many organizations simply say, "I have bought a manual, so I am compliant".
• Updating - The federal government requires every compliance program to be continuously updated. This necessitates the need to constant monitoring, adjusting, and retraining of compliance issues. This is either being done halfheartedly, in disarray, or in most cases, not at all.
• Support - Most organizations only call their compliance support company when they hit the panic button. As we learned in the case study at the beginning of this article, that is simply reactive when the goal with compliance is to be proactive.

The four points listed above are examples of how compliance is currently being supported in the healthcare industry. They are out-of-date and are simply ineffective in giving the healthcare industry the support it needs in order to comply with the federal regulations.

As previously stated, HCSI has taken it upon themselves to be the pioneer in the reformation process of healthcare compliance support. HCSI has recognized that in order to truly protect yourself from compliance liability and effectively adhere to the regulations, it is vital that a cultural change occur within the organization. By establishing a culture of compliance, any healthcare organization will be able to feel assured about their compliance adherence. In order to help healthcare organizations create a culture of compliance, here are the changes HCSI has made to compliance support in the healthcare industry:

• Training - Created effective online training where each employee is held accountable for their own training. Each administrator has control over adding, deleting, and monitoring their employees. At the end of each training module, a certificate of completion is printed as proof of employee compliance education.
• Policies and Procedures - Written policies and procedures that are effective in supporting the office are required. HCSI's Audit Manual contains required policies and procedures that the federal government agencies are looking for. In addition, HCSI has created an extensive Compliance Reference Guide that gives further support and understanding for Compliance Officers.
• Updating - The federal government calls compliance a "continuous journey" and it is this "journey" that they are looking for during an audit. For this reason, weekly, monthly, and quarterly updates are mailed out to each HCSI client. These quarterly updates are reviewed and initialed by each employee as an ongoing training initiative. These updates keep your employees and compliance staff up-to-date with current compliance information and are an important part of the "continuous journey" of compliance.
• Support - The excessive weight of compliance regulations are taking a toll on the healthcare industry. HCSI has recognized this issue and has addressed it. In order to help ease the weight of compliance, Utilizing Client Relationship Specialists (CRS), HCSI supports its clients in ways that are unique in the healthcare industry. Every new HCSI client receives a phone call on a quarterly basis. HCSI understands that this first year is critical in creating a culture of compliance within the organization. These quarterly calls are intended to support the administrators and ease their burden. After the first year, HCSI will reach-out to each of their clients multiple times throughout the year. Had this new process been in place previously, it would have helped prevent the OSHA violations Dr. Paul experienced in the case study. In addition to the proactive approach to support, HCSI talks with thousands of healthcare professionals who reach out to HCSI's CRS' for answers to their compliance questions. Nobody likes feeling as though they are in the dark. With effective compliance support, no healthcare professional has to feel that way.
• Additional Resources - In addition to training, policies, updating, and support, HCSI recognized one missing element of support that has been previously missing within the healthcare industry. Customizable forms, resource updates, informational blog, Facebook community, and a Linkedin group, are all additional ways the healthcare industry is able to receive, well over due, comprehensive compliance support.
  

As Dr. Paul learned in the case study, healthcare organizations are no longer able to simply buy a manual or do the bare minimum. Healthcare compliance support, as it stands now, is no longer a viable option as it is grossly ineffective in protecting the healthcare organization from liability, from protecting patient's information, and protecting the healthcare employees themselves.

HCSI is pioneering a new compliance support program that is revolutionizing how healthcare organizations are meeting the federal compliance regulations. To begin incorporating a culture of compliance within your healthcare organization, look to HCSI's Compliance Program.

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Afraid of Improving Your Employees

Are you afraid of improving your employees skills out of fear that they might leave?

The above question is one that has been pondered by many organizations. Some organizations have minimized training all together in order to keep their employees skill sets limited and thus minimizing their potential to leave for greener pastures. While other organizations have maximized training and the development of their employees while understanding the risks.

This is a discussion that needs to be had within every organization. What is the correct answer? There are four key points that will help any organization formulate the answer for their own situation.

Not All Employees Are the Same

When an employee is hired, nobody knows that employees true potential. When additional responsibilities are given to that employee, an organization is able to begin to see what the employee can offer. When an employee develops new skills through training and professional development, an employer is able to observe the true character and potential of that employee. When some employees are given new skills, they rise to the challenge and embrace the exciting change. These employees are looking to utilize their new found skills. While other employees who are given new skills do nothing with them and go right back to where they were before the new skills were learned. Giving employees new skills is an opportunity for an organization to identify employees with potential and possible future leaders. Not all employees will react to receiving new skills the same way. In regards to their potential, each employee is an individual and should be treated as such.

Resources or Cogs?

Every organization has a different mindset when it comes to their employees. Neither mindset is good or bad. Each mindset is derived from the business goals of the organization.

• Resource - Your employees are the greatest resource within the organization. Identifying, guiding, and developing employees with great potential and placing those employees into the areas of the organization where they can have the biggest impact. This is a process that takes time and some serious investment from the organization. As a resource to the organization, employees are developed and given new skills. Once those new skills are fully utilized, then that employee becomes more valuable to the organization.
• Cog - Your employees have been hired to do a job and it is expect that they will do that job well. Minimal amount of training or investment will be made by the organization as the employee only needs to know what is required for their particular job. Each employee is a cog working within a larger machine. If that cog is no longer effective and productive, then it will be quickly replaced by a new cog. All cogs are replaceable and are expected to burnout after a given amount of time.

Some people may object to employees being treated as a cog in a machine while others may object to investing too much into an expendable resource. As stated earlier, neither mindset is good or bad, but rather how a particular business operates.

Employee Value

Jack has just completed a week long training course. He is excited to begin implementing what he has learned into his job. There is a lack of enthusiasm from his supervisor about Jack's newly acquired skills. Nevertheless, Jack begins utilizing his newly learned skills and sees an increase in his productivity. Jack's confidence grows as he becomes a bigger contributor to the organization. However, as time passes, nothing changes with his job, responsibilities and perceived value. His supervisor did not appear to value the additional training Jack received nor the increased value of Jack himself. By this point, Jack has begun to feel frustrated and under valued. He got hired at a different company where Jack feels they value his skills, talents, and true value. After receiving Jack's two-week-notice, Jack's supervisor says to him, "I don't understand what happened. I thought everything was going as it always has." Jack then turned and said to his supervisor, "if that is what you think, then you don't know me."

When an employee receives training that adds to their professional skill set, they perceive that they become more valuable to the organization. If the organization sees that the added skill set did indeed make the employee more valuable, then that perceived value has become a reality and must be recognized. Recognition could come in many forms, including, but not limited to, increased responsibility of a leadership nature, monetary bonus, raise in salary, or a promotion. If the employee perceives their increased value, but the organization does not, then that employee-employer relationship will sour quickly and the employee will look for value validation elsewhere.

Succession Plan

What are your organizations future plans for leadership roles? Will those roles be filled with new employees outside of the organization or will those future roles be filled by developing talent within the organization? If an organization plans on filling future leadership roles with in-house talent, then giving employees new skills and knowledge is a critical component. As stated earlier, when you give employees new skills and knowledge through training and professional development, the true character and potential of that employee begins to surface. Once those potential future leaders are identified, then they must be valued and placed on a track of continued development. An organization's in-house talent will already have an understanding of your organization's culture and will be an example to other employees. There is a risk to developing in-house talent as some of that talent the organization has invested in will leave for another opportunity elsewhere. Should an organization only develop in-house talent? No, this tends to create group think and does not lead to new ideas or a fresh approach. It is important to fill some of the leadership roles with outside talent.

Conclusion

Deciding weather to give employees professional development and add to their skill set is a business decision that needs to be made by every organization. This decision should be based on the organizations' business goals and expected outcomes. There is no right or wrong answer to this question. Take a moment to think about this and ask yourself, "am I afraid of improving my employees?"

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