At Cleveland Clinic in Ohio, the chair of the corporate compliance committee and three other members are physicians, so Chief Integrity Officer Donald Sinko has given a lot of thought to the ways that physician burnout and shortages filter down at health care organizations.
“They play an important role in the compliance program, but when’s their ability to do administrative tasks and focus on the risk assessment? Who now has time to do that?” Sinko said. Similarly, with the nursing shortage, “Who is going to say you should spend X number of hours working on the compliance program instead of at the bedside?” There are ways to reduce the time commitment, such as physicians attending compliance committee meetings virtually, but there’s “exposure” every time compliance activities move further down the priority list.
The compliance and other repercussions of physician and nurse shortages and burnout—which took a turn for the worse with the COVID-19 pandemic—have been playing out at hospitals and health systems. They’re finding ways to support their clinicians and adapt compliance activities when necessary to a stressed workforce and cramped finances, but it’s a challenge.
“There’s burnout from having gone through the pandemic,” said Catherine Martin, chief compliance officer at Luminis Health in Maryland. She sees “something very different” because of the stress levels and the hours people have put in these past few years. As Martin rolls out annual compliance training, she notices that “people are worn out.” Complicating the goal of reinforcing a compliant corporate culture is the greater use of agency nurses and temp staff. Because they’re not a permanent part of the organization and may not live in the community, “naturally there’s a disconnect. There’s that sense of not being fully invested in compliance because ‘I won’t be here that long.’”
That raises the stakes for keeping compliance front and center. For example, Martin and her team have increased their rounding, visiting every department at Luminis hospitals, introducing themselves and handing out educational materials. They include a postcard series on various issues, such as ethical decision-making and snooping.
