Just because “nothing has changed,” doesn’t mean annual HR and compliance training should be avoided. Training can be easily forgotten.
As we prepare for 2016, I remind my clients to think about annual HR and compliance training for practice employees. Not surprisingly, clients often complain that it’s unnecessary because “nothing has changed” or employees still remember their training from last year. In my experience, employees forget most of their training (almost immediately) and those who do remember are complacent about applying their knowledge or are unable to practically apply training to real-life situations. For example, last year, just weeks after training a client’s practice, the following occurred:
A nurse in the practice (“Sue”) complained she had been sexually harassed by another male supervisor nurse (“Tim”). Sue and Tim are immediately put on different schedules so they could no longer interact and statements were taken from both parties (which tell opposite stories). There is no video evidence and no direct witness to the events, although statements are taken from other staff members.
Sue appears at work the next day apparently distressed and under the influence. Another nurse “friend” (let’s call her Jane) provides prescription medication to calm Sue and drives her to the hospital. Later, Jane is “so concerned” about Sue’s condition that she accesses the hospital’s EHR system (to which the practice is connected) to check on Sue’s status.
Sue calls the practice manager the next morning to inform him that she considers herself on family and medical leave (FMLA) and further insists the practice should have to pay for her leave (due to her complaints) since she has no accrued paid time off (PTO) left. The practice’s policy does not call for any paid FMLA leave (if Sue was to qualify).
This may seem like a crazy scenario, but it’s really not that surprising at all! What is unfortunate is that every one of the employees in the above scenario had been completely trained numerous times on the practice’s policies and yet various violations still occurred.
First, with regard to the alleged sexual harassment, there could be no conclusions made after the investigation was complete. The results of the investigation were still distressing since numerous witnesses, in addition to Sue and Tim, admitted there was a pattern of lewd, vulgar and inappropriate discussions going on throughout the workday and numerous employees complained (during the investigation) that they had asked Sue, who seemed to be the main source, to cease such behavior. It appeared that various staff and physicians were aware and participated in such sexual discussions, which clearly violated the practice’s sexual harassment policy. Specific scenarios during training had covered the exact violations that occurred and yet no employee recognized there was a violation of the policy. To address the matter, the practice issued warnings to all involved and hired an expert to bring in more training, which will now be repeated twice annually. Every employee will acknowledge and sign a new policy as well.
Another issue in the scenario that occurred was Jane’s violation of HIPAA by accessing another employee’s EHR at the hospital. She also went against practice policy by prescribing medications to an employee of the practice (who already appeared impaired). This was not Jane’s first HIPAA violation and per practice policy, she was terminated. Action is still being considered on the prescription issue and Sue’s appearance at work under the influence.
Finally, like other practices, this client has a policy for FMLA and paid time off. Our advice is that the practice should always try to follow its policies consistently and without exception. When a practice opts to reach a unique arrangement with an employee (such as letting them dip into future PTO), this should be documented. Certainly, a practice should never pay an employee who has made threats against the practice without talking to counsel, as such payment could be deemed an admission of wrongdoing.
No matter how much training a practice provides, there are always going to be violations of a practice’s policies that occur. The expense and hassle of dealing with the repercussion of such event is far greater than scheduling and/or paying for annual training. If you think your staff remembers everything they have been trained on in the past - try asking a few random questions and see whether you are surprised by the results!