Consistency Is Vital When Conducting Internal Investigations

MAY 03, 2018
Departments within a health care organization conduct internal investigations on a regular basis. Whether there is drug diversion suspected, misuse of 340B drugs, or time card abuse, there are a variety of reasons why a manager would have to conduct an investigation of employees. It is important to follow a consistent procedure to ensure that all individuals involved are exposed to the same process and treated equally, even though the infractions may differ.

The first step in establishing an internal investigation policy or procedure is to create or revise the complaint review policy. This policy should include how to report, who to report to, and provide anonymous reporting. Some organizations use their compliance departments to listen to employee concerns. Ideally, a third-party company to handle employee calls or emails would be best. 

It is important to establish a constant method of how employee concerns are handled by management. Employees will appreciate an established process and may be encouraged to report more often when irregularities are seen. Once communications are received by management, they should be reviewed and selected based on the available resources, the complexity, and the severity. Once it has been established that the organization’s policies have been breached, an investigation should begin promptly.  Swift investigations will increase the probability that employees and other witnesses, evidence, and supporting materials, will be available. A delay in beginning an investigation can mean that employees can leave the company, evidence can be lost, and witnesses may be unavailable. Also, the swift start of an investigation will establish a higher level of integrity with government agencies and law enforcement, if required.

When initiating an investigation, key information should be identified, including the issue, who should conduct the investigation, where should the investigation be conducted, who should be interviewed and how should the information be collected. In identifying the issue, there may be just 1 or many problems identified. The root cause must be identified. Organizations should not focus on the symptoms more than the root cause but prioritize. In terms of who should conduct the investigation, some organizations encourage managers from different departments to take part, leading to less bias. Many times, the immediate supervisor is the investigator and may include the human resources department. However, a manager's judgment can be clouded either negatively or positively. If there is a large-scale issue, a third-party organization may be asked to conduct the investigation. Location and timing is important to ensure the integrity of the information. Try to avoid scheduling employees to cross each other during the interview process. This will avoid the opportunities of information sharing. Finally, have 2 interviewers conduct the meetings, 1 to talk to the employee and the other to take notes. This allows for a better-quality interview with fewer distractions. This is also a benefit if the accused makes a confession, as it would be heard by multiple managers.

Seven steps are recommended in conducting an investigation, including analyzing, collecting, and organizing information; conducting interviews; ensuring confidentiality; providing interim protection, according to the Society for Human Resource Management.
 

Erica Lindsay, PharmD, MBA, Esq.
Erica Lindsay, PharmD, MBA, Esq.
Erica Lindsay, PharmD, MBA, Esq., is a healthcare attorney practicing in the greater Chicagoland area. Dr. Lindsay is active in various organizations including the American Bar Association, where she is chairwoman of the Nursing and Allied Healthcare Professionals Task Force, Illinois State Bar Association, Health Care Compliance Association, American Society of Pharmacy Law, American Intellectual Property Law Association and the Chicago Bar Association. She has recently published Protect and Empower: The Career Survival Guide for Healthcare Professionals. Dr. Lindsay can be contacted at erica.lindsay1@gmail.com
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