Healthcare compliance is the process of following rules, regulations, and laws that relate to healthcare practices. It can cover a wide variety of practices, internal and external rules, mostly related to patient safety, good clinical outcomes and the privacy of patient information.
Compliance in healthcare comes with the highest stakes because if the healthcare provider or the healthcare support staff do not follow standard algorithms, procedures and instructions they could endanger patients and other healthcare staff.
So, healthcare compliance is to ensure safe and high-quality patient care. Complying with the standard procedures and regulations helps healthcare organizations (HCOs) to continue providing and improving patient care.
It is important to be clear about the healthcare sector and its players i.e. the healthcare organizations; all the companies which are involved in products and services related to health and medical care represent the healthcare sector, and this comprises of; pharmaceuticals, biotechnology, equipment and distribution. While the healthcare delivery sector includes hospitals and clinics, diagnostic services, telemedicine, medical research and clinical trials, health tourism (including the associated services like representative offices, transportation, lodging, boarding) and medical insurance.
HCOs are also bound by strict standards, regulations, and laws from the government i.e. ministry of health, medical council, dug regulatory authority and the healthcare commission. Non- compliance could lead to lawsuits, fines, or provocation of licenses.
HCOs have to follow the same workplace regulations that apply to the other organizations; they even have to look after matters which are not regulated in Pakistan for example there is no independent legislation on occupational safety and health issues in Pakistan, but an accident at workplace becomes the responsibility of that workplace, so there has to be standard procedures in place for such eventualities.
The HCOs should have a compliance department to maintain compliance and it should have the authority to design strategies to implement compliance. Viable and working compliance department can come when the organization’s top leadership acknowledge its importance and need. So, the top leadership must put the charter in place to implement an effective compliance program, in order to decrease the cost by being proactive instead of being reactive.
It should be noted here that every member has to contribute in maintaining compliance. The success of the compliance program lies in the understanding and willingness of every team member of the HCO to follow procedures and regulations. The top leaders should encourage transparency and ethical behavior. Preferably, the HCOs should inculcate a culture of accountability within the entire organization and to help all the team member to understand the importance and benefits of compliance.
Strategies for developing an effective compliance program:
- Develop, and implement procedures, policies and the codes of conduct. These should be accessible so that the teams can read and understand how to comply with them.
- Employ a qualified compliance officer or compliance team, who should ensure that the proper controls are in employed effectively in the compliance program and keep updated on the changes in regulations. This team should report directly to the MD or CEO.
- Regular training on procedures, policies and the codes of conduct so that the employees understand the importance of compliance and promote a culture of compliance.
- Create channels of communication including confidential complaints, because the teams are better placed to spot violations of compliance. They should be trained to know how to report violations. Such open communication can address issues internally and avoid losses.
- Internal audits to check compliance programs to identify and stop issues before they become a problem. Anonymous surveys to the teams for any compliance concerns is also a way of audit.
- Establish the disciplinary actions for noncompliance. This will explain how serious compliance issue is. Signed acknowledgement of receipt should be practiced to ensure enforcement.
- Prompt response to offenses because discipline and corrective action is not only beneficial but it also creates examples that provide a learning to the others. This also avoids future incidents.
Healthcare compliance is an essential for organization protection, it results in good patient care (directly and indirectly) and ensures smooth running of the operations. If you want to develop a compliance program, you can communicate with me for communication and advice for compliance program, policies and training.