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Organizational Results: Conduct Compliance Audits

Jan 31, 2010
Organizational Results

Kendall L. Stewart, M.D.

Wouldn’t it be nice if we all just did what we are supposed to do? Some of us are more self-disciplined than others, but all of us tend to slack off if we can get away with it. All of us know that we should wash our hands between patients, but an astounding number of us will not do it unless someone is watching. It’s discouraging, but it’s just the way it is.

1. Specify the behavior you expect. Be very clear and specific. Describe precise behaviors. Resist the temptation to focus on attitudes. Assume nothing. When you have clarified exactly what you expect to happen, make it clear that you expect it to happen every time.

2. Inform people that you will be watching. Then watch. When people figure out that no one is watching, they will fall right back in to their natural patterns of non compliance. Do you really believe that anyone would follow the speed limit if the cops were never around?

3. Hold people accountable. The consequences for noncompliance must sting. If you issue parking tickets to those employees who park in the spaces reserved for patients but do nothing more, the transgressors will just tear up the tickets and keep parking improperly. And they will complain bitterly about receiving these annoying tickets. If, on the other hand, a ticket results in an automatic corrective action and a letter to their files, they will find another place to park.

How do you inspect what you expect in your company?

6 Comments
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6 Comments

  1. Vicki Noel  •  Jan 31, 2010 @6:16 pm

    I personally believe that the best way to “watch” the performance of the departments you represent without looking over shoulders is to be present and connected with the work being performed (if possible). Staying competent so that I can “roll up my sleeves” and fill in different roles within my depatment(s) provides me with the best insight into what work is being performed. As a bonus it is also appreciated when I can assist the department during peak times.

  2. Wendi  •  Jan 31, 2010 @8:25 pm

    I love to pitch in and roll up my sleeves. I find the work not only rewarding but you are right Vicki, it gives you a clearer perspective of what the employees deal with on a day to day basis. It helps with problem solving and shows your team that you are willing to be there for them when it is needed.

  3. Leeann Sammons  •  Jan 31, 2010 @9:45 pm

    I conduct audits formally and informally. Several of our patient and worksite safety leaders use formal inspection and audits to check and verify behaviors and processes. As I am out rounding I conduct informal audits. For example, I use the observation method to check that the proper PPE, such as eye protection, is being worn by maintenance staff when they are working above the ceiling or by direct care providers when handling body fluids. I also randomly check the tags on our fire extinguishers to see that inspections have occurred and have been appropriately documented as required by the National Fire Protection Association(NFPA) or that all of our egress paths are clear. Using these issues as teachable moments makes the time and energy it takes to conduct audits worth it.

  4. Kendall L. Stewart  •  Jan 31, 2010 @10:49 pm

    What barriers have you all overcome to accomplish your “inspections?”

  5. Leeann Sammons  •  Feb 7, 2010 @10:23 am

    To overcome the barriers of getting inspections started, I have used conducted inspections myself, used evidence-based practices, patience, challenging leaders and sometimes just demanding that it happen.

  6. Kendall L. Stewart  •  Feb 7, 2010 @5:49 pm

    Leeann, I agree that leaders cannot depend on persuasion alone.
    For those of us who long to be loved, making others uncomfortable is hard.
    We may be tempted to settle for mediocre performance instead of being unpopular.

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