How civility and culture affect compliance – Report on Medicare Compliance

In a recent edition of the Report on Medicare Compliance, Managing Editor Nina Youngstrom explored how civility and culture tie into compliance. Youngstrom decided to focus on the topic after attending a webcast sponsored by the Health Care Compliance Association and the Society for Corporate Compliance and Ethics. During the webcast, guest speaker, and ELI Vice President Tucker Miller asked the central question: Are we talking about generally doing the right thing, or doing the right thing right – in spirit and in fact?
Miller highlighted how every organization reaches a point where they can no longer prescribe behavior and expect results. This dynamic requires you to have a discussion about why, with so many rules in place, does bad behavior continue to be a problem. As an employer, you can either create rules where everyone is looking for the loopholes or you can encourage employees to embrace the spirit of the rule – and demonstrate their commitment to these standards by modeling appropriate behaviors.

No time to be nice?

Another interesting question presented during the webcast was not just knowing what the right thing is, but why do people do the wrong thing. Christine Porath, an associate professor at Georgetown University’s McDonough School of Business and co-author of The Cost of Bad Behavior, conducted a study that found more than half of the hundreds of people she surveyed say they behave badly because they’re simply overloaded; more than 40 percent say they have no time to be nice.
Are we really too busy to be nice or is something else going on? George Orwell said, “On the whole, human beings want to be good, but not too good, and not quite all the time.” Miller believes there’s truth in both of these views – we’re not just naturally compliant all the time. Then there are employees who are too stressed out and too busy to be nice and it’s that kind of behavior that negatively impacts the organization.

Your culture is defined by what you tolerate

The summation of these behaviors is what forms the culture of your organization, not your policies. You may have policies in place to prohibit bad behavior, but if you have a culture that says it’s acceptable for people to be dismissive or rude, or to ignore the need to be nice or respectful, you will develop systemic problems.
When people are behaving badly, it’s largely because it’s tolerated and so the question becomes what is your culture and how can you target it in a way that makes it more attractive to do the right thing than to do the wrong thing? What your culture tolerates leads to the day-to-day behaviors that eventually become habitual.
When you attempt to change behavior, it requires significant disruption of habitual behavior in order to break those habits. It requires deliberate thinking to make different choices and to capture those choices at a different point. When you’re looking for a solution to your culture, it means laying down a different track and encouraging people to pause at those transition points. This is where leaders can really make a difference by modeling desired behaviors and providing meaningful feedback. Helping employees think about the choices they have to select from, rather than following established patterns, is how the culture will change.

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