There is no shortage of opportunities to lose our cool in healthcare compliance. Investigations into high-risk issues (e.g., fraud, drug diversion, privacy breach), all get people’s hearts pumping fast. That can lead to murky thinking, flared tempers, and unproductive trips down rabbit holes.
According to Stressaholic author, Hedi Hanna, this behavior can lead to “second-hand stress”. That is, the issue itself is stressful, but how someone reacts to the issue creates additional stress that is felt by others. Think about a time when you saw a speaker experience technical difficulties like feedback from a microphone. If the speaker fumbles around for a solution or starts yelling at the AV team in the back – what happens? You start to feel anxious for that speaker. You might even lose confidence in the speaker or resent his or her berating behavior.
Now let’s apply that concept to your work as a compliance officer. What does that additional stress do when it shows up as you’re responding to an issue? Nothing good. At best, it’s distracting attention away from your actual response. At worst, it leaves your healthcare leaders questioning your ability to take the lead in managing an issue.
I find that when healthcare leaders come to us with a high-risk issue to resolve, they are functioning in a state of uncertainty and may already feel anxious. I have found this is often the result of them not understanding the regulations as much as compliance officers do. That leaves them unable to see a path forward. If I pile on to that anxiousness, it’s not going to help anyone.
Instead, my aim has been to show up as a problem-solver—someone who can lead the organization out of a mess. A significant way to accomplish that goal is modeling a calming presence as I’m responding to an issue that has been identified.
So how do you maintain a calming presence during stressful times? First, take a deep breath and make sure you’re physically and mentally ready to lead calmly. Then, follow these four approaches which have helped me greatly over the years.
Approach #1-Assess the Threat
When faced with a high-risk issue, the first thing to do is to assess the threat. At this stage, your focus should be on the big picture, considering questions such as:
What is the risk to patient care?
What is the risk to the organization from a compliance and reputational standpoint?
Does this appear to be accidental or intentional?
Does this appear to be an isolated incident or a pattern of behavior?
Additionally, as part of your threat assessment, consider whether you or a colleague has seen something like this before. If so, there may be prior experience you can leverage for how to respond to the issue. That can help you remove some of the uncertainty of the next steps needed in order maintain a calming presence.
So what if this situation is unique, and there is no prior experience or other resources to draw from? If that’s the case, then the latter approaches can help you.
Approach #2: Focus on the Facts—not Opinions or Assumptions
Another way to maintain a calming presence during stressful times is to focus your attention on facts and not opinions or assumptions. That is true whether the opinions or assumptions are coming from you or someone else.
At a very basic level, when it comes to making decisions, we do so based on the information we have available to us. When confronted with responding to a perceived crisis, you have to be able to determine what information is based on fact (i.e., verifiable) and what information is based on someone’s personal feelings. One way to ensure you are focusing on the facts is to ask yourself “is this conclusion supported by facts or personal opinion?”
As you are gathering your facts, be mindful about how you are asking questions. For example, if you are asking a leading question (“Isn’t it true that…”), it’s going to feel like you’re cross-examining the person you’re interacting with. Taking such an approach would only add to their stress and anxiety. Instead, you want to frame your questions from a place of curiosity—not judgment. Some examples of the types of questions you could ask include the following:
“I am not familiar with X; please help me understand what you mean when you say X.”
“ X is an area outside of my expertise; can you tell me what X means?”
“To make sure we are on the same page, can you explain X to me like you would to someone off the street?”
When you take a curiosity approach to questioning, it demonstrates your thoughtfulness to a particular situation which can lower the stress and anxiety felt by others.
Approach #3: Focus on what you can control and don’t take ownership for what you can’t control
Another way to maintain a calming presence during a time of perceived crisis is to focus on what you can control and avoid taking ownership for what you can’t control. When it comes to responding to an identified compliance issue, one way to maintain that perspective is to focus on the present and the future rather than the past. For example, if one of your healthcare leader’s has entered into a business arrangement that turns out to violate a regulation, that’s a business decision that was made in the past. You can’t control that because you can’t undo what’s been done. Also, that was a business decision that was not yours to make.
Instead, your focus should be on what you can control and the business decisions that are yours to make which lie in the present and the future. More specifically, navigating the organization to resolving the issue (i.e., the present), and taking steps to prevent a future occurrence (i.e., the future). The government recognizes regulatory violations are going to occur and compliance officers can’t be everywhere at all times. That said, once an issue is identified, the government does expect the organization to address them and take steps to prevent future occurrences.
Keeping your focus on the present and the future will help you demonstrate a calming presence through your interactions with others as you are resolving the issue.
Approach #4: Focus on the Process
With any high-risk issue, it’s “the unknown” that probably scares us the most. That in part is due to the trap that people can fall into with assumptions and opinions that I mentioned above.
When something has gone wrong, as human beings, it is natural for our mind to shift to a never-ending list of “What ifs” (e.g., What if a government investigation or audit gets triggered from this issue?). If you want to maintain a calming presence you have to avoid falling into the “What if” trap. Instead, make your focus on the process of resolving the issue.
How do you do that?
By keeping the big picture in mind as you approach your work to resolve the issue. That means identifying upfront what your steps are going to be as you move forward. For example, when an issue first gets reported to you, don’t jump to problem solving. That comes later. Instead, this is the time to gather information and be thinking about questions like:
What questions do you need to answer in order to resolve this issue?
What information do you need in order to resolve the issue?
Where can you get this information?
What are going to be your next steps to bring about resolution?
Having a big picture perspective identifies what is most important to focus on—and when it is important to focus on it. This helps you determine what is a true priority, which can aid you in demonstrating a calming presence.
Pulling it All Together
As compliance officers, we are tasked with serving as a problem-solver for the organization. Once an issue has been an identified, you will inherently enter a period of time when emotions will be running high (e.g., anxiousness, frustration, anger).
These are also the times when it becomes important to respond appropriately, so that you can maintain a positive business relationship with others. By following the approaches outlined above, you will develop your skills at self-regulating your emotions so that you create a calming presence felt by others around you. By developing this skill set you will build stronger relationships with your healthcare leaders which puts you in a better position to successfully navigate the politics of healthcare.
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