In any business, proactive audits are the best way to identify and prevent operational risks. But in the “every hat at once” world of healthcare management, how do you ensure audits are a benefit, not just another task overwhelming your calendar?
The key is establishing a comprehensive, self-motivating routine for audit activity, then working with staff and knowledgeable outside partners to make it an ingrained component of operational culture.
Why Conduct Internal Audits
Audits discover problems, some of them expensive and requiring immediate action, so why shine that light to begin with? Unfortunately, an unseen problem doesn’t go away—it festers, and the consequences can be severe.
When done well, effective audits:
- Are critical for a successful compliance plan
- Let you identify and correct problems before they become worse and more expensive to resolve
- Let you build a work culture that educates employees to prevent new problems
- Improve financial performance, freeing resources for high-value tasks
- Improve the quality of care, benefiting patients and institution alike
- Pre-empt government audits, which are much worse to endure than your own
Where to Start
Like the audits themselves, efforts to establish your procedures should be taken one step at a time, building a sustainable regimen as you go.
Determine What Internal Audits Your Medical Office Requires
Your day is busy, as is your week, month and year. Accordingly, it’s important to ensure audits don’t become a burden to your daily operations in themselves.
The best way to prevent this is by prioritizing your audit activity, focusing on operational areas that present high risk, high volume (with corresponding opportunities for mistakes and errors) and high cost of compliance failure.
There are many areas where your medical facility should be conducting regular audits, but in most cases, you can focus first on medical coding, compliance programming, billing, patient privacy, security, and fraud.
The best practice for compliance is to audit every area of operations, but when time and financial resources are tight, triage your way to risk-reduction.
Develop an Internal and External Planning Team
Effective auditing is innately supported by your bureaucracy, and you should build stakeholder structures accordingly. Start by creating task forces to improve compliance, mixing internal information sources and key personnel with expert external partners whenever possible.
Work with your experts to discuss the risks associated with each type of audit, then develop protocols that incorporate the feedback to mitigate those risks and address legal concerns, as advised by your facility’s counsel.
Your counsel can also advise you about areas where expert help is especially important to reduce your facility’s legal liability, like partnering with a fully certified and knowledgeable waste management provider.
Additionally, look for partnership opportunities within your industry, whether through support systems, associations or other resources that competing facilities have used to develop their own best practices and audit materials.
Create an Internal Audit Plan
Audit plans can vary widely, but they all follow a general cycle of five stages:
- Audit preparation
- Criteria selection for audit focus points
- Performance measuring
- Initiating improvements
- Sustaining improvements into the future
Whenever possible, seek resources from relevant regulatory bodies associated with the operational area you’re planning to audit. Use these standards to develop your internal audit criteria, then create checks and safeguards to ensure your medical office and staff adhere to the guidelines.
Ensure Training Follow-Through
An effective audit regime is not a “set it and forget it” activity. Instead, your training and education efforts must be similarly reconfigured to continue supporting such requirements. Work with your expert partners to develop an effective baseline system, then use every audit as an opportunity to identify new problems and find preventative solutions in future education efforts.
Once you’ve created an effective audit routine and built the sort of institutional mechanisms that provide their own inertia, your facility will find it much easier to stay on top of compliance concerns in the future.