Kusserow’s Corner: Tips on Debriefing Individuals Who Register Complaints

It is not often that a health care organization has a need for a full investigation, so when something serious does arise, it often catches off guard the Compliance Officer and others charged with resolving complaints.  It is worthwhile to have someone trained or at least familiar with conducting an investigation on staff, or have someone available that can be called upon to assist. Keep in mind when seeking expert assistance that just because someone is an attorney, it does not mean they are expert investigators.  The key to success of most investigations lies with following the right steps from the inception of a complaint through final report and disposition of a matter.  The following provide tips in debriefing complainants are drawn in large measure from a book I wrote on “Conducting Internal Investigation in Health Care Organizations.”

There are many reasons why someone will take the time and risk of filing a complaint or set of allegations.  It is important to understand their motivation, in order to properly evaluate the allegations and determine the appropriate response.  What this means is finding out why they are making the complaint and the level of personal concern for the issue raised in the allegation(s).  It is important to note that not all motivation is altruistic.  Sometimes a complainant is trying to strike back at someone, such as their supervisor or to deflect attention from their own conduct.  If possible, try to do a little homework on the complainant to learn if there are facts on record that may give some insight to the person.  Of course, full debriefing assumes the person has presented themselves in making their complaint or allegations.  In many cases, the complainant may have reported directly to the hotline anonymously.  In that case, the Compliance Officer will have to rely upon how well the operator debriefed the person and the details in the report.

Questions for Determining Motivation

  1. Has there been any prior history between complainant and subject?
  2. Is the complainant a friend or hostile to the subject?
  3. Is complainant personally affected by the conduct reported?
  4. Are friends of the complainant being affected by the alleged conduct?
  5. Why is the complainant raising concerns at this time?

Once the interview begins, it is important to hear out what the person wants to report in their own words, with as little interruption as possible.  Once this has been done, then it is time for specific clarifying questions to guide the person back through the information.  These questions should include the standard WHO, WHAT, WHERE, WHEN, and WHY.  These questions should be designed to expand on the factual details and to test and corroborate the information.  During the debriefing process, it is important to establish relevant time frames and chronology of events. It is important to look for avenues that will provide a means to either substantiate the allegations or dismiss them.  Inasmuch as the allegations may relate to a specific event, something personal or organization wide, an ongoing process problem, etc.  It is impossible to draft a set of question that would apply in every circumstance, however the following gives an idea about the types of questions that can be asked in a formal debriefing.

20 Debriefing Questions for Complainants

  1. What happened that led you to make the complaint?
  2.  Why are you coming forth now?
  3.  What occurred, where, when, and how?
  4. Has anyone else told you about similar conduct?
  5.  When did it occur (date and time)?
  6.  Where did it take place?
  7.  How did you respond when it occurred?
  8.  Who did you discuss this with and when?
  9.  What did you say?  What did they say?
  10.  How has this incident affected you?
  11.  Has your job been affected in any way?
  12.  Who else was present when the act occurred?
  13. Who else has any knowledge of the act?
  14.  Has anyone else discussed it with you?
  15.  If so, who and what did that person say?
  16. Who else was involved, knows about, or witnessed it?
  17.  Who else have you told (employees, supervisor, attorney, media, etc.)?
  18.  Why do you think it happened?
  19. What do you believe should be done to resolve this matter?
  20.  Has is happened before (an isolated event or part of a pattern)?

Once information is received, time is not a friend and immediate action is warranted.  Those who register complaints, by whatever means, may decide to make another call to an attorney, government agency, media, etc.  Furthermore, the key to resolving any issues that are raised in a complaint will be interviewing people, whose memory clouds and fades fairly quickly.  You need to speak with possible witnesses before that happen. Sometimes a single complaint may encompass several different allegations.  This is very common however, regardless of how many different allegations that may be included in a single complaint, treat each allegations independently. As with other sources of information that could predicate an investigation, it is critical that the information be acted upon immediately. Any delays could prove to result in serious problems and possible liability.

Richard P. Kusserow served as DHHS Inspector General for 11 years. He currently is CEO of Strategic Management Services, LLC (SM), a firm that has assisted more than 3,000 organizations and entities with compliance related matters. The SM sister company, CRC, provides a wide range of compliance tools including sanction-screening.

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Copyright © 2014 Strategic Management Services, LLC. Published with permission.