Nursing practice

What is whistleblowing? #

An individual who discloses infor­ma­tion, either inter­nally (e.g., manager, compli­ance officer, hotline) or exter­nally (e.g., regula­tory agencies, media, lawmakers, watch dog organi­za­tions) that he/​she reason­ably believes evidences a viola­tion of a law, rule or regula­tion, gross misman­age­ment, gross waste of funds, abuse of authority, or a substan­tial and specific danger to public health or safety.

A whistle­blower is

  • Often a current/​former worker with credible infor­ma­tion about wrongdoing/​illegality witnessed on the job.
  • Someone who discloses issues that require change to comply with law or to protect public interest.

https://​www​.whistle​blower​.org/​resources/

Best practices for healthcare organizations #

Report suspected violations or wrongdoing internally #

  • Contact the Compli­ance Office, the safety/​compliance hotline, or use chain of command. This is consis­tent with advice provided by the Office of Inspector General, Depart­ment of Justice, and U.S. Sentencing Commission.
  • Seek to resolve issues inter­nally before involving a govern­ment agency to oversee the process. 
  • Support an organi­za­tional culture of trans­parency and contin­uous improve­ment. Workers have an impor­tant role in ensuring safe/​quality care and a duty to report suspected wrongdoing/​viola­tions.
  • EXCEP­TION: Securi­ties law viola­tions — Anti-Retal­i­a­tion Protec­tions only extend to workers who have reported securi­ties law viola­tions exter­nally to the Securi­ties and Exchange Commis­sion (SEC).

https://​www​.forbes​.com/​s​i​t​e​s​/​i​n​s​i​d​e​r​/​2​0​1​8​/​0​2​/​2​3​/​d​o​d​d​-​f​r​a​n​k​s​-​a​n​t​i​-​r​e​t​a​l​i​a​t​i​o​n​-​p​r​o​t​e​c​t​i​o​n​s​-​a​p​p​l​y​-​o​n​l​y​-​t​o​-​w​h​i​s​t​l​e​b​l​o​w​e​r​s​-​w​h​o​-​r​e​p​o​r​t​-​t​o-the-sec/

Be alert for practices/​documents appearing to block workers from reporting violations externally #

  • Organi­za­tional Compliance/​Human Resources documents should not limit the worker’s ability to: 
  • File charges/​complaints with any federal, state, or local govern­mental agency or commission.
  • Limit the worker’s right to commu­ni­cate with any govern­ment agency or partic­i­pate in any inves­ti­ga­tion or proceeding that such an agency may conduct.
  • A health­care organization’s code of conduct, compli­ance policies and compli­ance training should promote internal commu­ni­ca­tion and specify that workers have a duty and right to report wrong­doing and legal viola­tions (without retri­bu­tion or retaliation).

https://​compli​ance​.com/​i​n​d​u​s​t​r​y​-​n​e​w​s​/​b​e​s​t​-​p​r​a​c​t​i​c​e​s​-​h​e​a​l​t​h​-​c​a​r​e​-​o​r​g​a​n​i​z​a​t​i​o​n​s​-​r​e​g​a​r​d​i​n​g​-​w​h​i​s​t​leblowers/

Considerations for healthcare whistleblowing #

If an illegal or unethical practice is identified, reserve judgment until adequate documentation is collected #

  • Individual(s) engaged in uneth­ical or illegal conduct will not welcome inquiry into their practice.
  • Collect data to substan­tiate the claim; remember that you are not protected from retal­i­a­tion in a whistle-blower situa­tion until you blow the whistle.
  • Blowing the whistle means that you report your concern(s) to the national and/​or state agency respon­sible for regula­tion of the organi­za­tion for which you work; criminal activity includes reports to law enforce­ment agencies.
  • Reporting recom­men­da­tions: put complaint(s) in writing; document objec­tively; retain documen­ta­tion of events, including all inter­ac­tions related to the whistle-blowing situation.

Before you report #

  • Seek counsel of someone you trust outside of the situa­tion to provide an objec­tive perspective.
  • Consult with WSNA or legal counsel, if possible, before acting to deter­mine how best to document/​communicate concern(s).

https://​www​.nursing​world​.org/​p​r​a​c​t​i​c​e​-​p​o​l​i​c​y​/​w​o​r​k​f​o​r​c​e​/​t​h​i​n​g​s​-​t​o​-​k​n​o​w​-​a​b​o​u​t​-​w​h​i​s​t​l​e-blowing/

Whistleblowing is a serious and often complex matter. Make sure that you know the facts before acting. #

Washington State Department of Health (WA DOH) #

Concerning #

  • Health profes­sional complaints.
  • Health facility complaints.

Contact information #

https://​www​.doh​.wa​.gov/​L​i​c​e​n​s​e​s​P​e​r​m​i​t​s​a​n​d​C​e​r​t​i​f​i​c​a​t​e​s​/​F​i​l​e​C​o​m​p​l​a​i​n​t​A​b​o​u​t​P​r​o​v​i​d​e​r​orFacility

Whistleblower protections #

RCW 43.70.075 – A whistle­blower who complains, in good faith, to the depart­ment of health about the improper quality of care by a health care provider, or in a health care facility, as defined in *RCW 43.72.010, or who submits a notifi­ca­tion or report of an adverse event or an incident, in good faith, to the depart­ment of health under RCW 70.56.020or to the indepen­dent entity under RCW 70.56.040, shall remain confidential.

Washington State Department of Labor and Industries
 #

Concerning #

  • Worker in immediate danger.
  • Safety and health concerns (workplace).

Contact information #

Whistleblower protections #

RCW 51.48.025 – An employee may not be discharged (or discrim­i­nated against) in retal­i­a­tion for filing (or commu­ni­cating an intent to file) a workers’ compen­sa­tion claim.

Washington State Medicaid Fraud Control Division #

Concerning #

  • Medicaid fraud, waste, abuse.
  • Resident abuse/​neglect in Medicaid funded nursing homes, adult family homes, boarding homes.

Contact information #

(360) 586‑8888

Office of Attorney General
Medicaid Fraud Control Division
PO Box 40114
Olympia, WA 98504

Whistleblower protections #

Refer to RCW 43.70.075 including RCW 4.24.500 and 4.24.520.

The Joint Commission (TJC)
#

Concerning #

  • Patient, staff, family safety concerns.

Contact information #

The Office of Quality and Patient Safety
The Joint Commis­sion
One Renais­sance Boule­vard
Oakbrook Terrace, Illinois 60181

Fax: (630) 792‑5636

Whistleblower protections #

Joint Commis­sion (and the National Committee for Quality Assur­ance) are private organi­za­tions and do not confer whistle­blower protections.