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.
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).
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).
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).
Whistleblowing is a serious and often complex matter. Make sure that you know the facts before acting. #
Washington State Department of Health (WA DOH) #
- Health professional complaints.
- Health facility complaints.
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
- Worker in immediate danger.
- Safety and health concerns (workplace).
- Worker in immediate danger call (800) 423‑7233.
- Safety and health concerns, visit https://www.lni.wa.gov/Safety/TrainingPrevention/Help/ReportHazards/complaints.asp
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 #
- Medicaid fraud, waste, abuse.
- Resident abuse/neglect in Medicaid funded nursing homes, adult family homes, boarding homes.
Office of Attorney General
Medicaid Fraud Control Division
PO Box 40114
Olympia, WA 98504
Refer to RCW 43.70.075 including RCW 4.24.500 and 4.24.520.
The Joint Commission (TJC)
- Patient, staff, family safety concerns.
The Office of Quality and Patient Safety
The Joint Commission
One Renaissance Boulevard
Oakbrook Terrace, Illinois 60181
Fax: (630) 792‑5636
Joint Commission (and the National Committee for Quality Assurance) are private organizations and do not confer whistleblower protections.