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The Challenge of Translating Healthcare Regulations into Training Curricula

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Providers across the healthcare continuum need to be certain they are compliant with all the regulations that apply to them as well as their individual clinicians. This necessary headache was the focus of a recent webinar, Challenge the Status Quo: Ending the Regulation Training Hunt, from HCCS, A HealthStream Company, that was led by Ben Diamond, Vice President of Compliance Solutions, and Debbie Newsholme, Senior Director of Content Development and Compliance Solutions.

Demonstrating the extreme regulatory environment, Newsholme began the webinar with some statistics about healthcare regulation:

  • $39 billion – the annual regulatory compliance cost to healthcare providers
  • 629 total discreet regulatory requirements – (341 hospital-related requirements and 288 post-acute care-related requirements)
  • 59 full time equivalents (FTEs) – a typical hospital’s staff dedicated to regulatory compliance
  • Different areas of compliance: quality reporting, meaningful use, hospital conditions of participation, fraud/abuse, privacy, security, billing, coverage verification requirements, etc.

Diamond shared that in addition to the 629 regulations covering healthcare entities, “there are literally tens of thousands of other federal and state regulations for individual clinicians and healthcare providers.” For anyone responsible for compliance training, he describes the nightmare involved “to find all these training requirements and then organize them into a curriculum specific for each job function within your organization.”

Planning Annual Healthcare Training

One scenario that occurs for many healthcare organizations is a planning meeting for everyone involved in annual healthcare training. Typically, the person in charge of learning gathers everyone with a role in this effort with their Joint Commission binders, lists of known regulations, and the documentation of everything that was required the previous year. Before any organization can even begin to include training for important initiatives, it has to make certain that all mandatory training is covered. State and federal obligations must be satisfied first.

Diamond offered that a common challenge is “to find out exactly what training is required for each learner based on their discipline and assign it to them. For example, respiratory therapists will likely have different state mandated requirements than a certified nursing assistant.”  Even though the applicable regulations are most likely available on the internet, they are often hard to find and even harder to interpret.

Case Study: Respiratory Therapist in Tennessee

To illustrate the difficulty that a typical healthcare provider may encounter, Diamond asks that we consider just one role in a single state—a respiratory therapist in Tennessee. First off, there are multiple government websites to check: “the OIG, CMS, OSHA, all of the other acronyms, plus the state board website for respiratory therapists in Tennessee, and possibly the Tennessee State Legislature website.” If the organization also operates across multiple states, that adds a further degree of complexity to the situation, requiring a similar search for regulations applicable in the additional jurisdiction. Add other care settings and you’ll have even more “variables we have to track.”

It’s not hard to imagine a scenario where important regulations are overlooked, especially when the approach to knowing them all is relatively piecemeal. Healthcare organizations need to be certain they are relying on a source for regulation that is comprehensive, trustworthy, and updated on a very regular, ongoing basis.

Learn more about HCCS Compliance training solutions.