Internal compliance investigations often begin with interviews. In this case, the first step may be the most difficult component of an internal investigation strategy to master, warns Steven Ortquist, chief compliance officer at Banner Health System in Phoenix. "The investigative interview is as much art as it is science," he says.
Here are six interviewing techniques that Ortquist says will allow even a novice compliance investigator to conduct an effective compliance investigation interview:
I. Two are better than one. As a general rule, Ortquist says it makes sense to conduct investigative interviews in tandem. For one thing, a second set of ears provides the interviewer with a witness to what is said in the interview and significantly reduces the ability of the interviewee to change his or her story at a later time, he says.
As witnesses and subjects of an investigation begin to understand the significance of the investigation, Ortquist says their willingness to disclose what they know may diminish. "Sometimes their recollections of what occurred are even altered by fear of the coming outcome of the investigation," he adds.
According to Ortquist, a second set of ears also assures a more comprehensive grasp of what the interviewee says, because interviewers often hear and focus on different things. Finally, he points out that a second interviewer who mainly is an observer will be able to focus more fully on answers to questions and may be able to take more comprehensive notes.
II. Put interviewees at ease. Being called into an investigative interview by the compliance officer rarely is a welcome process. Ortquist says this is especially true for lower-level employees who may have less trust in the protections that exist for those who disclose the improprieties of other employees.
According to Ortquist, investigators may be able to put the interviewee at ease by first discussing your organization’s nonretaliation policy and answering any questions about the policy or its operations. It also may help to relieve some anxiety by taking a few minutes up front to talk about something other than the problem at hand, he adds.
III. Ask open-ended questions. When conducting an investigative interview, Ortquist says it is important to ask questions that will draw the interviewee out.
Often when interviewees are encouraged to reflect on what they know about a situation, the investigators will learn new and unexpected facts that may assist in the investigation, he explains.
Ortquist says investigators should avoid questions that require only yes/no answers, or questions that appear to lead a person to a particular answer.
For example, he says "describe the billing process in your department, focusing on places where you believe there is a lack of controls" is more likely to provide information useful to the investigation than is the question, "are you comfortable with the controls built into the billing process in your department?"
IV. Ask specific questions to develop problems the interviewee identifies. When the interview identifies a weakness or problem that needs further development, interviewers should ask more focused questions, Ortquist suggests. "It will often happen that an interviewee will make assumptions about what you know," he explains.
To avoid that, he says investigators should encourage them to explain a situation fully, as if they were explaining it to someone who had
no knowledge of health care or the particular facts and circumstances involved in an alleged violation.
V. Allow people to answer fully. Just as it is possible for interviewees to assume that an interviewer understands certain aspects of a problem, interviewers can find themselves making the same assumptions, warns Ortquist.
"The investigative interview is not about what you know or assume you know about the operations of a particular area or the character of people who may be subjects of the investigation," he asserts. "It is not about what you have seen in your review of documentary evidence or heard from other interviewees in the investigation."
Rather, he says it is about finding out what the interviewee knows about the facts and circumstances that may be involved in the suspected impropriety. "Allow people to answer your questions fully," he says. "Don’t allow discomfort with silence while the interviewee considers his answer to cut short the answer that may be about to emerge."
VI. Take thorough notes — don’t rely on your memory. According to Ortquist, the significance of something said in a compliance investigative interview may not immediately be obvious.
"Take thorough notes of your conversations with interviewees," he says. "Write things down even if they don’t make sense at the time that they are said.
"Your memory may fade, and you may become confused about who said what, as one interview turns into several with other subjects or witnesses," Ortquist adds. "The more complete your notes of the conversations, the more correct will be your conclusions when the investigation nears its end." n