Panzer Jeffrey, Carlasare Lindsey E, Hamielec Maggie, Sinsky Christine A, Simon Jodi
AllianceChicago, Chicago, IL, USA.
Tapestry 360 Health, Chicago, IL, USA.
Perm J. 2025 Jun 16;29(2):3-11. doi: 10.7812/TPP/24.086. Epub 2025 Mar 4.
The volume and complexity of administrative regulations, standards, and associated tasks contribute to administrative burden in health care. Misinterpretation and misapplication of regulations impede efficiency and contribute to professional dissatisfaction.
The authors aimed to 1) understand the compliance professional role, training, and background; 2) uncover their perspectives toward documentation and administrative burden; and 3) identify common regulatory misconceptions by compliance professionals.
In June 2023, the authors surveyed a sample of professionals serving in compliance roles listed within the directory of a national network of federally qualified health centers. Data were collected through REDCap. Follow-up interviews were completed with 4 participants between September and November of 2023. Descriptive statistics were calculated for all quantitative variables; interview transcripts were analyzed using rapid qualitative analysis. Methodological triangulation was employed to identify themes across survey and interview responses.
About one-third (5/16, 31%) of compliance professionals had formal training. The majority (15/16, 94%) agreed or strongly agreed that "If a clinician's action is not documented it is not 'done.'" Compliance professionals' perceptions of regulatory adherence in clinical scenarios showed high variability, with some participants noting noncompliance in situations where there were no regulatory infractions. Participants perceived administrative burden and waste in health care but diverged in their views of whether they have a role in protecting clinicians from administrative burden.
This study reveals inaccuracies in compliance professionals' interpretations of regulations and standards and suggests a gap between written regulations and interpretation at the organizational level. This overinterpretation may create unnecessary work for physicians and their teams.
行政法规、标准及相关任务的数量和复杂性导致了医疗保健中的行政负担。对法规的误解和错误应用会阻碍效率，并导致专业人员不满。
作者旨在：1）了解合规专业人员的角色、培训和背景；2）揭示他们对文件记录和行政负担的看法；3）识别合规专业人员常见的监管误解。
2023年6月，作者对一个全国性联邦合格健康中心网络名录中列出的合规岗位专业人员样本进行了调查。数据通过REDCap收集。2023年9月至11月期间，对4名参与者进行了后续访谈。对所有定量变量进行描述性统计；使用快速定性分析对访谈记录进行分析。采用方法三角验证法确定调查和访谈回复中的主题。
约三分之一（5/16，31%）的合规专业人员接受过正规培训。大多数人（15/16，94%）同意或强烈同意“如果临床医生的行为没有记录，那就不算‘完成’”。合规专业人员对临床场景中监管遵守情况的看法差异很大，一些参与者指出在没有违规行为的情况下存在不合规情况。参与者认为医疗保健中存在行政负担和浪费，但在他们是否有责任保护临床医生免受行政负担方面存在分歧。
本研究揭示了合规专业人员对法规和标准解释的不准确之处，并表明在组织层面书面法规与解释之间存在差距。这种过度解读可能会给医生及其团队带来不必要的工作。
