Hospitals May Be Running the Right Kinds of Employment Background Checks, but What About the Staffing Firms They Use
The recent case of David Kwiatkowski, the traveling radiologic technologist who exposed countless patients to Hepatitis C, shines a spotlight on healthcare employment screening practices in general and those of healthcare staffing firms in particular. Kwiatkowski allegedly stole Fentanyl, a powerful synthetic opiate used as a post-surgery anesthetic, and replaced the syringes with saline where those needles were then used on patients, infecting them with Hepatitis C. Working for numerous healthcare staffing companies, this serial infector moved from state to state, harming innocent patients along the way. Kwiatkowski is believed to have infected over 30 patients at Exeter Hospital in New Hampshire until he was apprehended by authorities in July 2012.
At the heart of the tragedy is how Kwiatkowski managed to move effortlessly between states, staffing companies, and hospitals when he in fact has a history of substance abuse and drug diversion. Most disturbing is that some previous employers terminated him for these very reasons, and yet he was able to quickly hop on a plane and head to his next hospital stint. Prior to working at Exeter, Kwiatkowski worked in Arizona, Pennsylvania, Kansas and Georgia. It was while he was employed in Arizona that Kwiatkowski was fired for diverting Fentanyl. The Exeter outbreak that came to light only leads to more speculation about the extent of the damage he has wreaked.
Now that screening practices such as license verification and employment reference checking are being called into question, both the staffing companies that hired Kwiatkowski and the hospitals where he was placed are deflecting blame. Finger-pointing aside, this case forces healthcare employers and staffing firms alike to examine and fortify their own practices.
A hospital utilizing a staffing partner cannot afford to operate under assumptions. Before signing an agreement with a staffing provider, the hospital must lay out the terms of the background screening requirements. The individuals being placed by staffing firms are technically the employees of the staffing firm, not the hospital where they will be placed. However, patients, patients’ families, and the community at large do not distinguish between a hospital employee and a staffing firm employee. If a health provider’s name makes it in the news because of a patient violation, the community and public at large associate the crime with the hospital, not the staffing firm. Hospitals need to ensure they know who is working with their patients and colleagues.
So, how can healthcare employers and their staffing partners work together to ensure only the right types of individuals are being assigned?
- Hospitals should require more than a general attestation or a single clause in a contract requiring a staffing firm to vaguely "run background checks on their employees."
- The Hospital should outline in a contractual agreement the specifics of the types of screening the staffing firm is required to run on candidates it will place. In general, the staffing background check should mirror that which the hospital runs on its own employees.
- At minimum, the details should include the various search types and components (e.g. primary source professional license verification, education verification, previous employment verification, sanctions and exclusion screening, criminal records search, sex offender registry search, etc.), how far back searches need to be conducted, inclusion of maiden/alias name searches, search sources, etc.
- The hospital is also in a position to specify which approved background screening company or companies must or should be used.
- A decision must be made about who will be viewing the actual background check results. If the hospital will be gaining access to these consumer reports, the language in the consumer report authorization form should reflect this permission granted by the subject of the report.
- The two parties should agree on who will be reviewing and make decisions about any negative information that comes back on a report.
- And in advance of that discussion, there needs to be an understanding and agreement on what constitutes negative information. Will the staffing firm be interpreting the healthcare employer's hiring standards? Will that standard be specific enough and include details about what results are disqualifications for which positions?
- Both parties need to understand their duties under the Fair Credit Reporting Act and pay particular attention to properly carrying out their adverse action responsibilities.
Hospitals rely on the services of their staffing partners to deliver safe and effective healthcare to patients. They need qualified and experienced healthcare professionals who can fill a position quickly. Unfortunately, it's the need for speed that is sometimes directly responsible for shortcuts and oversights, like the ones that led to the repeated hiring of David Kwiatkowski. Healthcare employers must work effectively with their staffing partners to fully understand and approve of the screening that occurs prior to any candidates being placed in their facility.
Photo credit: Frenkieb.