WEBVTT 00:00:04.821 --> 00:00:06.540 position:50% align:middle - [Nancy] Okay. Hello, everyone. 00:00:06.540 --> 00:00:11.820 position:50% align:middle I'm Nancy Spector, the Director of Nursing Education at NCSBN. 00:00:11.820 --> 00:00:18.780 position:50% align:middle And I am here today with a panel where we're going to talk about fraud detection in nursing. 00:00:18.780 --> 00:00:24.090 position:50% align:middle And I have to tell you, I love all the lights in here because when I got ready 00:00:24.090 --> 00:00:29.030 position:50% align:middle this morning at 5:30 a.m., all our power went off at our house. 00:00:29.030 --> 00:00:32.804 position:50% align:middle And so, I got totally ready with no lights at all. 00:00:32.804 --> 00:00:34.624 position:50% align:middle Just flashlights. 00:00:34.624 --> 00:00:39.434 position:50% align:middle So all of you women in the audience know how that is to get mascara on. 00:00:39.434 --> 00:00:41.344 position:50% align:middle Not easy. 00:00:41.344 --> 00:00:48.114 position:50% align:middle So as you know, fraud is pervasive across all the professions. 00:00:48.114 --> 00:00:56.984 position:50% align:middle So the educators and employers as well as regulators really must be able to identify fake credentials that 00:00:56.984 --> 00:00:59.124 position:50% align:middle are sometimes presented. 00:00:59.124 --> 00:01:04.266 position:50% align:middle And therefore, NCSBN established a fraud detection task force. 00:01:04.266 --> 00:01:09.936 position:50% align:middle And that has been made up, we're still meeting, of leaders in nursing regulation, 00:01:09.936 --> 00:01:12.346 position:50% align:middle education and practice. 00:01:12.346 --> 00:01:18.456 position:50% align:middle And today, we have four esteemed representatives from that task force. 00:01:18.456 --> 00:01:24.676 position:50% align:middle And we're going to talk about some of the situations that they've experienced and give you some 00:01:24.676 --> 00:01:30.361 position:50% align:middle recommendations for detecting and hopefully preventing fraud. 00:01:30.361 --> 00:01:34.501 position:50% align:middle But before we get started with our discussion, our panelists would like to introduce 00:01:34.501 --> 00:01:36.911 position:50% align:middle themselves to you. So we'll start here with George. 00:01:36.911 --> 00:01:39.131 position:50% align:middle - [George] Hi. My name is George Zangaro. 00:01:39.131 --> 00:01:41.901 position:50% align:middle I'm from the American Association of Colleges of Nursing. 00:01:41.901 --> 00:01:45.091 position:50% align:middle I'm the chief policy and scientific officer. 00:01:45.091 --> 00:01:46.871 position:50% align:middle - [Gerianne] Hello, everyone. 00:01:46.871 --> 00:01:52.251 position:50% align:middle I'm Gerianne Babbo, Director of Education for the Washington State Board of Nursing. 00:01:52.251 --> 00:01:56.001 position:50% align:middle - [Beverly] Good morning, colleagues. My name is Beverly Malone. 00:01:56.001 --> 00:02:00.906 position:50% align:middle I'm the president and CEO for the National League for Nursing. 00:02:00.906 --> 00:02:04.736 position:50% align:middle - [Robyn] Hi, everyone. Good morning. My name is Robyn Begley. 00:02:04.736 --> 00:02:08.246 position:50% align:middle I'm the CEO for the American Organization for Nursing Leadership. 00:02:08.246 --> 00:02:12.996 position:50% align:middle I also serve as chief nursing officer for the American Hospital Association and it's great to be here 00:02:12.996 --> 00:02:14.456 position:50% align:middle with you this morning. 00:02:14.456 --> 00:02:16.298 position:50% align:middle - Thank you. 00:02:18.956 --> 00:02:22.316 position:50% align:middle And they have been great on this task force. 00:02:22.316 --> 00:02:26.646 position:50% align:middle So first question to all of you, to each of you. 00:02:26.646 --> 00:02:34.077 position:50% align:middle In your roles, have you ever experienced individuals presenting themselves with false credentials? 00:02:34.077 --> 00:02:40.647 position:50% align:middle And if so, what did you do or what could you have done now that you've been on our task force? 00:02:40.647 --> 00:02:44.057 position:50% align:middle Who wants to get started with that one? 00:02:44.057 --> 00:02:46.477 position:50% align:middle - I'll be happy to start. 00:02:46.477 --> 00:02:52.987 position:50% align:middle And actually, I've been in my role for almost five years, so I'm putting on my chief nursing officer hat, 00:02:52.987 --> 00:02:58.427 position:50% align:middle where I, you know, I was in New Jersey for 20 plus years prior to this role. 00:02:58.427 --> 00:03:06.811 position:50% align:middle And I'm going to, my brief story will be illustrating what I did wrong and what I learned. 00:03:06.811 --> 00:03:11.461 position:50% align:middle So this was in my early days as chief nurse, probably around the year 2000. 00:03:11.461 --> 00:03:16.791 position:50% align:middle I had been in my organization already for 15 years. 00:03:16.791 --> 00:03:22.431 position:50% align:middle We had processes we thought that were strong. 00:03:22.431 --> 00:03:26.811 position:50% align:middle And we had a robust tuition reimbursement program. 00:03:26.811 --> 00:03:31.760 position:50% align:middle My story is about a nurse who was a nurse manager. 00:03:31.760 --> 00:03:35.410 position:50% align:middle She was an RN, associate degree grad. 00:03:35.410 --> 00:03:44.890 position:50% align:middle This is back in the day when, in our pursuit of magnet, the requirement for a BSN-prepared nurse was, you know, 00:03:44.890 --> 00:03:47.710 position:50% align:middle was becoming the requirement. 00:03:47.710 --> 00:03:53.770 position:50% align:middle We had lots of our nurse managers, not a lot actually, a few nurse managers that did not have their bachelor's 00:03:53.770 --> 00:03:55.460 position:50% align:middle degree that needed to go back to school. 00:03:55.460 --> 00:03:59.340 position:50% align:middle But one nurse in particular started back. 00:03:59.340 --> 00:04:04.401 position:50% align:middle This was a little bit pre-online, lots of online education. 00:04:04.401 --> 00:04:12.471 position:50% align:middle So she went to Philadelphia twice a week, time off, tuition reimbursement, graduated. 00:04:12.471 --> 00:04:19.781 position:50% align:middle We had celebrations at work when she graduated, diploma hanging on the wall. 00:04:19.781 --> 00:04:27.451 position:50% align:middle She then decided she wanted to pursue her advanced practice degree, enrolled in a program, 00:04:27.451 --> 00:04:32.624 position:50% align:middle only to find out after about three and a half years that she never went to school. 00:04:32.624 --> 00:04:34.874 position:50% align:middle Never completed her baccalaureate. 00:04:34.874 --> 00:04:37.064 position:50% align:middle Never entered the program. 00:04:37.064 --> 00:04:40.274 position:50% align:middle Never entered, you know, a master's program. 00:04:40.274 --> 00:04:43.824 position:50% align:middle And when we did the deep dive, and someone tipped us off to this, 00:04:43.824 --> 00:04:49.674 position:50% align:middle and when we did the deep dive, we found that our internal processes were not 00:04:49.674 --> 00:04:51.714 position:50% align:middle obviously not sufficient. 00:04:51.714 --> 00:04:53.754 position:50% align:middle So lesson learned. 00:04:53.754 --> 00:05:00.923 position:50% align:middle Even if you know a person who is part of your organization, it's not necessarily a new hire, 00:05:00.923 --> 00:05:08.433 position:50% align:middle you know, those strict processes that we had after that, of course, implemented, you know, 00:05:08.433 --> 00:05:11.563 position:50% align:middle were something that you really need to use for everybody. 00:05:11.563 --> 00:05:15.703 position:50% align:middle And I'd like to emphasize now too, it's not so much, you know, paper. 00:05:15.703 --> 00:05:17.593 position:50% align:middle You know, we had paper transcripts. 00:05:17.593 --> 00:05:22.323 position:50% align:middle We had paper receipts for tuition reimbursement, things like that. 00:05:22.323 --> 00:05:27.933 position:50% align:middle And we dealt...now we, well, when I left, we were dealing directly with the schools. 00:05:27.933 --> 00:05:31.032 position:50% align:middle A real big lesson learned for me, for sure. 00:05:31.032 --> 00:05:32.182 position:50% align:middle - Yeah. 00:05:32.182 --> 00:05:38.822 position:50% align:middle Did you have any red flags or anything that, you know, it might have really predicted that this could 00:05:38.822 --> 00:05:39.572 position:50% align:middle have happened or? 00:05:39.572 --> 00:05:47.092 position:50% align:middle - You know, I ask myself that probably 1,000 times since this incident happened. 00:05:47.092 --> 00:05:52.782 position:50% align:middle You know, maybe because we, you know, one of the things was that it was always a 00:05:52.782 --> 00:05:54.562 position:50% align:middle reimbursement in this case, you know. 00:05:54.562 --> 00:05:57.902 position:50% align:middle And everything was to the person, not to the school. 00:05:57.902 --> 00:06:00.951 position:50% align:middle So we did see canceled checks, for example. 00:06:00.951 --> 00:06:01.741 position:50% align:middle I mean, things like that. 00:06:01.741 --> 00:06:06.181 position:50% align:middle But when you think about how easy it is to, you know, really to falsify some of that today, 00:06:06.181 --> 00:06:12.151 position:50% align:middle especially with modern technology, you know, that was a real big clue, I think, in retrospect. 00:06:12.151 --> 00:06:14.131 position:50% align:middle - Yeah. Right. Bev? 00:06:14.131 --> 00:06:16.621 position:50% align:middle - I'll follow my colleague, Robin. 00:06:16.621 --> 00:06:20.881 position:50% align:middle She's not a bad person to follow, colleagues. 00:06:20.881 --> 00:06:30.775 position:50% align:middle I hired someone, not too long ago into a position and found out that...there's an old song called, 00:06:30.775 --> 00:06:33.045 position:50% align:middle "It Was Just My Imagination." 00:06:33.045 --> 00:06:38.335 position:50% align:middle And it was just his imagination, his whole CV basically. 00:06:38.335 --> 00:06:46.625 position:50% align:middle And the way that that was revealed was through a probationary period where you had time to observe. 00:06:46.625 --> 00:06:55.275 position:50% align:middle So to me, the issues have to do with having something where you have an opportunity to view, examine, 00:06:55.275 --> 00:07:00.887 position:50% align:middle follow up, find out details and does it match what the... 00:07:00.887 --> 00:07:05.507 position:50% align:middle does the lived experience match what the paper or whatever is saying. 00:07:05.507 --> 00:07:11.707 position:50% align:middle With AI now, and with all of, you know, artificial intelligence, people, 00:07:11.707 --> 00:07:16.837 position:50% align:middle the imagination goes quite interesting beyond anything we thought of. 00:07:16.837 --> 00:07:24.427 position:50% align:middle So I think this is a time for vigilance and for management, for actual oversight and taking it 00:07:24.427 --> 00:07:28.317 position:50% align:middle responsibly and putting issues on the table when you find them. 00:07:28.317 --> 00:07:32.755 position:50% align:middle The only other thing that I would add to that, we helped him leave. 00:07:32.755 --> 00:07:38.638 position:50% align:middle It's called let the door hit you where the dog should have bit you. 00:07:42.775 --> 00:07:47.395 position:50% align:middle And helping people leave, it's a good thing. 00:07:47.395 --> 00:07:49.345 position:50% align:middle It's not always a bad thing. 00:07:49.345 --> 00:07:51.365 position:50% align:middle Some people need to leave the system. 00:07:51.365 --> 00:07:55.465 position:50% align:middle The only other thing that I wanted to say, this is a systems issue. 00:07:55.465 --> 00:07:58.035 position:50% align:middle Nursing is not immune from it. 00:07:58.035 --> 00:07:59.555 position:50% align:middle Look at the rest of the world. 00:07:59.555 --> 00:08:02.055 position:50% align:middle Look at the rest of the U.S. Look at Congress. 00:08:02.055 --> 00:08:05.068 position:50% align:middle We have folks who are getting very inventive. 00:08:05.068 --> 00:08:08.918 position:50% align:middle And so, why should nursing be any different? 00:08:08.918 --> 00:08:13.561 position:50% align:middle I know that our recorders were fantastic and some people believe we're angels, 00:08:13.561 --> 00:08:15.278 position:50% align:middle and you know better than that. 00:08:15.278 --> 00:08:22.518 position:50% align:middle And so, I'm thinking that we really need to be sincere and straight up about the fact, we are human beings. 00:08:22.518 --> 00:08:25.121 position:50% align:middle We need ethical standards. We need oversight. 00:08:25.121 --> 00:08:28.429 position:50% align:middle We need management. We need to make interventions. 00:08:28.429 --> 00:08:31.335 position:50% align:middle Thank you, Nance. 00:08:31.335 --> 00:08:32.875 position:50% align:middle - Gerianne? 00:08:32.875 --> 00:08:39.305 position:50% align:middle - My story is from a regulation standpoint and this happened a few years ago before we were talking 00:08:39.305 --> 00:08:43.005 position:50% align:middle about fraud detection in nursing education. 00:08:43.005 --> 00:08:50.025 position:50% align:middle Our licensing team had asked me to review nine transcripts, education preparation 00:08:50.025 --> 00:08:52.075 position:50% align:middle of applicants for licensure. 00:08:52.075 --> 00:08:58.475 position:50% align:middle And I was doing it on Sunday afternoon, and I tell you that because I could do it uninterrupted 00:08:58.475 --> 00:09:01.472 position:50% align:middle and I could do it sequentially. 00:09:01.472 --> 00:09:02.332 position:50% align:middle And I was almost done. 00:09:02.332 --> 00:09:07.882 position:50% align:middle I was on the very last transcript and I'm looking at it and I thought, "I've seen this transcript." 00:09:07.882 --> 00:09:15.532 position:50% align:middle So I went back, probably the third transcript I had done, and they are identical transcripts. 00:09:15.532 --> 00:09:22.572 position:50% align:middle But the degree conferred on one was a BSN and the degree conferred on the other one was 00:09:22.572 --> 00:09:25.662 position:50% align:middle an associate degree. 00:09:25.662 --> 00:09:30.635 position:50% align:middle But the same transcript with different people from the same school. 00:09:30.635 --> 00:09:33.105 position:50% align:middle So that was an alert, for sure. 00:09:33.105 --> 00:09:34.625 position:50% align:middle - Yeah. 00:09:34.625 --> 00:09:40.635 position:50% align:middle And what you were saying before when we talked about this, if it wouldn't have been so close to when you had 00:09:40.635 --> 00:09:44.045 position:50% align:middle first reviewed it, you might not have picked it up, right? 00:09:44.045 --> 00:09:45.135 position:50% align:middle - Yes, I might not have. 00:09:45.135 --> 00:09:48.225 position:50% align:middle I think it was because it was still fresh in my mind, I saw it. 00:09:48.225 --> 00:09:54.005 position:50% align:middle - Right. We need, like Bev says, systems to help us out with, you know, things like that. 00:09:54.005 --> 00:09:55.025 position:50% align:middle - Absolutely. 00:09:55.025 --> 00:10:00.704 position:50% align:middle - Yeah. Anything from you? 00:10:00.704 --> 00:10:06.584 position:50% align:middle - So I have, like Robin, an older issue that happened several years ago. 00:10:06.584 --> 00:10:15.644 position:50% align:middle An anesthesia provider practiced in the hospital for 10 years and did well, wasn't any issue, until there was a 00:10:15.644 --> 00:10:18.414 position:50% align:middle bad outcome with one of his patients. 00:10:18.414 --> 00:10:21.754 position:50% align:middle When the root cause analysis was done, it was investigated. 00:10:21.754 --> 00:10:25.574 position:50% align:middle His transcripts were incomplete. 00:10:25.574 --> 00:10:31.533 position:50% align:middle And his certificate, his graduation certificate was fraud. 00:10:31.533 --> 00:10:36.663 position:50% align:middle And we found out he went through most of the way through anesthesia school, 00:10:36.663 --> 00:10:40.633 position:50% align:middle but was dismissed from school for, you know, various reasons. 00:10:40.633 --> 00:10:45.663 position:50% align:middle So the lesson there is now with AI, we can detect a lot of this. 00:10:45.663 --> 00:10:49.603 position:50% align:middle We can find this, you know, ahead of time and look at systems and collaborate 00:10:49.603 --> 00:10:52.183 position:50% align:middle with our other organizations. 00:10:52.183 --> 00:10:55.343 position:50% align:middle One other thing I'd like to mention is preceptors. 00:10:55.343 --> 00:11:01.419 position:50% align:middle You know, a lot of education is moving to an online environment or has moved to an online environment. 00:11:01.419 --> 00:11:06.179 position:50% align:middle And when you vet a preceptor, when an advanced practice nurse comes and says, 00:11:06.179 --> 00:11:08.459 position:50% align:middle "I have a preceptor. 00:11:08.459 --> 00:11:13.919 position:50% align:middle Here's their email address, their phone number, their name," look at the email address. 00:11:13.919 --> 00:11:21.229 position:50% align:middle If it's not an address that is connected with the institution where they're employed at, 00:11:21.229 --> 00:11:28.999 position:50% align:middle if it's a Yahoo address, a Gmail account, AOL, I would question that. 00:11:28.999 --> 00:11:35.300 position:50% align:middle They, students, from my experience, have made up preceptors. 00:11:35.300 --> 00:11:41.610 position:50% align:middle They've made up clinical sites on the web and made a, you know, a site that you could go to and it looks 00:11:41.610 --> 00:11:43.360 position:50% align:middle like a hospital site. 00:11:43.360 --> 00:11:46.010 position:50% align:middle And looks like these are valid people. 00:11:46.010 --> 00:11:47.510 position:50% align:middle And they're not. 00:11:47.510 --> 00:11:54.790 position:50% align:middle So be cautious of emails that you're given for your preceptors. 00:11:54.790 --> 00:12:02.131 position:50% align:middle - It was a bad outcome that caught you onto this, would there have been anything else before that that 00:12:02.131 --> 00:12:06.911 position:50% align:middle might have been a red flag or a trigger that something was wrong? 00:12:06.911 --> 00:12:07.981 position:50% align:middle Or there just wasn't? 00:12:07.981 --> 00:12:08.721 position:50% align:middle - No. 00:12:08.721 --> 00:12:15.131 position:50% align:middle I mean, he practiced and, you know, was well respected by his peers. 00:12:15.131 --> 00:12:24.011 position:50% align:middle - Nancy, I think you bring up a really great point that we need to teach our industry partners and post 00:12:24.011 --> 00:12:30.591 position:50% align:middle secondary education institutions to look at transcripts, you know, to really look at those, 00:12:30.591 --> 00:12:35.691 position:50% align:middle to look at licensing, to truly investigate. 00:12:35.691 --> 00:12:36.821 position:50% align:middle - Yes. Bev? 00:12:36.821 --> 00:12:45.381 position:50% align:middle - I want to mention that when I do my CV, I'm very cautious about what I put down or what I give 00:12:45.381 --> 00:12:50.091 position:50% align:middle over for someone else to put down, because I'm just very concerned that it can be 00:12:50.091 --> 00:12:52.691 position:50% align:middle misconstrued in some way. 00:12:52.691 --> 00:12:58.881 position:50% align:middle And so, I just would suggest that you also take a look at your own papers and your own CVs. 00:12:58.881 --> 00:13:00.934 position:50% align:middle See how it's packaged. 00:13:00.934 --> 00:13:05.204 position:50% align:middle See if somebody said that because you spent a year in a family therapy institute, 00:13:05.204 --> 00:13:07.024 position:50% align:middle that you actually got that certificate. 00:13:07.024 --> 00:13:11.274 position:50% align:middle No, it was a two-year program so you didn't really get it, but you did do the one year. 00:13:11.274 --> 00:13:15.334 position:50% align:middle So I'm talking about things that seem very ordinary and you wouldn't even think of. 00:13:15.334 --> 00:13:17.944 position:50% align:middle But suddenly, it can become an issue. 00:13:17.944 --> 00:13:20.514 position:50% align:middle - Right. 00:13:20.514 --> 00:13:29.024 position:50% align:middle So how might we make education and practice leaders, like yourselves, aware that this fraud does occur? 00:13:29.024 --> 00:13:35.413 position:50% align:middle Because I think we all know that a lot of the educators in practice settings just don't realize it. 00:13:35.413 --> 00:13:37.961 position:50% align:middle Any ideas, thoughts? 00:13:39.673 --> 00:13:41.033 position:50% align:middle - I'll start. 00:13:41.033 --> 00:13:42.373 position:50% align:middle - I'll kick it off. 00:13:42.373 --> 00:13:46.693 position:50% align:middle First of all, you know, what Beverly said earlier about unfortunately 00:13:46.693 --> 00:13:52.803 position:50% align:middle fraud being, I don't want to say pervasive, but exists in all aspects of our society 00:13:52.803 --> 00:13:54.163 position:50% align:middle is certainly true. 00:13:54.163 --> 00:14:03.221 position:50% align:middle However, given that I truly do believe that most of the nurses, you know, providers that I've encountered 00:14:03.221 --> 00:14:06.321 position:50% align:middle in my career, have really been trustworthy individuals. 00:14:06.321 --> 00:14:08.461 position:50% align:middle So we are talking about the exception here. 00:14:08.461 --> 00:14:11.221 position:50% align:middle We're not talking about the rule. 00:14:11.221 --> 00:14:19.611 position:50% align:middle What I did in my previous role as chief nursing officer, but even more so now that we are, you know, 00:14:19.611 --> 00:14:27.361 position:50% align:middle leaders of our tri-council organization, regulatory, education and practice, is that we, 00:14:27.361 --> 00:14:33.398 position:50% align:middle on a national level, collaborate and communicate in a very prescribed 00:14:33.398 --> 00:14:34.918 position:50% align:middle and intentional matter. 00:14:34.918 --> 00:14:42.998 position:50% align:middle And that's what our practice leaders and our, you know, our education leaders and regulatory leaders need to do 00:14:42.998 --> 00:14:48.058 position:50% align:middle in our states and in our, you know, in our counties and regions on a regular basis. 00:14:48.058 --> 00:14:53.778 position:50% align:middle When we talk to our colleagues, you know, that are really, you know, at the front lines, 00:14:53.778 --> 00:14:59.883 position:50% align:middle practicing, leading their teams, educating our future nurses, we need to say to them, 00:14:59.883 --> 00:15:05.594 position:50% align:middle "You don't just need to meet once a year when you determine how many clinical sites you need. 00:15:05.594 --> 00:15:08.764 position:50% align:middle It really needs to be an ongoing conversation." 00:15:08.764 --> 00:15:14.134 position:50% align:middle And this is one of those topics that we should bring up and talk, and we do bring up at the national level, 00:15:14.134 --> 00:15:17.984 position:50% align:middle how we can, you know, how we can collaborate. 00:15:17.984 --> 00:15:20.444 position:50% align:middle What are those red flags we all need to be aware of? 00:15:20.444 --> 00:15:26.034 position:50% align:middle And then, we need to take that back and speak about that with our respective members. 00:15:26.034 --> 00:15:27.834 position:50% align:middle - Right. Bev? 00:15:27.834 --> 00:15:30.324 position:50% align:middle - I just want to say ditto to what my colleague said. 00:15:30.324 --> 00:15:31.674 position:50% align:middle There's nothing to add to that at all. 00:15:31.674 --> 00:15:32.964 position:50% align:middle It was perfect. 00:15:32.964 --> 00:15:39.094 position:50% align:middle But I'd also just want to acknowledge the tri-council members that are not on the stage with us, 00:15:39.094 --> 00:15:42.174 position:50% align:middle who are represented by my colleagues here too. 00:15:42.174 --> 00:15:48.594 position:50% align:middle And that is Deb Troutman is out there of AACN with George and somebody named Benton, 00:15:48.594 --> 00:15:50.114 position:50% align:middle is it a David somewhere? 00:15:50.114 --> 00:15:52.524 position:50% align:middle You kind of know him. 00:15:52.524 --> 00:15:57.164 position:50% align:middle And then, Loressa Cole, but Debbie Hatmaker is here representing ANA. 00:15:57.164 --> 00:15:58.894 position:50% align:middle So I just want to acknowledge them. 00:15:58.894 --> 00:16:03.785 position:50% align:middle - Yeah, yeah. Gerianne, what about regulation? 00:16:03.785 --> 00:16:06.595 position:50% align:middle You know, we certainly know about the fraud. 00:16:06.595 --> 00:16:12.755 position:50% align:middle What can regulation do to help to, you know, identify it, that it's occurring 00:16:12.755 --> 00:16:15.095 position:50% align:middle with practice and education? 00:16:15.095 --> 00:16:17.755 position:50% align:middle - I think there's a couple of different avenues. 00:16:17.755 --> 00:16:25.275 position:50% align:middle Certainly educating your teams, your licensing team, your educators, for fraud detection. 00:16:25.275 --> 00:16:32.272 position:50% align:middle The National Council of State Boards of Nursing has a wonderful pamphlet on fraud detection of transcripts. 00:16:32.272 --> 00:16:36.802 position:50% align:middle Communicating with your nurse educators in the state. 00:16:36.802 --> 00:16:41.882 position:50% align:middle We have a, what we call, CNEWS, the Council of Nurse Educators in Washington State. 00:16:41.882 --> 00:16:45.112 position:50% align:middle Our practice partners, again, as my colleagues have said. 00:16:45.112 --> 00:16:55.212 position:50% align:middle But I also think we need to educate students who are progressing in their education so they know what 00:16:55.212 --> 00:17:02.870 position:50% align:middle institutions that are representative of quality and legitimacy, so they have an awareness, 00:17:02.870 --> 00:17:07.420 position:50% align:middle they have the knowledge to choose a solid nursing program. 00:17:07.420 --> 00:17:12.420 position:50% align:middle - And really, that means going down to the high schools, because that's when they begin to choose. 00:17:12.420 --> 00:17:13.940 position:50% align:middle - Yeah. At all levels. 00:17:13.940 --> 00:17:19.510 position:50% align:middle - Yeah. Any ideas from you, George? 00:17:19.510 --> 00:17:24.250 position:50% align:middle - Yeah. I agree with what's been said here in collaboration is important. 00:17:24.250 --> 00:17:25.940 position:50% align:middle We can't work in silos. 00:17:25.940 --> 00:17:32.315 position:50% align:middle We have to collaborate across our organizations and not be afraid to say something's happened and speak 00:17:32.315 --> 00:17:36.875 position:50% align:middle to others as to how we can go forward to make it right. 00:17:36.875 --> 00:17:37.555 position:50% align:middle - Yeah. 00:17:37.555 --> 00:17:43.285 position:50% align:middle I think that collaboration can be really important for identifying fraudulent credentials, 00:17:43.285 --> 00:17:46.655 position:50% align:middle that we all come from different perspectives. 00:17:46.655 --> 00:17:53.415 position:50% align:middle And we have to work together and how best can education practice and regulation work together? 00:17:53.415 --> 00:18:00.127 position:50% align:middle A lot of times, when I've been at meetings, you know, they'll be talking about education and practice, 00:18:00.127 --> 00:18:01.084 position:50% align:middle education and practice. 00:18:01.084 --> 00:18:04.826 position:50% align:middle And I'll get up and I'll say, "Don't forget regulation," because, you know, 00:18:04.826 --> 00:18:07.746 position:50% align:middle the partnership can be really important. 00:18:07.746 --> 00:18:11.096 position:50% align:middle I mean, Gerianne, you go to the deans and director meetings, right? 00:18:11.096 --> 00:18:13.796 position:50% align:middle And there's a lot of information that can be shared there. 00:18:13.796 --> 00:18:16.146 position:50% align:middle - Sure. Absolutely. 00:18:16.146 --> 00:18:22.696 position:50% align:middle - Yeah. So that collaboration, I think, is really important. 00:18:22.696 --> 00:18:31.571 position:50% align:middle So as you know, our fraud detection task force is writing a guidance paper for all of you 00:18:31.571 --> 00:18:36.181 position:50% align:middle on detecting fraud, you know, such as using those fake credentials. 00:18:36.181 --> 00:18:38.651 position:50% align:middle I think that's really important. 00:18:38.651 --> 00:18:42.511 position:50% align:middle How might we disseminate that widely? 00:18:42.511 --> 00:18:50.931 position:50% align:middle And we can put it on our websites, but how can we really make the nursing community 00:18:50.931 --> 00:18:52.911 position:50% align:middle know about it? Any thoughts about that? 00:18:52.911 --> 00:18:54.941 position:50% align:middle - Yeah. 00:18:54.941 --> 00:19:00.712 position:50% align:middle We have a GovDelivery system that nurses in our state can sign up for. 00:19:00.712 --> 00:19:05.562 position:50% align:middle I imagine you all have something similar, but certainly that is an avenue that would have 00:19:05.562 --> 00:19:08.352 position:50% align:middle wide communication abilities. 00:19:08.352 --> 00:19:14.272 position:50% align:middle And then, taking it to all of our interested parties, to our practice partners, our education partners, 00:19:14.272 --> 00:19:15.692 position:50% align:middle to our nurses. 00:19:15.692 --> 00:19:18.202 position:50% align:middle I think we can disseminate it widely. 00:19:18.202 --> 00:19:21.664 position:50% align:middle - Yeah. And Bev? 00:19:21.664 --> 00:19:28.032 position:50% align:middle - I think the tri-council is another avenue, especially, because you've got education practice 00:19:28.032 --> 00:19:30.937 position:50% align:middle certification and regulation all in there. 00:19:30.937 --> 00:19:32.447 position:50% align:middle And our accrediting bodies as well. 00:19:32.447 --> 00:19:36.207 position:50% align:middle - Yes. Yeah. 00:19:36.207 --> 00:19:42.847 position:50% align:middle I think also publications and nursing outlook can be really helpful because it really takes 00:19:42.847 --> 00:19:45.327 position:50% align:middle everything into consideration. Bev? 00:19:45.327 --> 00:19:52.317 position:50% align:middle - I was just thinking that if all the folks here in this meeting would anxiously wait for that report and 00:19:52.317 --> 00:19:58.057 position:50% align:middle then tell somebody else about it when it comes out, that that would be a great way to kick it off. 00:19:58.057 --> 00:20:02.433 position:50% align:middle There's nothing like the word of mouth and the excitement that goes with that. 00:20:02.433 --> 00:20:08.773 position:50% align:middle I know that the internet and the social media is wonderful, I guess. 00:20:08.773 --> 00:20:13.363 position:50% align:middle But there is still nothing like hearing from a colleague that you treasure, 00:20:13.363 --> 00:20:16.753 position:50% align:middle their excitement when they say, "This is happening. Have we thought about this? 00:20:16.753 --> 00:20:18.853 position:50% align:middle What do you think about it? You've got to read it." 00:20:18.853 --> 00:20:22.733 position:50% align:middle So we need all of us here to take it back to our own shops. 00:20:22.733 --> 00:20:24.893 position:50% align:middle And nurses, we have so many identities. 00:20:24.893 --> 00:20:29.393 position:50% align:middle So I'm a psych nurse, as well as a nurse administrator, as well as a clinical psychologist, as well, you know, 00:20:29.393 --> 00:20:30.634 position:50% align:middle it goes on and on and on. 00:20:30.634 --> 00:20:36.120 position:50% align:middle And I think if we use all of our organizational sides of ourselves, that that's another way to get 00:20:36.120 --> 00:20:38.272 position:50% align:middle the word out. - Great idea. 00:20:40.540 --> 00:20:41.870 position:50% align:middle - Anything, Robin, or? 00:20:41.870 --> 00:20:44.060 position:50% align:middle - You know, I agree with her... - For practice? 00:20:44.060 --> 00:20:44.510 position:50% align:middle - Yeah. 00:20:44.510 --> 00:20:48.420 position:50% align:middle I agree with what's been said and I really do think that, you know, all the organizations 00:20:48.420 --> 00:20:54.530 position:50% align:middle of the tri-council, the five organizations, have their members and really formal ways 00:20:54.530 --> 00:21:00.213 position:50% align:middle of communicating, whether it's the journals, whether it's the biweekly emails that we send 00:21:00.213 --> 00:21:01.115 position:50% align:middle to our members. 00:21:01.115 --> 00:21:07.056 position:50% align:middle So we could link reports and information to that, and that is, you know, I know some of my members say, 00:21:07.056 --> 00:21:08.906 position:50% align:middle "I just get inundated. 00:21:08.906 --> 00:21:16.066 position:50% align:middle But your top three line items in the newsletter, I do always click on and read." 00:21:16.066 --> 00:21:19.086 position:50% align:middle So we have to prioritize and that's not at the bottom of the list. 00:21:19.086 --> 00:21:23.766 position:50% align:middle You know, put that up to the top and make sure that we send it out and maybe more than once, 00:21:23.766 --> 00:21:26.536 position:50% align:middle depending on the importance of the message. 00:21:26.536 --> 00:21:30.486 position:50% align:middle - And those relationships, those partnerships that we can develop, definitely. 00:21:30.486 --> 00:21:31.940 position:50% align:middle - Of course. 00:21:31.940 --> 00:21:37.987 position:50% align:middle - So in your institutions, do you have any fraud detection training of people or 00:21:37.987 --> 00:21:43.427 position:50% align:middle do you know of any in some of your members who will be, you know, maybe they'll be reviewing 00:21:43.427 --> 00:21:46.877 position:50% align:middle transcripts or applications. 00:21:46.877 --> 00:21:53.057 position:50% align:middle And do you think that would be an important step to have that? 00:21:53.057 --> 00:21:57.147 position:50% align:middle But do any of you know of any that are in your institutions? 00:21:57.147 --> 00:21:58.587 position:50% align:middle - Yeah. 00:21:58.587 --> 00:22:02.901 position:50% align:middle We actually have several different mechanisms. 00:22:02.901 --> 00:22:11.251 position:50% align:middle We have what we call a licensing suspected fraudulent document review worksheet that actually is a checklist 00:22:11.251 --> 00:22:16.851 position:50% align:middle of different areas to look at, things like what does the seal look 00:22:16.851 --> 00:22:18.351 position:50% align:middle like on the transcript? 00:22:18.351 --> 00:22:19.641 position:50% align:middle What are the signatures? 00:22:19.641 --> 00:22:21.651 position:50% align:middle Do the dates match? 00:22:21.651 --> 00:22:26.101 position:50% align:middle Looking at misspellings, discolorations, just some of those, you know, 00:22:26.101 --> 00:22:30.543 position:50% align:middle obvious kinds of things that sometimes cannot be that obvious. 00:22:30.543 --> 00:22:37.453 position:50% align:middle And then, we also have education verification forms that, if, you know, we have any questions or it's not 00:22:37.453 --> 00:22:42.393 position:50% align:middle clear from a transcript, that can further validate information. 00:22:42.393 --> 00:22:52.473 position:50% align:middle And a third document that we developed with our licensing team are supplemental education questions 00:22:52.473 --> 00:22:56.843 position:50% align:middle that specifically ask questions about where were your clinicals? 00:22:56.843 --> 00:23:00.018 position:50% align:middle What was the modality of your clinical. 00:23:01.490 --> 00:23:05.260 position:50% align:middle What was the modality of your skills labs? 00:23:05.260 --> 00:23:11.150 position:50% align:middle And that has been very interesting information too that we have received back. 00:23:11.150 --> 00:23:12.350 position:50% align:middle - Yeah. 00:23:12.350 --> 00:23:17.500 position:50% align:middle I'm going to be talking about now, a minute, a fraud toolkit that we're going to be, 00:23:17.500 --> 00:23:22.830 position:50% align:middle fraud detection toolkit that we're going to be developing and definitely will have some of that 00:23:22.830 --> 00:23:25.850 position:50% align:middle in there, because I think that can be very helpful. 00:23:25.850 --> 00:23:28.980 position:50% align:middle But what about education in practice? 00:23:28.980 --> 00:23:32.626 position:50% align:middle You know, regulation, we've been working at this for a while. 00:23:32.626 --> 00:23:38.336 position:50% align:middle But do you have any fraud training that you know of going on in education or practice? 00:23:38.336 --> 00:23:39.276 position:50% align:middle - Yeah. 00:23:39.276 --> 00:23:47.806 position:50% align:middle I know that in several hospitals that I'm familiar with, there's a course that actually was developed 00:23:47.806 --> 00:23:52.766 position:50% align:middle by the risk managers who, in many cases, are also nurses. 00:23:52.766 --> 00:24:02.305 position:50% align:middle And that is one of the things that they regularly offer to not only nurse managers or, you know, 00:24:02.305 --> 00:24:08.515 position:50% align:middle nursing leaders, but also, you know, you have to think about those folks that touch the, 00:24:08.515 --> 00:24:11.795 position:50% align:middle you know, the applications and interview applicants. 00:24:11.795 --> 00:24:14.735 position:50% align:middle So it might be HR people, you know. 00:24:14.735 --> 00:24:19.225 position:50% align:middle I know especially right now, there is a real push as we all know, 00:24:19.225 --> 00:24:26.215 position:50% align:middle to really compress the time from interview or intake to hire. 00:24:26.215 --> 00:24:31.116 position:50% align:middle And because we are, you know, experiencing such a shortage in so many parts 00:24:31.116 --> 00:24:32.226 position:50% align:middle of the country. 00:24:32.226 --> 00:24:38.926 position:50% align:middle So in fact, recently, for AONL, in our compendium of practices, 00:24:38.926 --> 00:24:46.696 position:50% align:middle we have a flow chart about the steps to hire and how to look at the duration of time. 00:24:46.696 --> 00:24:51.186 position:50% align:middle But I think we have to underscore that it's really important that these, you know, 00:24:51.186 --> 00:24:53.576 position:50% align:middle important safeguards still take place. 00:24:53.576 --> 00:24:58.876 position:50% align:middle So we can't skip over steps that are required. 00:24:58.876 --> 00:25:02.953 position:50% align:middle And I think the toolkit, perhaps when we develop the toolkit, 00:25:02.953 --> 00:25:06.773 position:50% align:middle some of that will really be able to be formalized perhaps across the country. 00:25:06.773 --> 00:25:09.193 position:50% align:middle - Oh, that'll be great. Yeah. Bev, did you? 00:25:09.193 --> 00:25:14.323 position:50% align:middle - You know, I'm a systems person and so, I think about what is the system that you're in and the 00:25:14.323 --> 00:25:16.373 position:50% align:middle culture that you developed in your organization. 00:25:16.373 --> 00:25:21.213 position:50% align:middle And one of the things the AONL has is one of our core values is integrity. 00:25:21.213 --> 00:25:24.093 position:50% align:middle And I think that's, like, a foundational piece. 00:25:24.093 --> 00:25:27.443 position:50% align:middle Now you say, "Oh, nurses are always full of integrity." 00:25:27.443 --> 00:25:30.323 position:50% align:middle Well, yes, most times. 00:25:30.323 --> 00:25:33.853 position:50% align:middle But we just don't happen to be angelic and we're not there. 00:25:33.853 --> 00:25:34.983 position:50% align:middle So we're not quite there. 00:25:34.983 --> 00:25:39.543 position:50% align:middle So how do we hold ourselves accountable for the humanistic piece of us? 00:25:39.543 --> 00:25:43.363 position:50% align:middle And I think you have to have some core values to establish your culture. 00:25:43.363 --> 00:25:48.163 position:50% align:middle And that's part of that toolkit piece that you're describing, that will be there. 00:25:48.163 --> 00:25:52.523 position:50% align:middle So I'm thinking in that way, put your culture together to say, 00:25:52.523 --> 00:25:54.473 position:50% align:middle "It is not acceptable." 00:25:54.473 --> 00:25:55.203 position:50% align:middle - Right. 00:25:55.203 --> 00:26:02.677 position:50% align:middle And I love your idea about looking at the system, because I think that's what really has to change. 00:26:02.677 --> 00:26:03.017 position:50% align:middle George? 00:26:03.017 --> 00:26:08.307 position:50% align:middle - One other... At AACN, we offer our schools the opportunity to enter 00:26:08.307 --> 00:26:13.337 position:50% align:middle into what's called NursingCAS, and that's a centralized application service. 00:26:13.337 --> 00:26:21.067 position:50% align:middle And along with that comes a criminal background check at the application process to detect fraud. 00:26:21.067 --> 00:26:27.247 position:50% align:middle We also then know that when students go into clinical, they get a background check as well. 00:26:27.247 --> 00:26:32.033 position:50% align:middle So that's a service that's offered to our schools and it does streamline the application process for the 00:26:32.033 --> 00:26:35.823 position:50% align:middle students that are applying to multiple schools, so... 00:26:35.823 --> 00:26:40.733 position:50% align:middle - Yeah. Good. So were you going to say something, Gerianne? 00:26:40.733 --> 00:26:41.113 position:50% align:middle - No. 00:26:41.113 --> 00:26:46.803 position:50% align:middle - Okay. What advice do you have for nurse leaders about fraud detection? 00:26:46.803 --> 00:26:52.333 position:50% align:middle If you were going to just think of one piece of advice to our nurse leaders in the audience, 00:26:52.333 --> 00:26:53.593 position:50% align:middle what would you say? 00:26:53.593 --> 00:26:55.183 position:50% align:middle - Collaborate. 00:26:55.183 --> 00:26:58.563 position:50% align:middle - Collaborate. Okay. You heard him. 00:26:58.563 --> 00:27:03.421 position:50% align:middle Well, I'll be collaborating with AACN. 00:27:03.421 --> 00:27:07.901 position:50% align:middle - I think I would say to do due diligence. 00:27:07.901 --> 00:27:13.821 position:50% align:middle I think when we get a nurse who goes into industry or wants to continue their education, we're thrilled. 00:27:13.821 --> 00:27:23.271 position:50% align:middle But to take the time to look at the educational background of your new hire and your applicants, 00:27:23.271 --> 00:27:28.941 position:50% align:middle to make sure that it has been a solid educational background. 00:27:28.941 --> 00:27:32.224 position:50% align:middle - Mine would be simply while you're pointing your finger at someone else, 00:27:32.224 --> 00:27:38.894 position:50% align:middle make sure that you also check out yourself or your organization so that the finger can go both ways. 00:27:38.894 --> 00:27:41.044 position:50% align:middle It's usually very helpful. 00:27:41.044 --> 00:27:47.254 position:50% align:middle - Well, in addition to what's been mentioned, I think evaluate your processes in your system. 00:27:47.254 --> 00:27:50.724 position:50% align:middle - Right. Good. 00:27:50.724 --> 00:27:55.784 position:50% align:middle Well, thank you to our panelists for a great conversation today. 00:27:55.784 --> 00:27:59.234 position:50% align:middle And as I said, I was going to tell you a little bit later. 00:27:59.234 --> 00:28:04.475 position:50% align:middle We are developing a toolkit and this will be our task force that will have a lot of say in it. 00:28:04.475 --> 00:28:07.635 position:50% align:middle And I can see we're going to use a lot of your resources. 00:28:07.635 --> 00:28:14.145 position:50% align:middle The guidance paper on detecting fraud will be in the toolkit. 00:28:14.145 --> 00:28:22.675 position:50% align:middle and that just has some major areas of really guidelines that you can use for detecting fraud, such as, 00:28:22.675 --> 00:28:25.691 position:50% align:middle you know, having fraud training in your organization. 00:28:25.691 --> 00:28:33.845 position:50% align:middle And there will be information in there as well about eNotify, which you remember is a licensure notification 00:28:33.845 --> 00:28:40.735 position:50% align:middle system that institutions that use it, and remember it's free, so anybody can use it, 00:28:40.735 --> 00:28:46.655 position:50% align:middle can receive real-time licensure and discipline data on their nurses. 00:28:46.655 --> 00:28:55.305 position:50% align:middle So eNotify could really help to prevent fraud from preventing maybe employers from hiring individuals 00:28:55.305 --> 00:29:01.705 position:50% align:middle with fraudulent credentials or faculty from admitting them to a nursing program. 00:29:01.705 --> 00:29:06.916 position:50% align:middle And, you know, there will be other materials in the toolkit as well, such as, you know, 00:29:06.916 --> 00:29:10.415 position:50% align:middle some of the tools you both just talked about. 00:29:10.415 --> 00:29:16.505 position:50% align:middle So I hope we have alerted all of you today that fraud does occur in nursing, 00:29:16.505 --> 00:29:24.375 position:50% align:middle but that there are resources available that will help you to detect and prevent fraud. 00:29:24.375 --> 00:29:32.028 position:50% align:middle So thank you to the audience for your attention and thank you to our wonderful panel for such 00:29:32.028 --> 00:29:34.238 position:50% align:middle an insightful discussion. 00:29:34.238 --> 00:29:37.488 position:50% align:middle And it just says 00 on our time, so we made it. 00:29:37.488 --> 00:29:39.428 position:50% align:middle - Perfect. - Thank you.