Cases like that of Charles Cullen, a New Jersey nurse-turned-serial-killer, serve as clarion calls for conducting extensive background checks on all potential hospital employees, from physicians to couriers.
Red flags to look for in a potential employee vary widely between jobs. For example, what usually triggers a red flag in a physician's history may not necessarily do so in a nurse's history.
Todd Sagin, MD, JD, vice president and national medical director of The Greeley Company, a division of HCPro, states, "People slip through the cracks all the time. Fortunately they're not all mass murderers. There are people who have issues of concern in their backgrounds who are hired every day. This case demonstrates the importance of performing due diligence."
Sagin adds, "Physicians with frequent changes in employers raise concerns. It's not common to uproot and move, and this sometimes suggests there might have been a problem." However, he says, people in other hospital staff positions tend to move more frequently. "In the current market, hospitals are competing with each other for employees," says Sagin. "You often see nurses moving from one hospital to another when a new signing bonus is offered."
When questionable information about an employee's background does surface, it's up to the hospital to decide whether it's appropriate and relevant to the job at hand. For example, a nurse who hasn't paid his or her college loans might not be a problem, whereas a courier with a number of drunken-driving charges is likely going to be an issue.
Tip: It is advisable for hospitals to create a formal peer review process for nurses and other nonphysicians that mirrors the process established for the medical staff. By providing an ongoing analysis of quality-of-care concerns, the hospital is more likely to detect errors and areas of concern before they are untreated or unnoticed.
