HIM 600 Module 8 Journal Example

Reviewed by Delia Ravenscroft, MSN, RN

This HIM 600 Module 8 Journal sample reflects on why people who see compliance problems often say nothing. It was written for SNHU HIM 600 (HIM-600), where the eighth module asks MS Health Information Management students to think about the human side of compliance, including reporting, culture and ethics. The composite compliance lead at a 38-physician orthopedic and spine group in Boise learns during feedback meetings that a senior coder noticed visit levels climbing two years before any audit and never raised it. The entry explores her reasons, the belief that nothing would change and the worry about challenging the surgeons whose work pays everyone's salary, connects them to research on organizational silence and ethical culture and ends with the writer's plan to change what happens after someone speaks up rather than only asking people to speak.

CourseHIM 600 Managing Compliance
ModuleModule 8
Paper typegraduate journal entry on speaking up about coding concerns
LengthAbout 390 words, 3 pages
FormatAPA 7 student paper
SchoolSouthern New Hampshire University
ProgramMS Health Information Management
UpdatedOctober 2026

Free sample paper for HIM 600 Module 8

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Module Eight Journal

Two Years of Knowing

This week, after a feedback meeting, our most experienced coder stayed behind and told me she had noticed the jump in level five visits in early 2024. She had even kept a list of notes she thought were overcoded. She never brought it to anyone. I asked why, and her answer has stayed with me: "Who would I have told, and what would they have done?"

What this page is doingThe entry opens with a disclosure that reframes the audit.
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Morrison and Milliken (2000) described organizational silence as a shared belief that speaking up is futile or risky, reinforced when managers fear negative feedback and when the people who raise problems are treated as disloyal. Both parts fit. Our coders release claims as physicians select them, nobody had ever asked them for an opinion and the surgeons generate most of the practice's revenue. She told me that when a colleague questioned a modifier years ago, a physician complained to the administrator and the coder was moved to the front desk. Silence was a reasonable reading of the evidence she had.

Kaptein (2011) found that unethical behavior was less common where employees could discuss dilemmas openly and where misconduct was consistently addressed. Our practice had neither. I also keep thinking about Kesselheim and Studdert (2008), who found that most large health care fraud cases began with insiders. People who are ignored inside an organization sometimes go outside it. She did not, but someone else might have, and the practice would have learned about its problem from a federal complaint instead of from her list.

What I take from this is that a hotline and a non-retaliation policy are necessary but not enough. People judge whether speaking up is safe by what happened the last time someone did. Our coder was not missing a phone number. She was missing proof that a concern would be heard and that the person raising it would be protected.

What this page is doingResearch explains the silence and its risk.
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I am going to change three things. I will ask the managing partners to tell all staff, in person, that the coder who was moved years ago was treated wrongly. I will start asking coders for their concerns monthly rather than waiting. And when someone raises an issue, I will tell them what happened as a result, even when the answer is small. I also thanked her, and asked to see the list.

What this page is doingThe writer commits to specific changes.
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References

Kaptein, M. (2011). Understanding unethical behavior by unraveling ethical culture. Human Relations, 64(6), 843-869. https://doi.org/10.1177/0018726710390536

Kesselheim, A. S., & Studdert, D. M. (2008). Whistleblower-initiated enforcement actions against health care fraud and abuse in the United States, 1996 to 2005. Annals of Internal Medicine, 149(5), 342-349. https://doi.org/10.7326/0003-4819-149-5-200809020-00009

Morrison, E. W., & Milliken, F. J. (2000). Organizational silence: A barrier to change and development in a pluralistic world. Academy of Management Review, 25(4), 706-725. https://doi.org/10.2307/259200

What the HIM 600 Module 8 instructions ask for

Module Eight of HIM 600 asks for a journal entry on the people and culture behind compliance. The entry is reflective, usually about a page, with one to three sources in APA 7 that help explain what you observed. Choose a real moment, from work or the course case, when someone noticed a problem and did or did not speak up, or when you faced that choice yourself. Describe what happened honestly and explore the reasons behind it, including power, fear, habit or a belief that nothing would change. Connect those reasons to research on reporting, silence or ethical culture. End with what you will do differently in your own role, stated specifically enough that someone could check whether you did it.

How this HIM 600 Module 8 journal example is built

Sawtooth Bone and Joint's senior coder had a list of overcoded notes from early 2024 and never raised it, asking the writer who she would have told. Morrison and Milliken's organizational silence explains her reasoning, sharpened by the memory of a colleague moved to the front desk after questioning a modifier. Kaptein's finding that open discussion and consistent responses reduce misconduct shows what the practice lacked, and Kesselheim and Studdert's insider whistleblowers show the risk of ignoring people. The HIM 600 journal concludes that a hotline is not enough and commits to three changes: a public acknowledgment from the partners, monthly requests for concerns and telling reporters what happened, plus a thank you to the coder.

Where the HIM 600 Module 8 rubric puts the points

Journal entries in HIM 600 are usually graded on honest reflection on a specific event, insight into why people behave as they do, use of research to deepen that insight rather than decorate it, awareness of the writer's own role and a concrete commitment for the future. Entries that stand out resist easy conclusions, such as blaming the person who stayed silent, and look instead at what the organization taught people to expect. Graders reward writers who connect culture to compliance risk, since silence inside often becomes a complaint outside. Specific next steps tied to the writer's authority, a professional but personal voice and correct APA 7 citations support the stronger ratings.

HIM 600 Module 8 help: the mistakes that cost points

Weak HIM 600 journals summarize course readings with no real event, blame individuals without asking what the organization rewarded, stay so general that nothing could change or end with a promise to encourage reporting. Should your module frame the entry around an ethical dilemma, a conflict with a physician, a time you raised a concern yourself or the code of ethics for health information professionals, send it with a few details from your experience and the entry will be written from them. Your role matters, since a coder, a manager and a director can each change different things. Our HIM 600 journals start from a real moment, explain it with research and end with checkable commitments.

Get HIM 600 Module 8 written to your instructions

Share the HIM 600 Module 8 journal prompt and a moment from your work or the course case when someone did or did not speak up. The entry will reflect honestly on what happened, use research on silence or ethical culture to explain it and close with specific changes you can make in your role, ready in a day or two, free the first time. The paper above is an original model document written by our desk, not a submitted student paper and not an official Southern New Hampshire University document.

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HIM 600 Module 8 questions, answered

Where can I find a free HIM 600 Module 8 Journal sample?

This page has the complete HIM 600 Module 8 journal, which reflects on a senior coder who noticed inflated visit levels for two years without reporting them and what the compliance lead will change.

What is organizational silence?

A shared belief among employees that raising problems is pointless or risky, often reinforced when leaders react badly to bad news, which leads people to withhold concerns they have.

Why do employees fail to report compliance concerns?

Common reasons include fear of retaliation, a belief that nothing will change, power differences with physicians or managers and not knowing whom to tell.

Is a hotline enough to encourage reporting?

Rarely. People judge safety by what happened to earlier reporters, so leaders must respond visibly, protect reporters and tell them what changed as a result.

What should a compliance journal entry include?

A specific event, an honest look at why people acted as they did, research that explains it and concrete changes the writer will make in their own role.