Evidence Needed for Diversion Verdict
What kind of evidence do you need to pronounce a guilty verdict when it comes to diversion? Catching someone in the act of placing medication in their pocket when they are supposed to be wasting or seeing vials fall out of their locker leaves little room for doubt. Watching someone on camera substitute saline for […]
Read MoreA Diversion Program in a Highly Reliable Organization
In hospitals everywhere, we need to have a contingency plan for our key employees. It is so easy to fall into the rhythm of having our knowledgeable Buyer, IT Pharmacist, or Diversion Specialist (to name a few), with no backup in case something were to happen to our star. That “something” could be an extended […]
Read MoreDo Your Staff Know How to Check for Tampering?
All across the country, pharmacy staff are picking up returned controlled substances and placing them back into pharmacy stock. They are removing them from automated dispensing machine return bins and placing them back into the dispensing pockets. Prior to placing the medication back into stock for dispensing, are they checking the item to confirm there […]
Read MoreTaking Ownership of Your Pharmacist-in-Charge (PIC) Status
I recently spoke to a pharmacist that shared the culture at their organization when it comes to monitoring for diversion. While they do have a team of diversion specialists that understand diversion and what to look for, they are managed by leaders who think they know better than those specialists. As a result, the voices […]
Read MoreAnother Life lost
There has been a lot of chatter on list serves within the diversion prevention community about the nearly 8 gallons of fentanyl diverted from a New Hampshire hospital. The initial report stated, “At least 23 bags of the drug had been removed without being wasted or provided to patients”, but that number climbed to 583. […]
Read MoreDrug Testing; Nail, Hair, or Urine?
There are many types of drug tests available, how do you know which one to use? Well, let’s look at the differences. Nail and hair drug testing have a long window of detection, making them an excellent way of testing for habitual drug use. The window for nail testing is 6-12 months and the window […]
Read MoreLooking for the Smoking Gun?
Every now and then when performing a diversion investigation, you will find the smoking gun. One that is so hot you don’t need the healthcare worker to admit to diversion in order to be 100% convinced they are diverting. However, 99.9% of the time, you will not find that smoking gun early on. And by […]
Read MoreEducation Surrounding a Facilities Diversion Program
An important component of a comprehensive diversion program is educating staff to the elements of the program. Education surrounding what diversion looks like, why prevention measures need to be put in place, why monitoring for diversion is important, and expectations of the staff. Additional education is needed for supervisors and managers that will be reviewing […]
Read MoreJust Culture Algorithm
Last week I gave a brief overview of the Just Culture model of accountability. I mentioned the three behaviors to consider with any error: human error, at-risk behavior, and reckless behavior. Human error is a mistake, a lapse, an inadvertent act. At-risk behavior is drifting from safe behavior when an individual does not believe the […]
Read MoreJust Culture Model of Accountability
A few years ago when I entered pharmacy management, the hospital I worked for promoted the “Just Culture” philosophy. Managers were educated on it, and we were all given a copy of the Just Culture Algorithm v3.2. I kept it close and found it to be very helpful to review prior to meeting with an […]
Read More