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Evidence Needed for Diversion Verdict

Rxpert Solutions > Blogs > 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 another medication is definitive. Interviewing a reliable patient immediately after a nurse charts administration of a pain med and hearing the patient did not receive it is conclusive. But what if you don’t have those types of “proof”. What if you have data that tells you this person practices differently than their peers? They dispense more, they waste more, they enter more verbal orders, or they do not account for some of the meds they have removed. They provide reasons for these differences that are not completely convincing and, at best, mean they may not be following some policies. Are abnormal numbers and failure to follow policies enough to call it diversion and report to the licensing agency? In many cases, yes.

After being in the diversion monitoring space for years, one recognizes that we may not have the act of diversion on camera, but seeing abnormalities in the data (without a legitimate reason for those abnormalities) requires next steps, which would be a formal interview with the person of interest. The data and the interview are what we will need to base our decision on. I find that many don’t feel comfortable declaring it diversion if they don’t get an admission. Some don’t even feel comfortable with a formal interview if all they have is data. In cases like this, some feel comfortable terming and reporting for unsafe practices while mentioning the failure to rule out diversion. What kind of evidence do you need to pronounce a guilty verdict when it comes to diversion? This may be a good discussion to have with your diversion team.

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Terri is absolutely phenomenal. She is an incredibly knowledgeable pharmacy resource. As the medication safety officer, the quality initiatives she implemented not only impacted the patients at our medical center but also reached into the community. Terri is a genuine professional who upholds accountability while creating community among her team members. She is a great listener to identify friction points and has actionable ideas to implement improvements.

T. Eagle. MBA, MLS(ASCP), CLS Lab Operations Manager

Terri is an expert at prospective risk identification -Failure, Mode and Effects Analysis (FMEA). Terri participated in CHPSO Patient Safety Safe Tables and was part of the Hospital Quality Institute’s Regional Quality and Patient Safety Leader Network.
She is an excellent public speaker and communicates well with public and professional audiences. I look forward to her continued work in medication safety.

Regional Quality Network at HQI

Terri has done a tremendous job with the controlled substance diversion program. She has had such a positive impact and has really made the hospital a safer place.

Tri-City Medical Center
Nurse Manager

We would not be where we are with the improvements we have made with opioid prescribing if it were not for Terri driving the process.

Tri-City Emergency Medical Group
Chief Physician

In addition to understanding the ins and outs of the [controlled substance use] process completely, she is very proactive in coming to me with provider issues that she detects. She truly balances the administrative duties and the regulatory components demand with a keen sense of what my practitioners do and what their needs are on the ground. Terri is instrumental in working with my department, balancing patient care, cooperation, ability, and integrity to get the job done.

UCSD Medical Center
Chief Anesthesiologist

Terri is knowledgeable and effective in pharmacy leadership. She has the ability to be able to anticipate and prepare for the future. Her ability to utilize resources effectively in this changing environment is a strong asset. She can adapt, evolve, mentor and still never say “no” when asked to assist. She exhibits great abilities to be flexible and is a “self starter”. She has a pleasant yet effective demeanor that commands results.

Candace Fong, Pharm D
System Director of Pharmacy and Medication Safety Common Spirit Health

Terri has always impressed me as being very smart. resourceful, creative, and easy to work with. Terri’s commitment to medication safety permeated our organization, raising the awareness of this important issue throughout all levels of the institution. Terri has always been engaged, cooperative, and generous with her time.

Cary Mells, MD
Chairman of the Department of Emergency Medicine Tri-City Medical Center

Terri has done more for the Pharmacy in her few months as Interim Pharmacy Director than any other Director has done during my 12 years here.

Anita Kennedy, MBA
VP of Ancillary Services Methodist Hospital

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  • 760.705.4078
  • tvidals@rxpert.solutions