Phases of a Diversion Investigation

There are three main phases of a drug diversion investigation:

  1. Identifying the inappropriate medication use activity through an extensive audit
  2. Audit finding review by the supervisor of the healthcare worker. This is essential because the supervisor is familiar with workflow patterns and their insight is crucial into identifying possible red flags and/or explaining possible aberrant activity.
  3. Interviewing the healthcare worker suspected of diversion

Many times, these last two steps are repeated:

  1. Further investigation of areas identified after the initial interview
  2. Second interview with the healthcare worker suspected of diversion

There are cases where the audit data will clearly paint a picture of diversion. It does not matter how badly the supervisor may want to protect their employee, they can’t deny the findings that indicate diversion. In these cases, even if the employee does not admit to diversion, the employer will most likely terminate and report to the licensing board anyway. However, there are cases where the data suggests a problem but further information, ideally an admission, is needed before making a definitive decision and taking next steps. This will be the case the majority of the time. It is in these cases where the whole thing could fall apart if the interviewer is biased or has no to little skills in interviewing. For this reason, I would suggest putting together a primary team to conduct the interviews. The members of this team need to have experience in the medication use process as well as solid clinical experience. If desired, pair them up so there are two people present during the interview although a single person will work as well. And very important, provide solid interview training for them. The entire process will fall apart if the interviewer is biased or does not have the clinical or interview experience needed to conduct a solid interview. I do not mean to suggest that if your interviewer meets all these criteria, the healthcare worker will always admit to diversion if they are diverting. However, you will have a higher chance of success and a skilled interviewer will leave the interview with a good sense of guilt or innocence in cases with no admission.

Rxpert Solutions provides interview training. Reach out for more information on how we can help you and share our 30+ years of knowledge and experience with diversion investigations and interviews.

The point of the interview is to get to the truth, not to get to what the interviewer wants to hear. —T. Vidals

Terri Vidals
Terri Vidals

Terri has been a pharmacist for over 30 years and is a drug diversion mitigation and monitoring subject matter expert. Her years of experience in various roles within hospital pharmacy have given her real-world insight into risk, compliance, and regulatory requirements, as well as best practices for medication and patient safety.

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