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Phases of a Diversion Investigation

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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

Our References

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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Address: 950 Boardwalk Suite 305, San Marcos, CA 92078

  • 760.705.4078
  • tvidals@rxpert.solutions