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In 18 months, the technician stole at least 216,630 tablets of hydrocodone, valued at more than $1 million.
nate educational campaigns, supervise D-DIRT activities and help investigate case reports.
5. Employ a waste retrieval system every- where injectable opioids are used in patient care. This entails enforcing a strict policy that quantities of all drugs drawn that aren’t used on patients be securely returned to a Class 2 controlled substances vault in the pharmacy, under the watch of cameras,
for reconciliation with both the ADCs and anesthesia records. Randomly test drugs retrieved to ensure they are authentic.
6. Throw out assumptions about healthcare workers who divert drugs, including:
» they are easily recognized due to odd behaviors;
» they are rarely discovered in areas with low opioid use;
» only workers with access to drugs divert them.
7. Know and keep track of areas through- out your organization that are most
vulnerable, from the loading dock to the incinerator, and update policies when new diversion schemes are detected.
8. Report drug diversion. Establish and communicate policies so employees know that federal law requires any healthcare worker found to be diverting drugs must and will be reported to the DEA. The hospital should also le reports to the responsible state professional licensing board or hospital licensing agency, and if the diverter is a physician or dentist, to the National Practitioner Data Bank.
9. Make sure hospital leaders understand that as healthcare systems get better at building barriers against theft of controlled substances in storage areas, thefts will likely occur closer and closer to patient care, including at the patient’s bedside and “at the stopcock of the IV.”
10. Offer treatment once an employee
is caught and terminated. Consider extending healthcare bene ts to provide coverage for substance abuse treatment.
Although the Mayo Clinic has an aggressive prevention program, it’s institution-wide reforms continue to uncover new drug diversion tactics. To that point, the Mayo continues to look and dig deeper to prevent and detect drug diversion and “do no harm” to patients.9
Laws of Intervention
Drug diversion results in several types of patient harm, including substandard care delivered by an impaired healthcare provider, denial of essential pain medication or therapy, and risk of infection trans- mitted by injectable drugs.10
Harm to patients, however dreadful, is not the only consequence. Revenue lost on drug theft, civil liabilities and tarnished reputations in the com- munity accompany patient harm. In addition, nancial penalties are being leveled by federal and professional agencies due to allegations that lax controls enabled employees to divert controlled substances for personal use.
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