Pharmacolog i Uppsala: Monitoring – the key to an effective drug diversion strategy


Strict monitoring of controlled substances is a very important part of any drug diversion prevention program. Few would say that tracking is not a good idea in principle, but in practice it can be difficult. Thorough surveillance often requires time and resources that are not available in busy healthcare facilities. Here we describe how monitoring can be done with minimal disruption to the current workflow.

The three elements of a comprehensive drug diversion program are prevention, control and surveillance, and investigation. All health care facilities are required to have systems in place to guard against the diversion of controlled substances. Best practices should be reviewed and implemented to prevent and detect drug diversion. These were briefly discussed in a previous article on our blog. While the implementation of prevention strategies will reduce the number of diversion events, it is essential to know as early as possible whether any controlled substances have been diverted. This is where monitoring and surveillance come in. With a comprehensive audit approach in place, deviations will be detected immediately, allowing you to quickly investigate and determine the cause of the route.

Move away from the reactive model
There are several workflow models when it comes to measuring drug diversion in healthcare facilities, the most fundamental being the reactive model. This all-too-common approach relies solely on staff members reporting suspicious activity to detect drug diversion. Unsurprisingly, this method is not effective, and it also places an additional burden on hospital staff who are already under a lot of pressure. Underreporting or discovering a diversion when it has lasted a long time is very common in this model. Although easy and inexpensive to implement, the cost of following up a drug diversion report is often much higher because the evidence must be gathered and evaluated from scratch and on an ad hoc basis.

Shifting to a proactive approach lightens the burden on staff and relies on processes and data. These data-driven models not only promote a better work environment, but they also provide a solid basis for assessing possible cases of drug diversion. Instead of relying on an employee’s testimonial, data-driven models simply compare a set of numbers. For example, the quantity of dispensing from the automated dispensing cabinet does not match the quantity documented on the medication administration record. A simple investigation could be conducted to find the cause of the deviation route.

You probably haven’t escaped your attention by now that prevention is the first step in implementing a drug diversion strategy and that a robust monitoring process really helps prevent the diversion from happening first. place.

Create a procedure
One of the biggest institutional concerns regarding drug diversion monitoring is the time and cost it will take to implement and maintain. From the start, it’s important to consider what the outcome of your monitoring efforts will be. One of the most valuable things you can generate is a procedure that allows tracking to adapt to your current institutional workflows. With a well thought out procedure, it will be easy to determine what resources are needed and most importantly, compare those resources to what is currently used today. Drug diversion is expensive with many direct and indirect costs, and it is important to compare them with surveillance measures that aim to reduce or eliminate diversion altogether.

Integrate automation into your monitoring processes when possible
Automation is your ally when it comes to monitoring drug diversion. Automation is becoming more and more a part of working life and can help you implement a robust monitoring system without additional burden on your staff. Automating your data reports is one of the easiest processes to implement. There are many software tools that analyze data from many different sources to identify trends that could be a sign of diversion.

Analytics is a very useful tool for detecting and preventing hijacking. It can produce detailed and customizable reports for your monitoring and surveillance program.

Immediate monitoring
An important and sometimes overlooked feature of your monitoring and surveillance program is immediate feedback. There are data collection instruments and methods that can allow information to sit on a server for weeks or even months before being analyzed. This poses a multitude of problems for trap monitoring. First, if too much time elapses between a diversionary event and detection, then it becomes much more difficult to catch the culprit. It is also very difficult to resolve issues with data sources or data collection if they are only assessed periodically. Therefore, we always recommend that you generate comments from your data as quickly as possible. If you use our device, Waste log®, it is possible to measure the content and concentration of a controlled substance before it is wasted, and the results are immediately gathered and shared with the hospital pharmacy office. This makes the rapid investigation of anomalies much easier. Again, simply recording and investigating small anomalies, even if they turn out to be nothing, is a great prevention strategy.

Choose the right solution
When choosing a solution, automation is a huge advantage as it allows you to integrate monitoring and surveillance seamlessly into your existing workflow. Our experience is that the least disruption in the work flow leads to long-term successful adoption of monitoring and surveillance systems. Automated systems often require an initial capital investment. When choosing between automated and non-automated solutions, a cost analysis can be a key element. Be sure to include the cost of labor and the time taken against the main tasks of the resources to implement and run a non-automated solution.

If you have any questions in this regard, we will be happy to explain how our instrument could be integrated into your automated monitoring program.

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