Key Points

  • Drug diversion is no longer something hospital leaders can ignore.
  • Facilities face real risk in the form of human well being, financial penalties, and damage to reputation.
  • Both federal and state governments are taking steps to address the drug diversion challenge

If you’ve been paying attention to our monthly physical security roundups, you’ve seen how many hospitals deal with damaged reputations after drug diversions from their facilities.

Increasing physical security is one of the most important steps healthcare leadership can take during this national opioid crisis. Before that though, it’s important to understand the problem, including risks, the toll is taken on providers, what the government is doing to address the problem, and critical next steps you can take.

Your Facility is at More Risk Than You Know

Don’t underestimate the impact of clinical drug diversions. Although there were 18.7 million pills lost to employee drug diversion in the first half of 2018; the problems run much deeper.

Your People’s Well Being

Patients are impacted in multiple ways when drug diversion is an issue.

First, if practitioners are diverting drugs for personal use, it’s highly possible that they’re treating patients while impaired — a direct risk to outcomes and a blow to patient safety. At the same time, in cases where diverted drugs get replaced with water or saline solution, patients who are in significant pain are left to suffer, potentially with incorrect dosages or even the risk of disease from a used syringe.

In some cases, the burden is more severe. Within one 16-month period at UT Southwestern Medical Center’s Clements hospital in Dallas, two nurses were found dead in a hospital restroom from fentanyl overdose. While this example is extreme, there are numerous similar stories of nurse deaths around the country.

Additionally, many health systems now burden their employees with the manual task of monitoring inventory and automated dispensing cabinets. This amounts to thousands of hours of work between staff in nursing, pharmacy, compliance, HR, and leadership. The additional work ultimately adds unnecessary burden and pulls staff away from work that directly improves patient care.

Your Reputation

It’s almost impossible to overestimate the value of a positive reputation for a health system. In money alone, the average lifetime value of a patient is estimated to be around a quarter million dollars.

The impact to reputation after a public drug diversion incident is unclear at this point. Although, we do know that hospitals who’ve suffered a data breach spend 64% more on advertising. It’s not unreasonable to assume something similar might happen in the case of drug or opioid diversion.

Regulations

Drug diversion is a public health crisis and the DEA is stepping up its efforts through penalties. In May of 2018, we saw the country’s largest settlement of its kindEffingham Health System paid the United States $4.1 million for not providing effective procedures and controls to deter loss and theft of controlled substances.

That’s just one case. We’ve seen recent settlements as high as $4.3 million and the penalties are trending upward. This adds up to serious and quantifiable average risk for any health system.

Government Response

You may have heard of the Opioid Crisis Response Act of  2018. The bipartisan bill received mixed reactions, but increases access to addiction treatment via telemedicine, supports state prescription drug monitoring programs, and addresses education and training for providers.

While the act was as not going far enough, it has been a start. Many states are stepping up their own efforts with initiatives ranging from treatment to partnerships with hospitals.

Next Steps

Keeping your facility prepared for the opioid crisis will be an ongoing task that requires participation from multiple stakeholders at your organization. Keep up with key insights from sources like the American Hospital Association and  this webinar from Advisory Board.