Lakeland Health in West Michigan is using software to prevent the diversion of drugs from its pharmacies by analyzing multiple types of data to ensure hospital staff members are following safety protocols and procedures to lessen the risk of prescribed drugs getting into the wrong hands.
The “wrong hands” the three-hospital delivery system is worried about are its employees, says Kurt Wyant, manager of pharmacy. “We want to ensure every patient in our system is protected from a potential mishandling of medication, while at the same time all team members are compliant with our policies and procedures.”
Drug diversion in hospitals is not a new problem, Wyant notes. An article in the January 2016 issue of Pharmacy Times estimates that 15 percent of pharmacists, 10 percent of nurses and 8 percent of physicians are challenged by alcohol or drug dependency. In all, as many as 10 percent of clinicians in the drug delivery loop may be diverting medications, the article states.
There are different ways for drugs to be diverted from the pharmacy. Employees with authorized access to medications may divert them to use personally or to sell, or give to another person. Lakeland's analysis has found that most drugs being diverted in its facilities are for personal use, not for selling or giving to someone else, Wyant says.
The delivery system is using a drug diversion platform from software vendor HelioMetrics to pull data from pharmacy, time and attendance and refill systems along with the medication administration record in the Epic electronic health records system to analyze and spot incidents of diversion.
At Lakeland Health, Wyant and other leaders submit queries to HelioMetrics, which conducts analyses using its platform. Results can show employees that use typical diversion tricks, such as pulling a medication 15 minutes before clocking into work, or clocking out for the day and then pulling a medication, or not being scheduled to work but coming in and pulling medications.
Analytics also assess physician prescribing patterns, such as a doctor who is prescribing controlled substances more than other physicians. These reports prompt further investigation to determine if there is either diversion or if clinicians may need additional training on proper prescribing practices.
Analytics also are conducted to monitor automated medication dispensing carts on hospital floors, from information systems vendor Pyxis. For example, an analysis can show if an employee took three tablets from a Pyxis cart and used two for patient care, or did not document a wasted tablet that was broken or dropped.
The drug diversion program started when the organization experienced diversions of large amounts of drugs by employees over an extended period, Wyant recalls. “We have so many systems and couldn’t monitor them all. We had quite a few spots prime for diversion that were difficult to readily see.”
All hospitals have a responsibility to monitor diversion, and Lakeland continues to improve its monitoring process. “It’s definitely helping us have a safer environment for our patients and our team,” Wyant concludes.
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