The impact of AI surveillance on 8 critical monitoring practices for drug diversion detection

Drug diversion technology alerts tailored to healthcare workers' workflows

Ensuring that diversion technology is tailored to the specific workflows of different healthcare workers is essential in effectively identifying and preventing medication misuse. Each role in the healthcare setting has distinct responsibilities and interactions with medication processes, which means a one-size-fits-all approach to diversion alerts can lead to inefficiencies and missed opportunities for intervention.

For instance, a nurse's workflow involves administering medications directly to patients, often during high-stress and fast-paced shifts. Diversion technology for nurses should focus on real-time, point-of-care alerts that warn of potential discrepancies immediately. This allows for swift corrective actions and minimizes the risk of errors or intentional diversion.

Conversely, pharmacists and pharmacy technicians manage medication preparation, dispensing, and inventory control. Their workflows often include detailed documentation and inventory management tasks, so diversion alerts for these roles should emphasize tracking inventory discrepancies or frequent overrides of standard procedures. By flagging these specific activities, the technology can help identify and address potential diversion at the point of medication handling.

Anesthesia workflow often involves administering controlled substances without explicit physician orders to various patients in differing surgical procedures. Drug diversion alerts in this area can track the amount of controlled substances administered per procedure, detect anomalous usage patterns, and ensure that documented amounts of administrations and wastes match dispensed amounts.

Tailoring alerts to the unique aspects of each role ensures that the diversion technology is both effective and minimally disruptive, thereby enhancing its acceptance and integration into daily operations. By aligning alerts with the specific responsibilities and workflows, we can create a more focused, responsive, and effective system for preventing drug diversion.

Tracking controlled and non-controlled substances for suspected drug diversion

Controlled substances are closely regulated due to their high potential for abuse and dependency, which necessitates stringent tracking protocols. Despite these measures, the challenge remains in ensuring real-time accuracy across different departments and shifts. Diversion often occurs in subtle ways, such as falsifying records or manipulating medication counts, making it difficult to detect discrepancies without robust monitoring systems.

Non-controlled substances are not subject to the same regulatory scrutiny, often leading to less rigorous oversight and documentation practices. This lack of tracking can create opportunities for drug diversion that go unnoticed until significant discrepancies arise. 

The complexity increases when considering the vast inventory of medications that hospitals must manage. Each type of medication requires specific handling, storage, and administration protocols, adding layers to the tracking process. Integration of advanced technology, such as automated dispensing systems and real-time analytics, can assist in monitoring both controlled and non-controlled substances. 

Indications of potential drug diversion through pain scores

Assessing pain scores provides valuable insights into potential drug diversion within a hospital. Excessively high or consistently elevated pain scores, despite appropriate pain management interventions, may suggest that patients are either being inadequately treated or that there are issues with medication administration. In some cases, healthcare workers may over-report a patient's pain to justify the administration of higher doses of pain medications, which can then be diverted for personal use or illegal distribution. Conversely, unexplained drops in pain scores with no corresponding medical interventions may also raise red flags, indicating potential record manipulation or unauthorized medication administration.

A thorough review of pain scores with medication administration records can identify potential diversion patterns. For instance, frequent requests for pain medications, particularly from specific patients or by certain healthcare workers, warrant closer scrutiny. Healthcare workers who frequently omit pain score documentation may not be actually assessing their patients and falsifying administration information in order to cover their tracks from diversion. Diversion can also involve subtle manipulation of pain assessment and medication documentation to avoid detection. Consistency in reporting and standardized pain assessment protocols can mitigate this risk by ensuring that any deviations or irregularities are promptly addressed.

Regular audits of pain scores and cross-referencing them with other clinical data, such as patient diagnoses and prescribed treatment plans, enhance the ability to spot discrepancies. Implementing robust pain management protocols, supported by continuous staff training and advanced monitoring systems, can also improve the accuracy of pain scores while reducing the likelihood of drug diversion. By maintaining a vigilant approach to pain score evaluation, healthcare facilities can better protect their medication inventory and ensure patient safety.

Comparing contract and float staff in a drug diversion program

Contract staff, who are often hired on a temporary or project basis, and float staff, who move between different departments as needed, both play essential roles in ensuring patient care continuity. However, their transient nature and varied responsibilities can pose unique challenges in monitoring and preventing drug diversion.

Contract staff might not be as familiar with the institution's protocols and culture as permanent staff, increasing the risk of oversight and procedural breaches. They may also have fewer long-term accountability measures. Comparing their activities and access to medications against those of regular employees can help identify any unusual patterns or discrepancies that might suggest diversion. Similarly, float staff, who frequently switch departments, can sometimes exploit their mobility to divert medications, believing their actions will be less traceable amidst their varied assignments.

By systematically monitoring and comparing the medication handling practices of these groups, healthcare facilities can establish benchmarks and identify outliers. This comparison can highlight areas where additional training, tighter security measures, or more robust oversight might be needed.

Enhanced scrutiny of contract and float staff activities, such as irregular medication counts or inconsistent record-keeping, can be pivotal in catching early signs of diversion.

Moreover, implementing advanced tracking technologies and routine audits tailored to the unique workflows of these groups can further strengthen diversion prevention efforts. Regular cross-referencing of medication usage data and adherence to safety protocols can ensure that deviations by contract and float staff are promptly detected and addressed.

Clinical surveillance and practice review alerts

Clinical surveillance ensures that potential issues are detected early, allowing for timely intervention and prevention of further incidents. Practice review alerts function as a real-time system for flagging deviations from established protocols and best practices. For instance, if a nurse administers a higher-than-expected dose of medication or logs multiple overrides into the dispensing system, an alert can be triggered to prompt immediate investigation. These alerts can be tailored to specific workflows, ensuring that they are relevant and effective. 

The integration of clinical surveillance and practice review alerts offers multiple benefits: 

• Ensure deviations are documented and can be traced back to the responsible individual. This accountability acts as a deterrent against diversion, as the likelihood of being caught is significantly increased. 
• Support the early detection of problematic patterns, such as repeated inconsistencies or unusual dispensing practices, which might not be evident through routine audits alone.

By analyzing the alerts and subsequent investigations, healthcare facilities can identify underlying issues such as workflow inefficiencies, knowledge gaps, or areas where policies may need to be strengthened. Using AI technology to identify and correct practice issues across your facility allows you to identify diversion more effectively.