6. Throw out assumptions about healthcare workers who divert drugs:
• They are easily noticed because of their odd behaviors. They are not, and they are skilled at hiding their activity. They are often the best workers who come in early, stay late, and volunteer to do extra work.
• They are rarely discovered in regions with low opioid use. Wrong. Diversion happens everywhere there are healthcare workers. Especially where there are healthcare workers, because that's where the drugs are. Minnesota for example, has one of the lowest rates of opioid overdose in the nation, but in Rochester, there are a lot more healthcare workers per capita than the rest of the state.
• Only workers with access to drugs divert them. Not true. While it's mostly nurses who divert drugs because their numbers are so large, people in every job description in the Mayo system have been caught diverting drugs, from janitors to nurses to physicians, even a toxicology lab tech who, as he tested the fentanyl for evidence of diversion, was caught diverting.
None of the major incidents nationally in recent years, which required notification and testing of 30,000 patients, involved workers whose job description gave them access to controlled substances.
Berge says that a hospital executive has not yet been caught, "but it will happen." The Mayo has even had several healthcare workers caught diverting drugs while they were patients in the hospital.
7. Know and keep track of areas throughout your organization that are the most vulnerable, from the loading dock to the incinerator and update them when new diversion schemes are detected.
8. Report it. Have a policy that when an employee is found to be diverting drugs, the hospital has an obligation to report that to the DEA, as federal law requires. The hospital also should report 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.