Analytics help Orange Regional tackle drug diversions

Analytics are helping Orange Regional Medical Center gain insight to clinicians and staff members who may have opioid problems and could be diverting drugs.

The use of technology is part a larger effort underway at the 383-bed Middletown, N.Y., facility, as it seeks to stem drug diversion problems while providing much-needed support to help them with their problem.

The organization wanted to reduce the number of personnel investigating diversions and automate the process via data analytics to find ways to identify persons who may be diverting—particularly emergency physicians, pharmacists, nurses and anesthesiologists—while changing the culture to a non-punitive environment that helps those clinicians and others.

Orange Regional had been experiencing an increase in drug diversions, but its existing process of having manual audits to identify suspected diverters, particularly related to opioids, was cumbersome and not reliable. “We were investigating events in an inconsistent manner and needed better tools, as the number of reported events were increasing,” recalls Maria Russo, director of pharmacy.

Also See: Inventory control, analytics aim to help stem drug diversion

Automated queries, supported by the analytics platform of Omnicell, were used to speed up time-consuming processes critical to licensure and livelihood, says Lisa Oldham, vice president of nursing operations and chief nursing officer. “We did a lot of education with nursing leaders and validated that they understood the processes.”

When new nursing leaders joined, however, the organization realized it could have done a better job of educating them, and recently a more formal education program was launched. Anesthesiologists also now are being educated.

Orange Regional also created an interdepartmental task force to break down silos between departments, putting equal responsibility on each department and creating one team to change the culture in the hospital to ensure employees who need help get it.



Creation of the task force was a pivotal change to the program, because no one person or group is responsible for the diversion program, and changes can quickly be made when a need arises, Oldham explains.

But it takes a certain skill set to investigate diversions; a novice nurse director may just think that because a medication is missing it has been diverted, so a standard process was created to not inadvertently jeopardize someone’s career. “We gave everyone the same skill set with analytics,” Russo says. “This gave us direction and guidance, and the time invested in investigations is now bearable.”

Analytics helps the department benchmark the frequency of controlled substances being pulled for what may be personal use with reports given to nursing directors who can run an analysis anytime, replacing a manual process that used to take hours or days.

However, some processes remain manual at Orange Regional Medical Center because it’s just easier. For example, a dose of three miligrams of medicine may have one dose left and not be needed, so a nurse will waste the medication in the presence of another nurse who will document the waste.