In this Quick Take, I’m addressing a concerning trend I’m seeing across healthcare facilities – the practice of concluding diversion investigations based solely on software analytics and audit data, without ever speaking to the healthcare professional involved.
Too many facilities are looking at their monitoring reports, conducting deep-dive audits of documentation and waste records, and then making a determination that unusual patterns are simply “practice issues” rather than potential diversion. But here’s the problem: you can’t possibly know that without having a conversation with the individual.
This shortcut approach creates significant safety risks and misses opportunities to identify both actual diversion and legitimate practice concerns that need addressing. Every facility needs to evaluate their investigation process and ask themselves: who is making the decision about whether to interview staff, and what criteria are they using?
The interview process doesn’t have to be adversarial or make staff feel targeted. When done correctly, it’s simply a professional conversation to understand the full picture behind the data. But skipping this critical step entirely? That’s a gap that puts both patients and facilities at risk.
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Transcript
Welcome to today’s Diversion Insights Quick Take. We’re going to talk about how software is not enough. And we’ve talked about this before in other podcasts or conferences, but this is a little bit of a different perspective. We’ve talked about before how software is not enough. You need someone to drive the software, and that is still true. Somebody’s got to look at it. Somebody’s got to see the data. Somebody’s got to interpret the data correctly. Somebody has to dive into the data and figure out what’s going on and notice those trends, and then pass that information to the appropriate people. Right?
This is where the discussion starts for today’s quick take, and that is what happens after the audit is given to whomever, depending on what your facility’s process is, and then it ends. Because whoever is in receipt of that information—people, right? more than one, potentially, hopefully—determine that it’s a practice issue.
How do they come to that conclusion? More and more, I am seeing I don’t know how they are coming to that conclusion. They either don’t have a proper understanding of how the software itself works, and they’re putting too much emphasis on the scoring. Right? Depending on which software you use, they call it different things: Iris scores, heat scores, those types of things. So maybe this person has a low score. Um, and maybe the trend is that it’s getting lower, but yet they have some activity that is concerning.
Maybe it looks like it might be practice, but as many of you know, practice and diversion can look very similar. Sometimes you can kind of make that decision when you’re looking at that deep dive. There’s no particular patterns. Um, it’s a here and a there. It looks a little sloppy, and so you’re fairly confident that it’s practice, and so I can see going with that and maybe just keeping an eye on things. But other times it’s not clear, and you really do need to have a discussion with that person to get a little bit more information to see how they answer and how they respond to your questions.
And sometimes it’s pretty darn clear because the pattern is there. I mean, it’s the same class of drug. Maybe they’re only missing four things, right, in three months, but it’s all the same drug or all the same class of drug. And to then say, “Oh, it’s practice.” Maybe not, but we don’t know.
And so this is the shout-out for you: Look at how you’re making those decisions of how or if an investigation progresses to an actual interview, because I am seeing more and more that things are not progressing when I believe they should. So, defining what your process is and being consistent with it and developing a culture that doesn’t mean that because we’re sitting you down for an interview that you’re going to lose your job, but we talk to everybody when there is a question because we just need more information. And so approaching it that way rather than, “Oh, what if we’re wrong and we call them in and, you know, we put them in a bad spot and they’ll feel targeted.”
Think about your program and what is the message that you’re getting out there. And is that message one that is preventing you from really ensuring safety? You know, we talk about patient safety, and it’s a liability to the organization as well. But then let’s not forget the healthcare professional. Maybe you are catching them at the beginning, and had you had a conversation, you would have gotten that information and taken it to the next step, and that would have been a huge improvement in safety.
So, look at your processes. And when do you take it to the next step of an interview? And who is deciding whether to take it or not? Um, is it somebody that really is educated on what diversion looks like, how to interpret the software? And, um, or is it not? And maybe you need to examine your committee, and maybe they need some more education, too. All right, that’s just the food for thought. Thanks, everybody, for listening.
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