For any drug diversion monitoring program, the team responsible for its success will need to accurately measure performance using Key Performance Indicators (KPIs). According to research from the University of Michigan, controlled substance diversion affects an estimated 10–15% of healthcare workers at some point in their careers, making structured program oversight not just a best practice but a patient safety imperative. These metrics also ensure accountability for the program’s overall success, evaluating and recognizing the program’s strengths and challenges while ensuring the team addresses the needs of the program in a timely fashion.
The importance that KPIs hold becomes evident when measuring the effectiveness of your diversion program over time. Though each organization must determine their unique blend of KPIs that will lead to the institution’s desired outcomes, industry leaders across top healthcare organizations have created some recommendations to help measure the ongoing success of your program.
Review 100% of Transactions and Users
Striving for complete visibility means tracking three interconnected KPIs:
- Percent of transactions reviewed: Many organizations currently capture only 1-5% of controlled substance transactions through report-running and periodic reviews. Reaching 100% audit coverage is the standard your drug diversion monitoring software should be held to.
- Percent of users reviewed: Transaction coverage alone isn’t enough. If your program monitors electronic logs but leaves anesthesiologists on a paper-and-pencil policy, you have a gap that can be easily exploited.
- Diversion incidents detected per year: An increase in detected incidents typically reflects improved monitoring, not a rise in actual diversion. More detections mean more accountability and stronger culture change.
Monitor False Positives and “Good Catches”
False positive rate
The false positive rate for traditional diversion monitoring programs is unacceptably high, yet simultaneously a necessary evil. A false positive result from any investigation is neither an opportunity for improvement nor an identified diversion incident. High false positive rates are very common with report-based methodologies for detection, which focus on looking at items like volume discrepancies, high volumes of opioids dispensed, or similar broad metrics that often have reasonable explanations.
“Good catch” rate
An organization’s rate of “good catches” results from legitimate opportunities for quality or practice improvement that are due to one’s diversion detection methodology. How much a program wants to focus on “good catches” can depend on the resources that exist for an institution, but incidents like inappropriate batches of wasting, delayed administration or documentation, or questionable waste witnessing practices all fall under the umbrella of cultural norms or individual performance that should be improved.
Improve Time to Detection and Case Resolution
Time spent per case
This critical metric is currently at troubling levels for many health systems. Many health systems report spending dozens of hours to resolve complex cases. This is time spent reviewing reports, gathering data, making requests from different departments for resources, and ultimately writing up conclusions. Driving improvement in these statistics not only allows diversion teams to focus on more strategic goals but also speeds time to resolution, another KPI with safety implications.
Time to detection
This metric is all about patient and workforce safety; the longer it takes to detect a diverter, the more damage they can do (to themselves, to others, or to the organization). Consider the number of patients that can be exposed to an impaired diverter, continuously increasing the health system’s liability. In addition to this, the diverter becomes more susceptible to an overdose of their own. Even if this does not occur, the likelihood of successful rehabilitation may drop as their addiction levels increase over this time period.
Time to resolution
The amount of time that it currently takes to resolve a case is largely a measure of workflow efficiency. This efficiency is reduced when diversion teams have to pass cases back and forth between departments. For instance, if a diversion workflow needs pharmacy review, then is handed off to nursing, security, then back to pharmacy, this process will likely take weeks (if not longer). However, if all of the information generated by those handoffs is presented up-front, a timely resolution may be reached within minutes, or possibly hours if an interview is required.
The key to measuring the success of your drug diversion monitoring program is to review the KPIs in a historical context (when possible) and to use your current methodologies to decide which ones you want to focus on improving. The team can then create actions to ensure improvement. Some interventions, like standardized documentation, may reduce time to resolution in a targeted sense.
Others, like implementing drug diversion monitoring software, may improve several pharmaceutical key performance indicators simultaneously. Whatever you choose to do, the key is to start tracking and reporting on these metrics to show progress and hold all teams involved accountable.
Ready to put these KPIs into practice? Watch our on-demand demo of ControlCheck to begin evaluating and optimizing your organization’s current diversion monitoring program.