The Mayo Clinic, is rigorous about preventing opioid-addicted workers from stealing injectable drugs and putting patients at risk. It may be more relentless in its efforts than any other healthcare organization in the country.
That's because it has encountered the problem so often—at least 40 times in the last five years, says Keith Berge, MD, a Mayo anesthesiologist who chairs the clinic's Medication Diversion Prevention Committee and heads the Minnesota Board of Medical Practice.
Knowing that opioid-addicted clinicians are out there, the Mayo, with 59,000 employees in five states, now looks harder than ever to find them.
The focus on healthcare worker diversion started 15 years ago, Berge tells me. That's when the clinic realized it was sending at least one anesthesia worker a year into treatment for fentanyl addiction, one of the drugs to which that specialty has easy access.
Then in 2008, the clinic discovered that a catheterization lab nurse at Mayo's hospital in Mankato, MN was stealing patients' fentanyl, using the syringe on herself, then replacing it with saline for use on the patient "so cath lab patients were getting no sedation for their procedures," Berge says.
"It ended up being on the front page of the Minneapolis Star Tribune, and caused a lot of angst at the highest levels. People suddenly realized, 'Jesus, this is a very scary problem. We need to make it stop.' "
Fortunately, no patients had been infected. Yet.
So the Mayo created D-Dirt, the Drug Diversion Intervention and Response Team led by a special diversion coordinator. The team developed policies for various units. The prevention and detection ball started to roll.