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Fundamental Drug Diversion Certificate

September 26th

The IHFDA Executive Board could not be more excited with the advent of the brand new fundamental course on drug diversion inside healthcare facilities. This ground breaking 8 hour compilation of some of the most experienced and trusted experts in this field should prove extremely helpful whether you are just starting to seriously look at drug diversion inside your institution or you have been doing it for several years. We have provided a well rounded course that will address the main concerns of everyone who is tasked with these crucial investigations, with the ability to ask questions of the actual presenters. The presenters are either currently working on drug diversion inside a healthcare facility, or have spent many years in the field.

The first offering of this course will provide continuing education credits and will be presented virtually with live Q/A on the first day of the conference for both virtual and in-person attendees. Registrants will receive the entire 8-hour session approximately two weeks prior to our annual conference which is scheduled for September 26-28, 2022. This allows registrants two weeks to view the program and prepare for any questions they want to ask the presenters. The presenters will be in Nashville on the morning of Monday, September 26th, and will take your questions virtually. If registrants are also attending the annual conference in Nashville, they can attend in person to ask their questions.

Registrants can take the virtual course independent from the conference for $200.  If you are attending the annual conference, you can add-on the course for $150. Either way, continuing education credits would apply and a certificate of completion will accompany this course, the first of its kind!

This is something many of you in the field have been asking for years to be available for your new people in this area of investigation and those who desire a refresher course while also seeing the most recent methods and means of today’s investigators. Thanks for your input and support as we embark on this very important educational forum.

Course Agenda

“Drug Diversion: Personal Impacts, Patient Harm and Unexpected Outcomes” (1 hour)
Lauren Lollini IHFDA Executive Board Member

In 2009, Rose Medical Center in Denver Colorado experienced an outbreak of Hepatitis C (HCV) which infected 19 patients. A CDC investigation occurred after two patients tested positive for HCV having procedures two days apart at the same facility. This incident led to the arrest of a surgical technician who had been diverting syringes of fentanyl for her personal use. This presentation will explore the events leading up to the outbreak as well as highlight how the steps follow a typical pattern of drug diversion cases.

The presenter will give attendees a deeper understanding of drug diversion through the eyes of a harmed patient offering a non-healthcare perspective as well as the lessons learned leading to her role as a patient safety advocate. Attendees will better understand the damage caused not only by an employee’s diversion but from a broken healthcare system.

This presentation will set a framework for the multifaceted scope of the drug diversion problem, who is involved and the cost of non-compliance. An overview of this case helps to outline the multiple red flags which were not heeded resulting in a Hepatitis C outbreak while emphasizing how the role of healthcare workers can be a part of the solution. A summary of needs moving forward will highlight how we can better identify, respond, and handle diversion events more quickly as well as minimize patient harm and encourage recovery for the diverter.

“Overview of Institutional Drug Diversion” (1 hour)
John Burke, IHFDA Executive Board Member

This one hour represents a summary of 25 years of law enforcement work in the field of drug diversion inside healthcare facilities. This was gained while I was the Commander of the Cincinnati Police Department’s Pharmaceutical Diversion Unit, where we detained on the average of one health professional per week involved in diverting medications from hospitals and nursing homes.

The presentation will explore the basic profile of a diverter along with methods of detection, interviewing and interrogation. In addition to diversion prevalent on each floor, a special look at the Operating Room will also be analyzed. Discussion will also continue with the aftermath of these detentions, along with attempts for rehabilitation and in some cases, return to the workplace.

The presentation will also dissect one of the most egregious healthcare diversion offenses that entailed multiple health facilities across the United States. Information on how this subject was finally caught after infecting dozens of patients nationwide with a bloodborne pathogen. This case, and others, will spotlight the importance of each institution properly reporting these drug diversion offenses and the unfortunate consequences when laws and regulations are illegally bypassed.

“Drug Diversion Interviews in Healthcare: Gateway to the Truth” (1 hour)
Kevin Vanover, IHFDA Executive Board Member

The intent of this presentation is to focus on what we believe is the most critical component of the investigation process: The Interview. The interview is all too often overlooked, misunderstood, and mishandled by well-intentioned leaders who may not be fully prepared to perform this responsibility at the level needed. There are inherent obstacles when trying to determine the truth under very stressful circumstances.

Drug diversion interviews are by their very nature high-stress with much at stake. To overcome these challenges, the interviewer needs to possess a significant level of training and experience. The latter poses its own set of challenges when the interviewer is unaccustomed to utilizing conversation on a daily basis to determine the truth. To help better understand the importance of a sound interview approach, it is helpful to possess a general awareness of drug diversion nuances in healthcare.

"The Public Health Perspective: Injectable Drug Diversion and Bloodborne Pathogens Transmission” (1 hour)
Dr. Pamela Talley, M.D., IHFDA Executive Board Member

Healthcare facility drug diversion programs across the United States are increasing in sophistication in step with increasing rates of opioid use disorder generally, including among healthcare workers (HCW). Persons who inject drugs (PWID) are themselves at very high risk for infection with bloodborne pathogens (BBP) including hepatitis C, HIV, and hepatitis B, particularly if they share injection equipment with others. Since these infections are often asymptomatic, an infected healthcare worker may be unaware of their status. A HCW who is infected with a BBP and engaging in drug diversion of injectable products using tampering and substitution methods is at high risk of infecting patients who receive contaminated medications. Large multi-facility, multi-state hepatitis C outbreaks have been described.

This session will review well described BBP outbreaks caused by diversion with an emphasis on high risk tampering and substitution methods and violations of injection safety best practices. The case will be made to add for-cause BPP testing at the time of intervention or termination to inform other response activities. A Centers for Disease Control and Prevention assessment approach to determine the need for patient notification and BBP testing will be described. Additional recommendations and resources will be shared.

“Developing a Comprehensive Drug Diversion Monitoring Program” (3 hours)
Heidi McNeely Ph.D., RN, IHFDA Executive Board Member
&
Derek Empey R.Ph., IHFDA Executive Board Member

This session will cover multiple components and processes necessary to be included in a comprehensive healthcare drug diversion monitoring program. The course will cover recommendations around positions to carry out the program work, committee structure, and response team makeup. Policies/procedures, risk assessments, security considerations for controlled substances, and analytical tools will be reviewed as important components of a drug diversion prevention and monitoring program. Course instructors will also talk in depth about monitoring, surveillance, investigations, and reporting. Finally, the need for creating a culture of safety which includes education will be reviewed. The course will provide applicable tools and resources along with interactive real life case studies and opportunities for discussion and asking questions.
“The Intersection of Peer Support and Substance Use Disorder in Nurses” (1 hour)
Kristin Waite-Labott, R.N. Veritus

Objectives:
1. Gain an understanding of substance use disorder (SUD) in nursing.
2. Realize the benefits of peer support and learn about the peer support program for nurses in Wisconsin.
3. Decrease the stigma surrounding SUD by listening to one nurse’s recovery journey with an open mind.

The speaker will share her personal journey as a practicing nurse suffering from SUD. She will share her struggle with diversion, SUD, and stigma, as well as her support (lack of peer support), treatment, and recovery. Her story will provide an inspiring, humanistic lens to clinicians working with patients and co-workers suffering from SUD. This presentation aims to raise awareness and reduce the stigma associated with SUD in nurses.

Speaker Bios

Lauren Lollini

Director of Outreach - IHFDA
Lauren is a mother, a psychotherapist and a patient safety advocate focused on drug diversion education. But to truly understand Lauren’s involvement with the patient safety cause, you have to take a step back and get her story. After a routine surgery at Rose Medical Center in 2009, Lauren discovered she had Hepatitis C. She was a victim of Kristen Parker, a surgical scrub technician at Rose, who diverted drugs from operating rooms for her own use and spread the disease to hospital patients.

Shortly after her diagnosis, Lauren felt the strong desire to speak out to help others realize the victims of this tragic case of drug diversion, leading to the senseless infection of 19 innocent patients with the hepatitis C virus, were real people with families who suddenly found themselves with a deadly disease and to impress the lasting impacts it would have on their lives. Their plight was covered by news agencies across the state and Lauren was the spokeswoman as many of the victims were either too sick or too ashamed to do it themselves. Lauren has helped to pass legislation in the state of Colorado to insure better reporting procedures among healthcare workers who abuse their position in any way as well as make it mandatory for surgical scrub technicians to be licensed with the state regulatory agency.

She has lobbied for healthcare reform on Capitol Hill. She has partnered with HONOReform and is the co-author of their blog raising awareness on injection safety as well as commenting on drug diversion incidents internationally. Lauren has also been able to lend her voice to the One and Only Campaign in Colorado and other state branches around the country.

Most notably, Lauren is a member of the Drug Diversion Prevention Committee partnering with representatives from public health, health professionals organizations, legislative, law enforcement, and other patient advocates to address and prevent drug diversion in health care facilities. Their work has been helping to further the voice of drug diversion education and has started a national dialogue in regard to steps to more easily identify healthcare workers who may be putting patients at risk due to their diversion.

Lauren is an outspoken advocate who is tireless in her efforts to spread the word about her own experience in the hopes her message will be heard and outbreaks such as the one in Colorado will not be repeated.

John Burke

IHFDA Executive Director
Commander Burke has been a law enforcement officer for almost 48 years. He spent 32 years with the Cincinnati Police Department, working in uniform patrol until he was promoted to detective. He then spent several years investigating homicides, rapes, and child sexual assaults and abuses. He was promoted to the rank of sergeant and was ultimately assigned to the Internal Investigations Section. In 1990, he was asked to form and institute the department’s Pharmaceutical Diversion Squad (PDS). The PDS, made up himself, six investigators, and a secretary, soon accrued considerable notoriety in the law enforcement world.

The office was first featured in the FBI monthly magazine, and then spotlighted on NBC’s Dateline for their work on the investigation of drug diversion in health facilities. After retiring from the Cincinnati Police Department, Commander Burke accepted a new position late in 1999, and continued as the head of the Greater Warren County Drug Task Force in southwest Ohio until his retirement in October 2015. The drug task force investigates the illegal distribution of both licit and illicit drugs.

In 2004, he was named as the co-commander for the Southern Ohio High Intensity Drug Traffic Area (HIDTA) for major drug case initiatives and interdiction. Commander Burke has provided education and lectured across the United States to law enforcement and health professionals on the topic of prescription drug abuse. He has published numerous articles on the topic, and has written a monthly column for the past 10 years in Pharmacy Times magazine on pharmaceutical diversion.

He is the past president of the National Association of Drug Diversion Investigators, and is the owner and president of Pharmaceutical Diversion Education Inc., a company which provides education and consulting work on a wide variety of prescription drug abuse issues to law enforcement, health professionals, and the pharmaceutical industry (www.rxdiversion.com).

Kevin Vanover

Vice President of Finance - IHFDA
Kevin is a proud graduate of Elder High School, Cincinnati Ohio; Class of 1998. Kevin continued his education at Cincinnati State Technical College where he attended classes to become an EMT-B. After shadowing a Cincinnati Police Officer during a ride assignment, Kevin realized that being a police officer was his calling. He entered the Ohio Peace Officer Training Academy in 2001 and has enjoyed this line of work since day one. Kevin was hired as a police officer, with the Elmwood Place Police Department September 2001 and remained there for 14 years.

He was assigned to a small local drug task force and continued his investigation education in the field of narcotics. In 2013, He was promoted to Police Lieutenant in charge of all felony crimes with focus on narcotics and drug diversions case work. Kevin remains current in law enforcement on a part time basis and enjoys working road patrol. Kevin has attended numerous courses, conferences and presentations related to drug trafficking and drug diversion.

Currently Kevin is employed by TriHealth, a large health system in the Greater Cincinnati Area as a Protective Services Investigator where he handles drug diversion investigations for multiple locations within the system. Kevin is well educated in best practices related to diversion within a healthcare setting. He has gained the professional respect of local, state and federal authorities as well as regulatory board personnel due to his case work in addition to his presentation of case work within the board setting.

Dr. Pamela Talley

IHFDA Executive Board Member
Pam Talley received her undergraduate degree from Dartmouth College, her medical degree at the University of Rochester School of Medicine and Dentistry and trained in Family Medicine at the University of Iowa Hospitals and Clinics. After a 20 year clinical career, she pursued a Master in Public Health in epidemiology at the Colorado School of Public Health followed by a two year applied epidemiology fellowship with the Centers for Disease Control and Prevention as an Epidemic Intelligence Service Officer.

In addition to her role as IHFDA board member, she is active in the Council for State and Territorial Epidemiologists (CSTE) drug diversion work group. Recent work experience in public health includes her role as the Deputy Director of Healthcare-Associated Infections & Antimicrobial Resistance, and currently as the Medical Director of HIV/STD/Viral Hepatitis at the Tennessee Department of Health. Her passion is for increasing awareness of the underappreciated risk of viral bloodborne pathogen transmission and life-threatening bacterial infections secondary to tampering and substitution.

Heidi McNeely Ph.D.

Vice President of Education-IHFDA
Dr. Heidi McNeely is a pediatric Clinical Nurse Specialist and has been a nurse for over 20 years. Heidi has a PhD degree in Nursing from the University of Kansas with a minor focus in health policy. She also completed her Master of Science in Nursing focusing on pediatric patients with special needs in 2005 and received her Bachelor’s of Science in Nursing in 2000 from Regis University in Colorado. Heidi is actively involved in research around the opioid crisis and local responses to the crisis as well as research focused on substance use among healthcare professionals.

Heidi is currently the Drug Diversion Prevention Officer at Children’s Hospital Colorado. Heidi has worked in acute care nursing in pediatric hospitals around the country and in public health nursing in Colorado. She is the current chair of the Commission on Certification with the American Nurses Credentialing Center and serves her local community through her role as Vice President of the South Adams County Water and Sanitation District. Heidi has served past roles with both the national and local chapter of the Society of Pediatric Nurses. She has presented her quality improvement, evidence based practice, and research work at multiple conferences over the past 10 years and has several published peer reviewed articles.

Heidi prioritizes time to collaborate with professionals across the country to share best practices and learn together with others in her field. She facilitates a pediatric networking group of diversion specialists across the country that meets virtually on a quarterly basis and a local networking group of diversion specialists in Colorado that also meets quarterly. Heidi was appointed to the IHFDA board in 2019 as a Director and then in 2022 was promoted to the Vice President of Education for IHFDA. Heidi is also a mom to three children and has been married for 20 years. She enjoys fishing, hiking, reading, and board games. Heidi is often involved in outreach activities, volunteering, and giving back to her community.

Derek Empey R.Ph.

IHFDA Executive Board Member
Derek Empey is a pharmacist at Upstate University Hospital in Syracuse, NY. Current roles include clinical pharmacist, clinical informatics and IT, as well as Drug Diversion program manager covering 2 campuses. A graduate of Albany College of Pharmacy, and recently from Louisiana Tech University with a MS in Health Informatics, he has had supervisory roles in retail pharmacy, regional leadership roles in chain operations, long term care pharmacy, and inpatient hospital pharmacy. His main interests revolve around Health IT, the use of data and analytics to improve patient care quality and safety, and most recently how data analytics and technology can aid in the opioid crisis and prevention of drug diversion.

Current projects include multi-hospital collaboration on examining opioid prescribing metrics, hospital wide “Waste with Me” education pilot program, and creation of various metrics dashboards for monitoring clinical quality measures, as well as pieces for drug diversion monitoring.

Kristin Waite-Labott, R.N.

Veritus
Kristin has been an RN since 1991. After losing much to alcohol and drug addiction, she turned her life around. She now works as a behavioral health nurse, has published a book about her story of recovery called “An Unlikely Addict”, writes a blog on issues surrounding addiction and works with others who struggle with addiction. Her goal is to increase awareness about the problem of substance use disorder in healthcare.

She accomplishes this by presenting to nursing students at colleges and universities around the country, by speaking at nursing conferences, and by being an active participant in IntNSA (International Nurses Society on Addictions) including serving as president of the Eastern Wisconsin IntNSA chapter. She has appeared on several local and national TV and radio news programs as well as an episode of “The Doctors” talk show.
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