[MCOH-EH] Hospital Drug Diversion Programs

[Hudson, T. Warner]

See below

T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health
UCLA Health System and Campus
Office 310.825.9146
Fax 310.206.4585
Pager 800.233.7231  ID 27132
E-mail twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu>
Website www.ohs.uclahealth.org<http://www.ohs.uclahealth.org>

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Sumeet Batra
Sent: Thursday, August 25, 2016 1:54 PM
To: mcoh-eh at mylist.net
Subject: [MCOH-EH] Hospital Drug Diversion Programs

Hello all,

Higher-ups at my hospital are considering randomized drug testing in high risk departments (anesthesia, pharmacy, ED, ICU) to deter drug diversion.  There is particular interest in using a larger panel to catch drugs commonly used in these departments, such as fentanyl.  I am not sure if there is evidence to justify the cost and time involved with testing these employees but I wanted to see what members of the group are doing.
I would especially like to know:

A)     If your program is doing random tests or only for-cause testing We do post offer drug testing for health system employees and reasonable suspicion based testing only; DOT CDL drivers are in DOT random pool

B)     What panel you're using DOT like 7 panel for onboarding and Quest HPP comp 1 panel for suspicion based

C)      If you're doing testing in-house or at an outside facility (or a mix) We collect on site and send to Quest to run the tests.  We do on site breath alcohol as part of suspicion based protocol along with DT collection

D)      Any results or evidence from the medical literature that you may have. Most of the literature re onboarding testing is from other occupations; Navy, US Postal, Georgia Power, DOT and others I've done random testing of safety sensitive positions in California in the past and it is a long road to ramp up, notify employees and expensive and time consuming to implement, but it certainly worked.  And the lawyers explained we had to document the need, examples, keep a documentation of need file, and so on, which we had.   Currently suspicion-based in the health system seems to be working without the headaches of random which would be penalizing all for the acts of a few and at significant cost.


Thanks in advance,
Sumeet Batra, MD, MPH


Medical Director, Occupational Health Services
Cook Children's Health Care System
Phone: (682) 885-1129
Fax: (682) 885-6717


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