Grant: Project Grant

As the opioid crisis escalates, so too does the rate of opioid loss and theft from Canadian hospitals, otherwise known as diversion. Freedom of information requests to Health Canada reveal that 800 to 1000 self-reported hospital losses of controlled drugs are captured each year, with some reports showing losses of several drugs at a time. Between 2010 and 2016, hospital losses of controlled drugs increased over 200%, with true numbers likely higher due to under-reporting and the difficulty of detecting diversion. In turn, these challenges impede awareness of, and research on, this stigmatized issue. Diversion is associated with serious safety concerns, affecting health care workers (HCWs) (e.g., those with substance use disorder often overdose), patients (e.g., impaired staff have committed errors on the job), population health (e.g., a single HCW infected over 40 patients with hepatitis C), and costs (e.g., hospitals have paid million dollar lawsuits). The main goal of this study is to improve opioid guidance for Canadian hospitals. First, we will review, appraise, and consolidate recommendations to prevent or detect diversion. We will then design and evaluate an online risk-assessment tool for hospitals to assess their opioid safeguards against the consolidated recommendations, and a quick reference guide (QRG) to help them decide what to do with their results. Finally, we will disseminate the risk-assessment tool and QRG to Canadian hospitals which will have the double knowledge translation benefit of (1) delivering best available guidance to hospitals (e.g., assess their individual vulnerabilities) and (2) aggregating information from hospitals to highlight systemic issues that require further focus (e.g., innovation, research, future diversion prevention efforts). Consequently, the outputs of this study will help improve hospital opioid safety in the short- and long-term, minimizing opioid-related harm to patients, staff, hospitals and the larger community.