The Emotional Connection Interview

The Emotional Connection Interview

Drug Diversion Interviews in Healthcare: Gateway to the Truth 

The Emotional Connection Interview

By: Kevin Vanover and Rich Cinfio

The intent of this article is not to provide an in-depth review of drug diversion in healthcare; rather, it is to shift the primary focus to 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.  

Drug Diversion in Healthcare

Internal diversion of controlled medications by hospital employees erodes the care plan and safety of patients, hurts the service image of the care provider and supports the employee’s unhealthy and unlawful lifestyle. Further compounding this is the possibility of state-imposed fines, Joint Commission sanctions and patient initiated civil litigation. Typically, clinical care providers, such as physicians, nurses and pharmacists, have the most access to controlled medications. Despite existing systems to deter such activity, some caregivers possess the motivation and opportunity to circumvent safeguarding protocols to use medications for their own purposes. One motivation is drug addiction.  The American Association of College for Nursing estimates there are 3.8 million registered nurses in the United States. Various studies place drug addiction rates among nurses at 8 to 15%. This is not to assume, however, that all drug addicted nurses divert medication.   The frequency of diversion is also a factor to consider. John Burke, President of the International Health Facility Diversion Association, using extrapolated data from medical facilities in Ohio,  estimates that 37,000 drug diversions occur nationwide annually at an estimated loss approaching $200 million. 

What is clear, is the consequences of drug diversion are significant and harms everyone involved. In many instances the patient is denied pain relief and the risk of exposure to blood-borne pathogens from the cross contamination of supplies can elevate.  Other concerns include inaccurate billing for medications never received and criminal and state regulatory board investigations resulting in sanctions.    

Common Methods Used to Divert Medications

Some common methods for diverting medication include “wasting product”, which occurs after a patient refuses the medication or the dose pulled is inconsistent with the amount ordered, and the remaining dose is then used for the healthcare workers (HCW) own purpose. “Substitution” of medication occurs when the HCW diverts the intended medication and administers a common uncontrolled medication in its place.  Another way to divert medication is the concept of “One for you and one for me”.  This occurs when the HCW pulls two doses of medication – often two pills – scans the dose in the system and gives one dose to the patient while keeping one for their own use.

Prevention Strategies

There are many systems commonly used to support prevention and detection of diversion activities. In addition to having a sound early recognition system to detect anomalies and other patterns of possible diversion, common defense strategies include strict transportation and storage guidelines, the tracking of retrieved or “pulled” medication from storage systems, such as “Pyxis machines”, and documenting when and to whom the medication is provided.  

Suspected Diversion: Initial Response Options

Despite existing systems and protocols to prevent and detect diversion, it does occur on an all too frequent basis. Responses can vary and typically consist of:

  • Monitoring the behavior to determine if additional steps need to be taken.
  • Remedial education and training if established protocols are not being followed.
  • A review of practices and behavior exhibited by critical stakeholders involved in the dispersion of medication processes.
  • Convening an internal review group consisting of experts representing various medication touchpoints to examine and assess existing facts.
  • Reporting to state regulatory agencies.  Typically, each state has a regulatory oversite board that falls under various branches of the state government.

While there are numerous response strategies available when diversion is suspected, it is our belief that all must strike the proper balance between protecting the patient, provider and employee. Fairness, balance, compassion and sensitivity is highly important when ensuring the determination of truth and the inherent accuracy of facts. Taking an aggressive posture that wrongly accuses the employee will leave them feeling abandoned by the organization with trust irrevocably broken. At the same time, determining the truth is a significant safety and risk- management concern for all involved parties.

Despite the existence of numerous response strategies, interviewing the employee is often the only available course of action that yields the greatest results and determines the truth. The question then becomes how to fairly balance everyone’s interest while protecting the needs and safety of the patient?  It is our belief the interview and statements provided by the employee most often sheds direct light on what occurred and in a fair manner; thus, eliminating the need for speculation and an unsettled outcome. A truthful admission has many benefits including:

  • A legitimate explanation that clears up a misunderstanding.
  • Identifying training gaps that need to be rectified; very helpful when the employee is new.
  • Providing clarification on next-steps to help guide the recovery process.
  • Preventing future diversion attempts in a timely manner.
  • Shedding light on protocol adjustments in the event the interview does not yield a clear direction.
  • Gathers facts that can be used to prevent future activity by strengthening oversight.
  • Serves as a mitigation strategy for patient safety, risk management and liability exposure.
  • A fair process done in a compassionate way messages to the organization and patients that the organization has a strong, yet balanced approach while focusing on a zero-tolerance standard.

It has been our experience, however, that this most valuable tool, in our professional opinion second only to direct observation of theft (which rarely occurs), is often mishandled resulting in a cloud of confusion, frustration and mistrust. Common interview pitfalls include:

  • Rushing to conclusions.
  • Supervisor and others dismissing or downplaying the facts: rationalization and denial.
  • Inherent bias when leaders make decisions based on personal relationships with staff.
  • Interviewing before all available facts are known.
  • Poor or non-existent documentation.
  • Using harsh language and tone of voice.
  • Conducting a “police interrogation” first.  
  • Attempts to outsmart and outwit the healthcare worker or bluffing with false information: “The Colombo approach”. The mistaken belief that a factual “gotcha” moment will result in an admission.  

In addition to failing to establish an emotional bond with the employee, one of the more common mistakes is having too many people involved in the interview process. There is the mistaken belief that some bit of information will be missed, or an employee’s right will be violated so every entity who touches the diversion process needs to be in the room. With so many group representatives involved, the interview takes on the appearance of an inquisition.  This all but guarantees an unsuccessful outcome because the interview focuses on what occurred thus failing to answer the more important question – why it occurred. It is the “why” that provides the gateway to determining the truth. Simply stated, having too many people in the room more often than not severely limits the interview and prevents a connection. This was one of many reasons why criminal investigators, who perform sensitive and stressful interviews, transitioned away from this model decades ago

A Different Approach: The Emotional Connection Interview & Determining the Why

Unrealized by many, interviews are highly complicated, involve many facets and require the interviewer to make an instant emotional connection with the interviewee. A connection that fosters trust, reduces fear and provides the best opportunity for establishing the truth. The interviewer needs to actively listen for a small kernel of information that requires a seamless and instant pivot towards a new direction; the ability to ease the employee’s concerns, fear and eliminate untruthful defenses while genuinely investing in their future recovery.  There are five primary facets to the emotional connection interview: Preparation, Environment, Opening, Narrative and Closing. The following is a brief summary for each:  

Preparing for the Interview

Preparations in advance of the interview include:  

  • Reviewing and understanding all facts associated with the incident.
  • Examining the employee’s work history.
  • Determining what is known that could drive the employee to engage in this behavior.
  • Preparing the interviewer’s mindset – determining how best to approach the interview.

Interview Environment

A proper interview environment is critical. In general:

  • Conduct the interview at a neutral and confidential location that is free of distractions.  
  • Silence cell phones. 
  • There should be no more than two factfinders in the room.  
  • Only one person should ask questions.
  • Initially, only take written notes when necessary. Note taking is a distraction and prompts defensiveness.
  • Prepare a few questions in advance and avoid a script.  

The Opening

Explain to the HCW that the interviewer is here to understand why this happened. Explain that we know what happened, but we don’t know why. The why is important for many reasons including setting the context for what occurred – the salient driving issues – which help set the foundation for discussion.  

  • Summarize that you are representing everyone involved including them. Recognize and discuss the pressures the employee must be feeling.
  • Explain that the organization has a robust analytical system that provides the pharmacy team with anomalies associated with the distribution of medication and these cases are investigated daily just looking for answers.
  • Allow the HCW to explain the processes they use when performing their medication responsibilities for narcotics and non-narcotic medications.  
  • Assure the HCW that this process has the ultimate goal of making sure that the HCW is healthy and to have better work-life balance.

The Narrative

  • Practice active listening by letting them talk.
  • Listen for defensive themes designed to mislead the interviewer. Themes many times include statements that attempt to imply the theft did not occur or they are not responsible. Examples include, “I know you won’t believe this but…”; “To tell you the truth…” or “I swear on…”
  • Explore opportunities to reaffirm that “good people make mistakes”.
  • Compare many life events to the interviewee with the ultimate goal of minimizing what has occurred.
  • Speak to the root-causes for the behavior not the behavior itself.
  • Empathize with them as they explain the why.  You are asking them to open up and to be vulnerable. Be prepared to be vulnerable yourself. 
  • Vary tone of voice to encourage conversation and to display compassion.

The Closing

Once there has been sufficient conversation to adequately address all facts and concerns, then the interview can enter into the closing phase.

  • Explain to the HCW that this investigation has to be reported to the state regulatory board and local law enforcement for separate investigations. Emphasize that their cooperation with the additional investigations is optimum to reaching the end goal of a healthy lifestyle.
  • Actively share in their relief by telling the truth; be encouraging and non-judgmental.   
  • Let the HCW know that they will be supported through the Employee Assistance Program to include the drug screen process prior to leaving the site on the day of the interview. Think of it this way: The ultimate goal is to determine the truth and to bring closure for all involved. Done right, the employee may reach out and thank you in the future for impacting their life in a positive way, sharing with you the recovery process.

The investigation of suspected diversion can be a complicated, emotionally charged and stressful endeavor. A properly trained interviewer has the ability to obtain the truth, streamline the process, lessen stress for everyone involved and enhance future safety.

To learn more about diversion and The Emotional Connection Interview, contact Premier Risk Solutions at

Kevin Vanover Bio:

Kevin has served law enforcement and healthcare security for over 20 years. He is a recognized security expert who specializes in complex investigations with a special focus on drug diversion. Previous experiences include serving as a law enforcement officer in the State of Ohio, including a special assignment to a drug task-force, and was subsequently promoted to Lieutenant in-charge of felony investigations. Kevin is currently employed by a large healthcare system in the Greater Cincinnati Area where he serves as a Protective Services Investigator, supporting drug diversion investigations for multiple locations within the system. Kevin is well educated and highly experienced in best practices related to diversion within a healthcare setting. His work 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.

security should embrace technology

security should embrace technology

Technology is sometimes seen as the enemy, a big change or perhaps even competition to mankind. We spoke with Eddie Sorrells, COO for DSI Security Services about the positive effects of technology in the security world.

The tipping off point for the interview was an old article Eddie re-posted on his LinkedIn. I found it interesting because the idea of how cameras are placed and monitored is still one of the most common areas of concern in risk assessments. From dummy cameras to footage no one is watching…Eddie talks about how prevalent that problem is and what we are seeing years removed from that article. Eddies says currently 70 million cameras are up in the U.S., that number increasing daily.

Eddie discussed more convenient ways to monitor footage and integrate autonomous responses. Listen to Eddie’s interview for more on how the security industry should be embracing the newest and latest technology, as it will be the key to safety.

Continue to visit our website for more videos like this one, or if you have an area of interest you’d like to speak to, email

security should embrace technology

Empathy through the human connection in the workplace

In this week’s edition of “Strong, Safe & True,” we sit down with Minette Norman. Norman spent 30 years in the software industry but now she spends her time helping companies lead with empathy, encouraging diversity and inclusion. We talked to her about safety and security, both physical and psychological.

Minette spoke about the importance of human connection in the workplace. She points out that not only does it fulfill an emotional need for employees, but having those relationships truly helps solve the hard problems that arise for businesses. It also leads to higher productivity and lower turnover.

When you can create solid, safe workplaces in an emotional capacity, it can lead to stronger physical safety. Most domestic violence cases against women happen at the workplace, but because women fear being seen as bringing drama or problems with them, won’t open up to employers or coworkers. If people feel safe and protected at work, they would be more likely to share threats. That way, an employer could help guard their well-being.

Listen to the video to hear Minette talk about the importance of inclusion and diversity. Come back to our website for more videos like this one.

security should embrace technology

Maintained Client relationships provide new opportunities

In any business, servicing clients properly and maintaining client relationships is key to success. PRS was recently approached by a publication to weigh in on one of our clients and our quotes will be included in the print version of this article. In the meantime, we are throwing the spotlight on Brad Minnis, Juniper’s Vice President of Environment, Health Safety & Security. We are honored to have been working with Brad for years.

Brad Minnis Keeps Silicon Valley Safe – American Builders Quarterly

Check out Mike’s thoughts on successfully servicing client relationships over the years. Continue to watch videos on our website for more videos like this one!

Fighting Human Trafficking in the Puget Sound Area

Fighting Human Trafficking in the Puget Sound Area

Children’s bodies being sold. This is not a new topic, however, with the lack of resources and ever evolving technology, putting human traffickers behind bars has become even more challenging. We sat down with Detective Sgt. Brandon James of the Seattle Police Department and Jim Fuda of Crime Stoppers to talk about the issue.

To lend perspective, 1 in 25 children will be solicited for sex online. That was a 2017 pre-pandemic study, so Fuda suspects that number is even higher. Think of the level or resources it takes to try to combat that amount of predators. We are seeing the trickle down effect of vaccine mandates and the labor shortage across our country, including in the security world. The Seattle Police Department is also seeing that. The number of investigators they have, just fell and the job is already more demanding because of new technology. Calls come in all the time about incidents involving exploited children. One of the more recent, elementary school kids who sent inappropriate pictures through apps. What concerns both James and Fuda, is the ongoing lack of awareness of the danger that lurks online.

James often has to parent the parents, explaining that a child does not have a right to privacy on a device. We preach stranger danger, but he reminds us all that when we allow a child to speak with strangers online, we are inviting into our homes. It is the same thing. Children need to realize just because someone says they’re 12 years old, doesn’t make it true.

The hard part is once these children are targeted, the grooming begins. It starts innocently enough, questions like, what’s your favorite hobby, do you have a dog, what kind of music do you like. Then the perpetrator finds out details, like where the child goes to school and uses them. It goes from asking for pictures of a puppy, to the child’s “pretty face” and the decline progresses. Then if the child wants to tell, sometimes they can’t because of fear. Predators will threaten harming loved ones. Once inappropriate pictures are out there, there’s no way for them not to be. The bottom line is parents should be monitoring everything online, especially video chats. It is very hard to recover evidence from chats.

It’s also important to get tip lines out there! You can contact the National Center for Missing and Exploited Children at 1-800-843-5678 or Someone can also reach out to Crime Stoppers at 1-800-222-TIPS or by using the P3Tips mobile app.

Click on the video to see the interview and learn more valuable information to help keeps kids safe! Visit our website for more videos just like this one!

Executive Protection: An International Assignment Case Study

Executive Protection: An International Assignment Case Study

The Client: In this executive protection case study example, PRS assisted a Fortune 500 high tech company based in the USA during business travel to Lagos, Nigeria during the fuel crisis in Western Africa.

The Situation: The client had 2 of their senior executives flying into Lagos, Nigeria in late May
2015 to attend several high-level business meetings around town in various locations and at
various times throughout a 3-day period. The travelers were new to the region and unfamiliar
with the surroundings and risks day-to-day in such logistics moving in & around the city.

The Solution: The local PRS private security services partner in Nigeria has vast resources
and experience operating day-to-day in country. PRS deployed 1 security driver and 1 close
protection officer (armed, concealed, plain-clothes) to escort the business travelers for the
duration of their stay. The PRS EP team put together a travel management plan in advance
of the travelers’ arrivals and shared the plan with them via email to best prepare &
familiarize the travelers with the EP team as well as rough expectations. The EP team met
the travelers outside baggage claim at the airport, greeting them with a hand-held sign that
was somewhat innocuous in name (actual names of individuals nor the company name were
not utilized), and escorted them to their hotel and other meetings around town for the
duration of their stay. The PRS partner has their own fuel storage cells that are private so
the fuel shortage that was occurring in Nigeria at the time of their travel did not impact the
business travelers schedule or routine. The travelers were returned to the airport without

The Result: The client executives had productive meetings while visiting for business
that were uninterrupted, on-time, reliable and professional allowing for the maximum
efficiency of the use of their time.

“Alex and team were timeous, and flexible as the
itinerary changed a lot due to the fuel crisis in
Nigeria last week. I was also impressed that they
were able to keep their vehicles going as they
apparently had private fuel reserves at their
premises. Thanks again for organizing.”

Juniper Networks

“Everything went perfect thanks. Alex and his
crew gave us great hospitality, and operated in
a professional manner.”

Juniper Networks

Premier Risk Solutions provides the best in class global protective, consultative and investigative solutions for organizations to adapt to evolving business objectives and allow for scalability and agility. Through partnerships and strategic alliances, PRS offers support in 65 different countries. Our clients consistently tell us that our solutions are a cut above the competition. We foster a collaborative relationship with clients and vendors leading to the most successful service execution for all parties involved. We strive for each and every service no matter how small or large to have the best customer service experience possible. At PRS you will feel you are working with a partner who has your organizational brand and integrity in-mind.

Case Study: May Day Protest Activities 2015

Case Study: May Day Protest Activities 2015

The Client: In this case study example, PRS assisted a Fortune 500 financial services company
during the May Day (International Workers’ Day; May 1st 2015) Protests in Seattle, WA USA.

The Situation: Historically the May Day Protests in Seattle have experienced violence and
rioting that have targeted capitalistic organizations. Many businesses in the downtown
corridor of Seattle have recently decided to shut down operations early in the day on May 1st
each calendar year in order to avoid life safety & security related issues. Much property
damage has been known to occur during the protests that turn into riots as the day turns into
night. The client themselves have experienced significant property damage in year’s past.
The client desires optimal business operations during this day that will cause the least amount
of interruption to their customers and employees.

The Solution: PRS deployed 7 agents from its private security services pool at various times
throughout the course of the business day to cover higher risk locations where protest
activity has been known to occur. PRS also implemented a dedicated project manager to
work alongside the client to monitor all social media activity related to protest and anarchist
activities to keep deployed agents situationally aware of protestor movement. Further, 2 of
the 7 agents were on foot patrol and dressed to blend into the crowd to appear as
protestors to feed back “real time” info on observations, activities, threats, etc to provide
enhanced situational awareness.

The Result: The client experienced zero interruption and zero loss. At several locations the
client closed business operations a few hours early to let employees go early in an effort to
divert them from the main protest activity of the day, but also to help alleviate any
customers from the very same. The main client point of contact was able to focus his
energies and efforts on internal communications while being fed relevant, pertinent
information to their business interests. PRS personnel ensured each employee departed their respective workplace location without harm or harassment.

Premier Risk Solutions provides the best in class global protective, consultative and investigative solutions for organizations to adapt to evolving business objectives and allow for scalability and agility. Through partnerships and strategic alliances, PRS offers support in 65 different countries. Our clients consistently tell us that our solutions are a cut above the competition. We foster a collaborative relationship with clients and vendors leading to the most successful service execution for all parties involved. We strive for each and every service no matter how small or large to have the best customer service experience possible. At PRS you will feel you are working with a partner who has your organizational brand and integrity in-mind.