Workshops for collection staff ensure good practice

Collections are the weakest link in any drug testing program, and the staff that do the collections usually receive little formal training, says Otto Rogers, MD, FACEP, medical director of occupational health services at FirstHealth of the Carolinas in Pinehurst, NC. For that reason, Rogers plans to implement a series of workshops to formally train his occupational health staff in how to collect samples for drug testing and process the paperwork.

The testing itself is closely regulated, and as long as you use a certified laboratory and a medical review officer (MRO), there is little chance of major errors occurring in those areas, Rogers says. But there is ample opportunity for errors in the collection and paperwork process, largely because staff handling those functions often just learn informally on the job. Even though some of the staff are extremely good at handling the drug testing paperwork, there sometimes is not the consistency that Rogers would like to see in the 13 FirstHealth clinics covering four counties in North Carolina.

"It doesn’t happen often, but it’s a disaster when the paperwork is screwed up," he says. "You have to throw it all out and call the employer to say there’s been a goof. It makes for bad relations with the employer."

Rogers notes that processing drug-testing paperwork is no easy task. Even though he has been an MRO for 15 years, he avoids processing the paperwork himself because he is not sufficiently familiar with that part of the drug-testing program.

"I find someone who does it on a regular basis," he says. "I tell them, I know my part as the MRO, but you fill out the paperwork, or I’ll screw it up and the whole thing will be for naught.’"

Confidentiality of paperwork is crucial

In particular, Rogers is concerned about the confidentiality of drug-testing paperwork. He has seen some providers treat drug-testing results as no more sensitive than a common blood test report. For example, they leave the paperwork lying around in a common area where any staff and possibly patients could see them. Rogers recalls an incident at an urgent care center he once managed where a patient’s chart was left lying on a counter. Another patient saw a notation that the patient had had an elective abortion in the past.

"The patient who had the abortion came from a very fundamentalist family, and this was a small town where the news spread quickly. There was a big fallout from that," he says. "I could see the same thing happening with drug-test results, with someone seeing that a co-worker or a cousin tested positive for marijuana."

Without formal training, the occupational health staff also might inadvertently report positive results to any contact at the employer, rather than the individual designated to receive those reports. To counter those problems, Rogers plans to institute a series of workshops at each of the FirstHealth clinics in which he and others will provide training on the collection process and explain specific policies on how to handle the resulting paperwork. Confidentiality will be a major focus, he says.


For more information on drug policy workshops, contact:

Mary Ann Gaster, Director of Occupational Health Services, or Otto Rogers, Medical Director, FirstHealth of the Carolinas, 5 Aviemore Drive, Pinehurst, NC 28374. Telephone: (910) 215-6052. Fax: (910) 215-6055. E-mail: