Prison report suggests ways to improve inmate healthcare

A recent report on Delaware's prison healthcare system recommends changes are needed in order to deliver high-quality, safe and cost-effective healthcare to inmates.

“In general, the review found a passionate caring healthcare and corrections workforce who work daily to meet the needs of their patients, especially considering the challenges and resource constraints of the work environment,” the report reads. “While some challenges are inherent to prisons, the team found that other quality and safety challenges result from a healthcare system that has not fully operationalized foundational components of patient and staff quality and safety and process-improvement programs.”

Citing a high turnover rate of healthcare workers and ongoing vacancies as a persistent problem, the report states, more money could improve prison infrastructure but a long-term commitment is needed to ensure high-quality healthcare, which includes creating strategic partnerships that ensure goal-setting and accountability.

“While the appropriation of funds to address the identified deficiencies in the physical plant, equipment or IT infrastructure is critically needed, that is only part of the solution, and done alone will serve only as a Band-Aid to more deep-seated barriers to optimal healthcare delivery in this environment,” the report reads.

A Christiana Care team of 15 doctors, nurses and support staff took six weeks to review seven Department of Correction facilities including the state's three prisons. There was no cost to the state for this review, the report states.

At Sussex Correctional Institution, the report noted, the way healthcare workers kept track of and counted sharp instruments had presented a safety risk. In order to keep better track of sharp instruments and improve accuracy counts and staff safety, the report notes, instruments are now photographed to familiarize everyone with the healthcare tools.

DOC spokesman Jason Miller said the change was made by healthcare and security staff in the medical and dental areas for inventory purposes. “This process improvement intitiative was not the result of any missing or unaccounted-for items,” he said.

Miller said security staff are not trained medical professionals and may be unfamiliar with the names of medical and dental tools. Creating a system using photos to identify certain tools, he said, helps security staff keep accurate inventory and ensure overall security measures and safety within the facility.

The report also recommended that staff be recruited, retained and rewarded in order to embrace safety, quality and performance; implement facility-based staff groups to develop solutions to improve operations and performance; and engage key strategic partners to set goals, and improve quality and costs for healthcare services.

DOC Commissioner Claire DeMatteis said the Christiana Care critique is exactly what the prison healthcare system needs in order to move forward.

“Not only does it highlight areas where we are doing well, but it provides a roadmap on how to improve the delivery of healthcare services to the 5,100 individuals in our custody,” she said in a statement. “This is a manageable challenge, and the improvements it drives will benefit not only offenders but also our medical and behavioral health teams, counselors and correctional officers.”