gms | German Medical Science

Background: The provision of health care in jails and prisons is unique because the primary mission is public safety, not public health. The local ownership and leadership is focused on outcomes that are not necessarily conducive to adequate health outcomes. Typically, jails and prisons are resource-constrained settings further limiting clinical decision-making. As result, the challenge is to produce best practice outcome through: adequate advice and guidance at the local level, fostering physician leadership for change, and promoting standards and guidelines that reflect local priorities for change.

Context: The aim is to improve the quality of correctional health care through: standardized health care across the correctional health care domain, developing recommendations for clinicians through clinical guidelines and position statements on public-correctional health issues, and uniformly implementing standards, guidelines, and benchmarking practices.

Description of best practice: The presentation will cover a brief history of correctional health care and standards development in the U.S., an initial description of the national standards and clinical guidelines that have been developed, and presentation of data on successful improvements in the quality of patient care through quality process and outcome improvement studies.

Lessons for guideline developers, adaptors, implementers, and/or users: The presentation will conclude with an assessment of the future direction of guidelines and benchmarking data and their implications and challenges for all correctional health care systems and other resource restricted health organizations.