Standardizing Chronic Illness Care Behind Bars

Abstract

Correctional health care systems regularly standardize many aspects of patient care. However, the care of those with chronic illnesses seldom is standardized, but is left entirely to the discretion of individual practitioners. In such a situation, staff turnover and inmate transfers result in a wide variety of patterns of care and management criteria, and a chance of serious omissions in the care of this high risk, problem-prone group. A system is described for the standardization of the basic elements of adequate care of those with the common chronic illnesses, using practice guidelines. When these guidelines are stated in simple, objective, measurable terms, they can be incorporated into flow sheets and also into quality improvement monitoring tools. The guidelines can be augmented easily to meet patients’ special needs for individual treatment plans. This system has been shown to facilitate the responsible management of patients with chronic medical conditions.