Dr Cameron Loy - RACGP Victoria - Standards for Health Services in Australian Prisons: RACGP


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Cameron Loy delivered the presentation at the 2014 Correctional Services Healthcare Conference.

The 2014 Correctional Services Healthcare Conference - addressing the gaps, promoting multidisciplinary care and improving the continuum of care into the community.

For more information about the event, please visit: http://bit.ly/correctionalsvs14

Published in: Health & Medicine
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Dr Cameron Loy - RACGP Victoria - Standards for Health Services in Australian Prisons: RACGP

  1. 1. RACGP Standards for health services in Australian prisons Dr Michael Civil Dr Cameron Loy
  2. 2. RACGP • Represents urban and rural general practitioners • Over 20,000 members • Mission: to improve the health and wellbeing of all people in Australia by supporting GPs, general practice registrars and medical students through its principal activities of education, training and research. standards@racgp.org.au
  3. 3. Standards “There are no real standards for general practice. What a doctor does and how he does it depends entirely on his own conscience” 'condemnation of general practice in its present form; but (my observations) have also led me to recognise the importance of general practice and the dangers of continuing to pretend that it is something which it is not.” Collings JS. General practice in England today. Lancet 1950; 1:555-85
  4. 4. Standards Standards for - Practitioners - Ongoing education - Training - Fellowship - Guides, guidelines, resources - For General Practices and other locations where General Practice occurs
  5. 5. Standards standards@racgp.org.au
  6. 6. RACGP Standards for general practices • Template for quality care and risk management • 1991 – RACGP, AMA, Commonwealth Government resolved to develop a set of national standards • Independent and voluntary system of practice accreditation • 1996 - Entry Standards for General Practices • 2000 – RACGP Standards for General Practices (2nd edition) • 2005 - RACGP Standards for General Practices (3rd edition) • 2010 - RACGP Standards for General Practices (4th edition)
  7. 7. Section one: Practice Services Standard 1.1 Access to care Standard 1.2 Information about the practice Standard 1.3 Health promotion and prevention of disease Standard 1.4 Diagnosis and management of health problems Standard 1.5 Continuity of care Standard 1.6 Coordination of care Standard 1.7 Content of patient health records Section two: Rights and needs of patients Standard 2.1 Collaborating with patients Section three: Safety, quality improvement and education Standard 3.1 Safety and quality Standard 3.2 Education and training Section four: Practice management Standard 4.1 Practice systems Standard 4.2 Management of health information Section five: Physical factors Standard 5.1 Facilities and access Standard 5.2 Equipment for comprehensive care Standard 5.3 Clinical support processes
  8. 8. RACGP Standards for health services in Australian prisons - background • Unique nature of a prison environment • Characteristics of the patient population • Framework for the delivery of safe, high quality healthcare to prisoners • Support for GPs working in prisons
  9. 9. RACGP Standards for health services in Australian prisons - development • Acknowledgement of complex problems faced by patient population • Consultation, including with state and territory health and justice departments • Mixed feedback from jurisdictions regarding relevance
  10. 10. RACGP Standards for health services in Australian prisons - challenges • Requirements of Standard guidelines for corrections in Australia • Closed environment of prisons • Patient population generally characterised by complex clinical needs • Illicit drug use and abuse • Mental health problems • Incarceration rate of Aboriginal and Torres Strait Islander people
  11. 11. Standard 1.1 ACCESS TO CARE Criterion 1.1.1 Scheduling care in opening hours Criterion 1.1.2 Visits to patient living quarters by appropriate clinical staff members Criterion 1.1.3 Care outside normal opening hours Standard 1.2 INFORMATION ABOUT THE HEALTH SERVICE Criterion 1.2.1 Health service information Criterion 1.2.2 Informed patient decisions Criterion 1.2.3 Interpreter services Standard 1.3 HEALTH PROMOTION AND PREVENTION OF DISEASE Criterion 1.3.1 Health promotion and preventive care Standard 1.4 DIAGNOSIS AND MANAGEMENT OF SPECIFIC HEALTH PROBLEMS Criterion 1.4.1 Evidence based practice Criterion 1.4.2 Clinical autonomy for medical and other clinical staff Standard 1.5 CONTINUITY OF CARE Criterion 1.5.1 Continuity of comprehensive care Criterion 1.5.2 Continuity of the therapeutic relationship Criterion 1.5.3 Consistent approach Criterion 1.5.4 System for follow up of tests and results Standard 1.6 COORDINATION OF CARE Criterion 1.6.1 Engaging with other services Criterion 1.6.2 Referral documents
  12. 12. Standard 1.7 CONTENT OF PATIENT HEALTH RECORDS Criterion 1.7.1 Patient health records Criterion 1.7.2 Health summaries Criterion 1.7.3 Consultation notes Standard 2.1 COLLABORATING WITH PATIENTS Criterion 2.1.1 Respectful and culturally appropriate care Criterion 2.1.2 Patient feedback Criterion 2.1.3 Presence of a third party Standard 3.1 SAFETY AND QUALITY Criterion 3.1.1 Quality improvement activities Criterion 3.1.2 Clinical risk management system Standard 3.2 EDUCATION AND TRAINING Criterion 3.2.1 Medical staff qualifications and training Criterion 3.2.2 Qualifications and training of other staff with clinical roles Criterion 3.2.3 Training of administrative staff Standard 4.1 HEALTH SERVICE SYSTEMS Criterion 4.1.1 Human resource system Criterion 4.1.2 Occupational health and safety
  13. 13. Standard 4.2 MANAGEMENT OF HEALTH INFORMATION Criterion 4.2.1 Confidentiality and privacy of health information Criterion 4.2.2 Information security Criterion 4.2.3 Transfer of patient health information Criterion 4.2.4 Retention of patient health information Standard 5.1 FACILITIES AND ACCESS Criterion 5.1.1 Health service facilities Criterion 5.1.2 Physical conditions conducive to confidentiality and privacy Criterion 5.1.3 Physical access Standard 5.2 EQUIPMENT FOR COMPREHENSIVE CARE Criterion 5.2.1 Health service equipment Criterion 5.2.2 Doctor's bag/emergency trolley Standard 5.3 CLINICAL SUPPORT PROCESSES Criterion 5.3.1 Medicines Criterion 5.3.2 Vaccine potency Criterion 5.3.3 Perishable materials Criterion 5.3.4 Infection control http://www.racgp.org.au/download/documents/Standards/201105racgpstandards_prisons.pdf standards@racgp.org.au
  14. 14. RACGP Standards for health services in Australian prisons - accreditation • Quality Innovation Performance (QIP) ISQua accreditation •Voluntary process • Gap analysis • Two surveyors (one GP and one registered nurse) undertake the survey visit • Accreditation is for 3 year period • Quality compliance check to review any high risk areas conducted at the 18 month mark
  15. 15. RACGP Standards for health services in Australian prisons - feedback • Good starting base • Room for expansion and improvement • Areas unique to prisons health services that would benefit from improvement: • Security • Consent and third party participation in consults • Access to services •Transfer of information from one facility to another
  16. 16. RACGP Standards for health services in Australian prisons – active feedback • Opportunity for those who work directly with prison health services to provide feedback to help make sure the RACGP Standards for health services in Australian prisons remain relevant for health services in Australian prisons standards@racgp.org.au
  17. 17. Thank You! standards@racgp.org.au