Inmate healthcare review: “We clearly can do better”

DOVER, Del. – The Delaware Department of Correction believes inmates are already receiving good care but officials admit they can do better. On Thursday, state officials shared the findings of an independent review that looked at the care inmates receive.

It’s all outlined in a 16-page report by ChristianaCare with a focus on eight recommendations. Two of the priorities that stand out are the outdated electronic medical record system and the vacant medical staff positions. Believe it or not this is the first time, in more than three decades, that the DOC has taken a step back to look at what they need to do better when it comes to healthcare.

“We need to update how we do business in delivering healthcare,” says Claire DeMatteis, the commissioner of the DOC. “What this report will do is help us make that better and hold our vendor accountable and hold us accountable to key quality assurance measures.”

ChristianaCare agreed to review the DOC’s system for free back in August. The provider’s report is critical but also describes the workforce as passionate and caring, something the DOC’s Commissioner echoes. “It takes a special person to be a nurse anyway. But it takes a really special person to be a nurse in a correctional facility and I think our offenders appreciate that,” says DeMatteis.

But ChristianaCare also says the system hasn’t been kept up to date, leading to quality as well as safety challenges, and that’s a concern for people on the front lines.

“We have been behind the times when it comes to providing medical care for the inmates and it’s a stress factor that affects the inmates and staff and everyone inside the facility,” says Geoff Klopp, the president of COAD.

It’s people on the front lines that are needed, a staffing shortage that Commissioner Claire DeMatteis believes should get easier as time moves forward. “I think one of the reasons, to be honest, that it got harder over the past couple years was because of the riot and murder. And as we get past that and as our officer numbers increase, we’re going to try and keep that positive recruiting going for medical staff as well,” says DeMatteis.

Outdated technology is also highlighted in the report with a focus on the electronic medical record system. “It will be really good to get the updated medical charting system for them and I think that will lead to unseen improvements in it of itself,” says Klopp.

But ChristianaCare says upgrading technology alone is putting a band aid on the problem, adding that leadership needs to change and officials need to be help accountable. “We used to do much more auditing of our healthcare vendor and our outcomes and our patient safety and quality and we have to get back to that,” says DeMatteis.

DeMatteis says she is hopeful, given her track record with improvements to James T. Vaughn. “I was handed a 169-page report with 41 recommendations and we got 40 of the 41 done in a year. We can get this done…So when I’m handed a 16-page report with really eight recommendations, this is manageable to me.”

The commissioner says they will start implementing changes in January. Klopp says that’s acceptable. The commissioner also adds the only change that will cost money is the electronic medical record system. That’s estimated between to cost between three and five million dollars.

Another topic the commissioner addressed Thursday was the investigation into alleged forgery of medical records by their health care provider, Connections. Last week, the Attorney General’s office told the DOC that the investigation is still ongoing and did not provide them a timeline.

See below for the eight recommendations:

  1. Engage key strategic partners in prison healthcare delivery to promote collaboration, joint accountability and to set short and long-term objectives to improve prison healthcare in the areas of quality, cost, patient experience and staff experience.
  2. Establish a three-part leadership structure in each Level V (prison) and Level IV (violation of probation/work release) facility with leaders from the Department of Correction, the Bureau of Healthcare, Substance Use Disorder and Mental Health Services and the DOC’s medical and behavioral healthcare vendors – with mutual accountability to achieve outcome-based goals.
  3. Engage key strategic partners in prison healthcare delivery to promote collaboration, joint accountability and to set short and long-term objectives to improve prison healthcare in the areas of quality, cost, patient experience and staff experience.
  4. Launch ongoing quality improvement and process improvement initiatives and initiate regular staff development and training in quality, process and safety improvement.
  5. Implement facility-based “huddles” and create facility-based forums to engage and empower staff to identify challenges and develop solutions to improve operations and performance.
  6. Invest in information technology infrastructure, including improvements to the electronic health record system, to increase productivity, reduce waste and improve delivery of care.
  7. Recruit, retain and reward staff that embrace a safety, quality and performance culture.
  8. Train managers to analyze healthcare data to proactively identify risks, improve quality and safety of care and implement innovative practices.
Categories: Delaware, Local News