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Table 5 Quality indicators and performance measures identified for use in the prison setting

From: Quality indicators and performance measures for prison healthcare: a scoping review

 

Source

SECTION 1: HEALTHCARE

 1. Routine health assessments

  Percentage of people receiving physical health examination within first week following admission

(Greifinger, 2012; Laffan, 2016; Stone et al., 2006; Watts, 2015)

  Percentage of people dental examination within first month following admission

(Stone et al., 2006; Watts, 2015)

  Percentage of people receiving a mental health evaluation within 24 h of admission

(Teleki et al., 2011; Watts, 2015)

 2. Access to care

  Percentage of people with urgent sick calls accessing primary care the same or the following day

(Teleki et al., 2011; Watts, 2015)

  Percentage of people referred to urgent specialty care accessing care within 14 days

(Teleki et al., 2011)

  Percentage of people with non-urgent sick calls being seen within 48–72 h (Watts) or 14 days (Teleki)

(Teleki et al., 2011; Watts, 2015)

 3. Infectious diseases

  Receipt of influenza vaccination for people deemed high-risk (age and/or chronic conditions)

(Greifinger, 2012; Stone et al., 2006; Teleki et al., 2011)

  Receipt of pneumonia vaccination for people deemed high-risk (age and/ or chronic conditions)

(Greifinger, 2012; Teleki et al., 2011)

  Receipt of hepatitis B vaccine or documented immunity for people with hepatitis C infection or HIV

(Teleki et al., 2011)

  Pre- and post- HCV RNA testing of people with a diagnosis of hepatitis C who are receiving anti-viral treatment

(Teleki et al., 2011)

  Percentage of HIV positive people with viral load counts under 50,000

(Stone et al., 2006)

  Percentage of people with HIV/AIDS prescribed potent ARV therapy

(Teleki et al., 2011)

  Percentage of people with HIV/AIDS who were prescribed PCP prophylaxis within 3 months of low CD4þ cell count

(Teleki et al., 2011)

  Percentage of people with HIV/AIDS for whom a CD4þ cell count or CD4þ cell percentage was performed at least once in the previous 6 months

(Greifinger, 2012; Teleki et al., 2011)

  Percentage of new admissions with documented tuberculosis screening in accordance with guidelines

(Teleki et al., 2011)

  Percentage of people with positive test for tuberculosis completing curative therapy within 12 months

(Stone et al., 2006)

  Percentage of people with syphilis, gonorrhoea or chlamydia receiving medication within 3 days of lab reports

(Greifinger, 2012)

 4. Mental health care

General:

  Treatment planning for all people with mental health needs

(Greifinger, 2012; Hoge et al., 2009)

  Monitoring of medication adherence

(Hoge et al., 2009)

Condition-specific:

 a) Depression

  Percentage of people meeting criteria for major depressive disorder (MDD)

(Teleki et al., 2011)

  Percentage of people with MDD received at least 3 follow up contacts with a mental health practitioner during the acute treatment phase

(Stone et al., 2006; Teleki et al., 2011; Watts, 2015)

  Percentage of people who remained on an anti-depressant during the acute treatment phase

(Stone et al., 2006; Teleki et al., 2011; Watts, 2015)

  Percentage of people who remained on an anti-depressant during the treatment continuation phase

(Stone et al., 2006; Teleki et al., 2011; Watts, 2015)

 b) Bipolar 1 disorder

  Percentage of people with bipolar 1 disorder who have evidence of use of a mood stabilizing or antimanic agent during the first 12 weeks of pharmacotherapy treatment

(Teleki et al., 2011; Watts, 2015)

  Percentage of people with bipolar 1 disorder with documented lithium levels in the therapeutic range

(Greifinger, 2012; Hoge et al., 2009; Teleki et al., 2011)

  Percentage of people on lithium treatment with a record of serum creatinine and TSH

(Greifinger, 2012; Hoge et al., 2009; Teleki et al., 2011)

  Percentage of people presenting with depression who were assessed for the prior or current symptoms and/or behaviors associated with mania or hypomania

(Teleki et al., 2011)

  Pre- and post-treatment initiation liver function tests for people prescribed valproic acid

(Greifinger, 2012; Hoge et al., 2009)

  Percentage of people receiving tegretol whose levels are in the therapeutic range

(Stone et al., 2006)

 c) Schizophrenia

  Monitoring of abnormal involuntary movements

(Greifinger, 2012; Hoge et al., 2009)

  Percentage of people on antipsychotic medication receiving between 300 and 600 CPZ equivalents per day`

(Teleki et al., 2011)

  Percentage of people referred to weekly therapy who have received it

(Watts, 2015)

  Percentage of people receiving a dosage of antipsychotic medication outside the recommended range whose medical record documents the dosage given

(Teleki et al., 2011; Watts, 2015)

 d) Suicide

 

  Annual incidence of suicide

(Teleki et al., 2011)

  Percentage of people who attempted suicide who had an MH score of > = 3

(Stone et al., 2006)

  Universal screening recommended on admission using validated tool; people deemed at risk should be put on suicide watch and immediately referred to the mental health team. All serious attempts at suicide should be reviewed

(Greifinger, 2012; Hoge et al., 2009)

 e) ADHD

  Percentage of people treated with stimulant medication who had at least three follow-ups with a prescribing practitioner in the acute treatment phase

(Watts, 2015)

  Percentage of people treated with stimulant medication who had at least one follow-up with a prescribing practitioner during the continuation phase

(Watts, 2015)

5. Physical health conditions care

 a) Cardiometabolic

  Percentage of people with coronary artery disease prescribed antiplatelet or beta-blocker medication

(Teleki et al., 2011)

  Percentage of people with chest pain who have an ECG

(Teleki et al., 2011; Watts, 2015)

  Monitoring and treatment (e.g. ACE inhibitors, beta-blockers) of people with heart failure

(Teleki et al., 2011)

  Percentage of people receiving aspirin or beta-blockers after acute myocardial infarction

(Stone et al., 2006; Teleki et al., 2011)

  Cholesterol screening after acute cardiovascular events

(Stone et al., 2006; Teleki et al., 2011)

  Percentage of people with atrial fibrillation at high risk of thromboembolism prescribed warfarin

(Teleki et al., 2011)

  Number of months in which people on warfarin for atrial fibrillation had at least one International Normalised Ratio measurement

(Greifinger, 2012; Teleki et al., 2011)

  Blood pressure monitoring for people with hypertension, diabetes, CKD, coronary arterial disease, cardiovascular disease

(Greifinger, 2012; Raimer & Stobo, 2004; Stone et al., 2006; Teleki et al., 2011; Watts, 2015)

  Percentage of people with chronic kidney disease referred for AV fistula

(Teleki et al., 2011)

  Offloading (pressure relief) treatment for diabetic foot ulcers

(Teleki et al., 2011; Watts, 2015)

  Cholesterol and blood glucose monitoring for people with diabetes / chronic kidney disease

(Bisset & Harrison, 2012; Teleki et al., 2011; Watts, 2015)

 b) Respiratory

  Percentage of people with persistent asthma referred to outside facility or emergency department

(Stone et al., 2006; Teleki et al., 2011)

  Percentage of people with bronchitis not treated with antibiotics

(Watts, 2015)

  Percentage of people with asthma evaluated by the primary care provider within the designated follow-up time frames

(Teleki et al., 2011)

  Percentage of people with COPD receiving appropriate care

(Stone et al., 2006; Teleki et al., 2011)

  Percentage of people with chronic obstructive pulmonary disease (COPD) with spirometry results documented

(Teleki et al., 2011; Watts, 2015)

  Number of visits for people with a chronic skin ulcer without a prescription or recommendation to use wet to dry dressings

(Teleki et al., 2011)

 c) Musculoskeletal

  Back pain assessment of those with diagnosis of back pain

(Teleki et al., 2011; Watts, 2015)

  Osteoarthritis assessment

(Teleki et al., 2011)

 d) Screening and prevention

  Smoking cessation treatment or advice

(Watts, 2015)

  Colorectal cancer screening

(Teleki et al., 2011)

  Breast cancer screening and follow-up evaluation

(Stone et al., 2006; Teleki et al., 2011; Watts, 2015)

  Cervical cancer screening

(Stone et al., 2006; Teleki et al., 2011)

  Percentage of people with a history of falls who have a documented care plan for falls

(Teleki et al., 2011)

  Retinal screening for people with diabetes

(Stone et al., 2006; Teleki et al., 2011; Watts, 2015)

 e) Reproductive health

  Pregnancy tests

(Teleki et al., 2011)

  Pre-natal care

(Stone et al., 2006; Teleki et al., 2011; Watts, 2015)

  Percentage of live births delivered by Caesarean section

(Stone et al., 2006)

  Post-natal care

(Stone et al., 2006; Watts, 2015)

 f) Wound care

  Number of visits for people with a chronic skin ulcer without a prescription or recommendation to use wet to dry dressings

(Teleki et al., 2011)

 6. Substance use

  Percentage of people with a diagnosed substance abuse disorder receiving Screening, Brief Intervention and Referral to Treatment (SBIRT), group or individual substance abuse treatment

(Watts, 2015)

  Average daily rate of inmates receiving substance abuse treatment

(K. N. Wright, 2005)

  Opioid use monitoring

(Watts, 2015)

SECTION 2: ORGANISATION-LEVEL INDICATORS

 1. Grievances and adverse events

  Number of medical grievances filed in a month that are handled at the facility level

(Teleki et al., 2011)

  Percentage of prisoner grievances related to health care services found in favour of the prisoner in the past 12 months

(Teleki et al., 2011)

  Percentage of grievances appropriately addressed within 5 working days

(Greifinger, 2012)

  Percentage of non-emergency grievances resolved within 20 business days

(Watts, 2015)

  Percentage of emergency grievances resolved within 10 calendar days

(Watts, 2015)

  Number of grievances received and resolved

(Laffan, 2016)

  Percentage of adverse events (including deaths) reviewed within 30 days

(Greifinger, 2012; Watts, 2015)

  Inappropriate prescribing (i.e. prescribing drugs to be avoided for older people) to people over the age of 65

(Teleki et al., 2011)

 2. Inclusivity

  Provision of interpreters where needed; sick call slips and patient education in other languages

(Greifinger, 2012)

  Assessment for and provision of assistance with the activities of daily living for people with disabilities

(Greifinger, 2012)

 3. Co-ordination and transfers

  Percentage of people whose medication list was received within 4 h of admission Monday-Saturday 9 am-8 pm, or 24 h outside of that timeframe

(Greifinger, 2012; Watts, 2015)

  Percentage of people receiving an off-site service who were seen for a follow-up appointment after an offsite visit

(Greifinger, 2012; Watts, 2015)

  Percentage of people discharged from hospital with unique discharge diagnoses

(Watts, 2015)

  Percentage of timely routine or urgent medication administration

(Greifinger, 2012; Watts, 2015)

  Proportion of people whose health records reviewed within 12 h of transfer

(Watts, 2015)

  Completeness of medical-record keeping

(Greifinger, 2012)