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Triaging prison healthcare

Tuesday, November 1, 2016

Believing his cough had progressed to pneumonia, Jeff requested medical attention. He was coughing up blood. After several days without a medical appointment, Jeff contacted us and we responded on a priority basis later that day.

Fortunately, Jeff had been seen by the centre’s nurse that same day. Nonetheless, we still had questions. We continued our investigation, confirming that Jeff had submitted three health care requests over five days before finally receiving medical attention.

The nurse booked Jeff to see the doctor the following day. We received the diagnosis –
pneumonia, as Jeff suspected. Jeff was immediately put on a treatment plan and received a chest x-ray to determine how far the pneumonia had progressed.

Jeff happily reported to us a few days later: he was much better. Once Jeff received medical care his condition improved.

The centre explained the delay in Jeff’s care, noting that the centre receives around 100 health care requests each day. It was a lot to go through. Other inmates sent multiple requests before Jeff, leading to Jeff’s first three requests going unreviewed until medical officials caught up five days later.

This first-come-first-serve process seemed inconsistent with the effective provision of health care. The centre agreed, promising to more proactively screen health care requests based on need. Now, nurses will review requests as they come in and process the urgent ones first. If more time remains in the nurse’s shift, they will then process the non-urgent requests. At the end of the day, the non-urgent requests will then be organized by date submitted, so they can be processed in order during the next shift after any new urgent ones. We expect that these adjustments will result in potentially urgent healthcare situations like Jeff’s being more consistently identified and responded to on a priority basis.