Academic–Correctional Health Partnerships

Abstract

Providing health care in corrections is challenging. Attracting clinicians can be equally challenging. The future holds a shortage of nurses and primary care physicians. We have a unique opportunity, now, to develop and stabilize our workforce, create a positive image, and enhance quality before the health care landscape changes even more dramatically. Focus groups were conducted with 22 correctional health care professionals divided into three groups: physicians (6), nurses (4), and nurse practitioners/physician assistants (12). Content focused on curricular themes, but additional themes emerged related to recruitment and retention. This article describes recruitment challenges, strategic themes identified, and the proposed initiatives to support a stable, high-quality correctional health workforce.

Cardiovascular Disease in Incarcerated Populations

“…Even though 80% of incarcerated individuals report seeing a physician at least once (24), there are unique barriers to seeing a health care provider while incarcerated, including patients paying a copay to be seen (25), security concerns, and lack of providers (26). The consistency and quality of CVD care across correctional health care settings varies, and is potentially challenged for a number of reasons (27): 1) funding health care services (i.e., infrastructure, staffing, and equipment) for incarcerated individuals may not be the highest priority for the public, elected officials, and private corporations, and is further limited by government budgets or profit-making; 2) many correctional authorities lack the expertise to properly oversee health care operations under their jurisdiction; and 3) many health care professionals do not view practicing in a jail or prison as a desirable setting; thus, it can be difficult to attract qualified providers (28).…”

A National Survey of Medical School Curricula on Criminal Justice and Health

“…This perceived lack of preparation may help explain correctional facilities' difficulty filling clinical positions and high levels of burnout among correctional providers (Hale et al, 2015;Kalra et al, 2016). In other curricular areas, groups have developed competency-based systems such as the interprofessional competency self-assessment developed by the National Center for Interprofessional Practice and Education (Norris et al, 2015).…”

“…Understanding the specific health and social risks associated with incarceration may allow medical providers to connect patients with necessary resources, counsel appropriately, and even reduce recidivism (Shavit et al, 2017). In addition, correctional facilities experience substantial clinician shortages, which increased trainee exposure has the potential to mitigate (Hale, Haley, Jones, Brennan, & Brewer, 2015).…”

Evaluation of an Interprofessional Student–Faculty Collaborative Clinic in a Jail

“…Dental, medical, advanced practice nursing, physician assistant, and undergraduate students contribute to these services as well as to the leadership of the clinic. Jail-based student clinics, though uncommon, may help address correctional provider shortages (Hale, Haley, Jones, Brennan, & Brewer, 2015) and improve trainee skills in caring for previously incarcerated individuals. Additionally, the clinic environment serves as an opportunity for interprofessional education (IPE) among multiple health disciplines.…”

“…The volunteer survey results support the claim that an interprofessional experience in the correctional setting can improve student comfort treating incarcerated populations. This carries additional importance considering the shortage of correctional providers at many facilities (Hale et al, 2015). Participants may also better understand how a history of incarceration impacts the care of patients in the community.…”