Rieder Jean-Pierre, Casillas Alejandra, Mary Gérard, Secretan Anne-Dominique, Gaspoz Jean-Michel, Wolff Hans
Unit of Penitentiary Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Int J Prison Health. 2013;9(1):20-30. doi: 10.1108/17449201311310779.
In the past, health management in Geneva's six post-trial prisons had been variable and inconsistent. In 2008, the unit of penitentiary medicine of the Geneva University Hospitals was mandated to re-organize and provide health care at all six prison facilities. The specific aim of this paper is to outline the example as a practical solution to some of the common challenges in unifying the structure and process of health services across multiple small facilities, while meeting European prison health and local quality standards.
DESIGN/METHODOLOGY/APPROACH: Geneva's post-trial prisons are small and close to one another in geographical proximity - ideal conditions for the construction of a health mobile team (HMT). This multidisciplinary mobile team operated like a community ambulatory care model; it was progressively launched in all prison facilities in Geneva. The authors incorporated an implementation strategy where health providers partnered with prison and community stakeholders in the health delivery model's development and adaption process.
The model's strategic initiatives are described along the following areas, in light of other international prison health activity and prior care models: access to a health care professional, equivalence of care, patient consent, confidentiality, humanitarian interventions, and professional competence and independence.
ORIGINALITY/VALUE: From the perspective of the HMT members, the authors provide the "lessons learned" through this experience, especially to providers who are working on prison health services reform and coordination improvement. The paper particularly stresses the importance of partnering with community health stakeholders and prison staff, a key component to the approach.
过去，日内瓦六所审后监狱的健康管理一直存在差异且缺乏连贯性。2008年，日内瓦大学医院的监狱医学部门受命对所有六所监狱设施进行重组并提供医疗服务。本文的具体目的是概述这一实例，作为在统一多个小型设施的健康服务结构和流程时应对一些常见挑战的切实解决方案，同时满足欧洲监狱健康和当地质量标准。
设计/方法/途径：日内瓦的审后监狱规模较小且地理位置相邻——这是组建健康流动团队（HMT）的理想条件。这个多学科流动团队采用社区门诊护理模式运作；它逐步在日内瓦的所有监狱设施中启动。作者纳入了一项实施策略，即在健康服务提供模式的开发和调整过程中，健康服务提供者与监狱及社区利益相关者建立伙伴关系。
根据其他国际监狱健康活动和先前的护理模式，从以下几个方面描述了该模式的战略举措：获得医疗专业人员的服务、护理的等效性、患者同意、保密性、人道主义干预以及专业能力和独立性。
原创性/价值：作者从健康流动团队成员的角度，介绍了通过这次经历获得的“经验教训”，特别是给那些致力于监狱健康服务改革和改善协调工作的提供者。本文特别强调了与社区健康利益相关者和监狱工作人员建立伙伴关系的重要性，这是该方法的一个关键组成部分。
