Finnie Adam John
Health Promoting Trust Office, Education Centre, Eastbourne District General Hospital, Eastbourne, UK.
BMJ Open Qual. 2018 Jan 3;7(1):e000097. doi: 10.1136/bmjoq-2017-000097. eCollection 2018.
Many people enter prison with poor health from a background of deprivation and with unhealthy lifestyle habits, yet spending time in prisons is often actively detrimental to health. There is therefore a clear value in providing high-quality health promotion services in prisons that are effective at reaching those who need support to improve their lifestyle. The health promotion service at HMP Brixton provides a health trainers clinic to address lifestyle issues but found that it was sometimes challenging to identify appropriate patients and that the service was inefficient as a result. Analysis of our referral sources suggested that taking steps to increase the proportion of referrals made during screening and other clinics might lead to more appropriate and engaged patients. In this study, we set out to use quality improvement methods to increase referral from these sources. This involved improvements to the processes involved in delivering National Health Service Health Checks that were the primary source of referrals for health trainers and by improving links between the health trainer team and other clinicians. The changes were successful in increasing referrals from these sources. This work was completed during a period of exceptional disruption in the prison service and is relevant to secure healthcare sites that aim to ensure prevention activities are efficient and targeted.
许多人带着因贫困背景导致的健康问题以及不健康的生活习惯进入监狱，然而在监狱服刑往往对健康有积极的损害。因此，在监狱提供高质量的健康促进服务具有明显价值，这些服务要能有效地惠及那些需要支持来改善生活方式的人。布里克斯顿监狱的健康促进服务提供了一个健康培训师诊所来解决生活方式问题，但发现有时很难确定合适的患者，结果导致服务效率低下。对我们转诊来源的分析表明，采取措施增加在筛查和其他诊所期间进行的转诊比例，可能会带来更合适且参与度更高的患者。在这项研究中，我们着手使用质量改进方法来增加这些来源的转诊。这涉及改进提供国民健康服务健康检查（这是健康培训师转诊的主要来源）所涉及的流程，并改善健康培训师团队与其他临床医生之间的联系。这些改变成功地增加了这些来源的转诊。这项工作是在监狱服务异常混乱的时期完成的，并且与旨在确保预防活动高效且有针对性的安全医疗场所相关。
