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Standards for health services in Australian prisons

Criterion 4.1.1 Human resource system

Our health service has a system to manage its human resources.


Indicators

A. Our staff can describe their roles within our health service (interview).

B. Our health service can identify the person who coordinates seeking patient feedback and investigating and resolving complaints (interview).

C. Our health service can identify the health professional who leads clinical improvement (interview).

D. Our health service can identify the health professional who leads our clinical care (interview).

E. Our staff are able to discuss administrative matters with the health service managers and/or owners when necessary (interview).

F. Our health service has an induction program for new staff (document review).

G. Our staff have position statements/job descriptions (document review).

H. Our health service has regular staff meetings (interview or document review).


Explanation

Research from both general practice and other industries supports the importance of effective human resource management.

For example, research in Australia and the United States of America confirms that teamwork is important to the quality of care. The research literature identifies teamwork as an important success factor in a number of safety initiatives across different industries. The alignment of role, competence and (where required) licensing, was also identified by the authors of a study of high performing clinical teams as a common element.43

Staff need to have position descriptions that outline their roles, responsibilities and conditions of employment. A position description establishes the role of the employee within the organisation, documents the parameters of the responsibilities and duties associated with that position, and forms the basis for evaluation and lines of accountability. Recruitment, training and development, performance evaluation, remuneration management and succession planning can all be based on the measure of an individual against their position description.

It is important for health services to have an induction program for new medical staff (including registrars and locums) as well as other clinical staff and administrative staff. Official visitors to the health service will also need an induction for special procedures such as a lock down which may occur in the prison. Such inductions should be designed to improve the safety of visitors while they are in the prison.

New staff need to understand the day-to-day operations of the health service including occupational health and safety issues (eg. security and infection control policies) relevant to their roles, as well as the processes by which the privacy and confidentiality of patient health information is maintained, including what information can be released to the relevant government department and in what circumstances. Medical and other clinical staff in particular need to be aware of key public health regulations (eg. reporting requirements for communicable diseases) that will affect how they work. Medical and other clinical staff also need to be made aware of local health and community services (eg. pathology and local hospitals) they are likely to refer to in the course of routine consulting. All members of the staff team need to understand the role of the Commonwealth Ombudsman and the role of local state/territory health complaints bodies. An induction program that covers these issues as well as the specific operational processes of the health service is essential to assist new staff to perform their roles properly.

It is important for health services in prisons to provide specific information to new staff members relevant to the correctional environment. In particular, it is suggested that any induction program include the following.

  • The rights and obligations of people who are incarcerated particularly relating to healthcare access
  • Processes for engaging with the prison management
  • Processes for engaging with the relevant government department (see Criterion 1.6.1: Engaging with other services)
  • The protocol for the notification of concerns regarding the provision of healthcare (see Criterion 1.4.2: Clinical autonomy for medical and other clinical staff)
  • Payment arrangements for the health service’s clinical services and arrangements for payments to external health providers, and associated access costs
  • Information about particular cultural groups within the patient population.

Health services that have not employed new staff in the past 3 years are not required to have an induction program already developed. However, these health services need to be able to describe what they plan to do when employing a new staff member.

It is important that the health service team has identified leaders44 in areas such as clinical care and improvement, information management, complaints/ feedback, and human resources. In the clinical care area, leadership might include convening a health service meeting to review the quality of care provided to a patient, or the mentoring of new staff. In the clinical improvement area, leadership might mean instigating a plan to monitor the management of patients on particular treatments (eg. methadone treatment programs or mental health management) with a view to improving the way the health service manages these patients. Sometimes, the person who leads clinical care may not lead the clinical improvement strategy within a health service, though both are important and it is assumed both would be led by a health professional.

In order to respond to patient feedback and make related improvements, health services need to identify a team member responsible for examining issues raised by patients and facilitating improvements in the health service.

It is possible for a single individual within the health service to assume all these leadership responsibilities. In some health services however, different members of the health service team will undertake leadership in these areas. In this case, a structured opportunity to discuss and agree on clinical matters is needed in order to meet the Standards.

It is important that staff have the opportunity to discuss administrative issues with the health service managers and/or correctional administrators when necessary. When a person or corporate body other than the practising medical staff own the health service, medical and other clinical staff need to have defined avenues for discussing health service administrative matters with the owners.

Further information about human resource issues can be obtained from:

  • the Australian Association of Practice Managers publication, The guide: AAPM business manual for healthcare (available for purchase from www.aapm.org.au)
  • a range of resources from the Australian Medical Association (www.ama.com.au)
  • the RACGP publication, General Practice Management Toolkit (www.racgp.org.au/publications/tools).45

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