December 1, 2006

Ongoing process for addressing inmate concerns

We have jail health staff available to respond 24 hours per day, seven days per week, to the health concerns of the nearly 55,000 inmates that come through the King County Jail system each year. We are also ready to respond to health emergencies at any time.

Any inmate can seek health care services through a kite, which is a written request for assistance, or may present without a written request to the triage nurse, who visits every housing unit in the jail system every day, if they have any health concerns. Nurses will refer to a provider for care when needed.

Role of the Ombudsman in supporting inmate health

At any time, an inmate may also choose to use the King County Ombudsman’s office hotline to raise concerns about their welfare in the jail, including their medical care.  In most cases where medical questions are involved, Ombudsman Office staff work directly with Jail Health staff, by phone and/or e-mail, to assure that inmates are receiving the care they need.

Since 2004, the Ombudsman’s Office received about 70 complaints regarding medications per year. To put this information in context, we issued 153,192 new or refill prescriptions in 2005, or nearly 3,000 per week. This is a complaint rate of 0.045% of the total prescriptions issued in a year. For comparison, the national medication error rate in hospitals, based on the review of data from the National Clinical Pharmacy Services database, is 5.22% of all hospital patients.

Every complaint we do receive from the Ombudsman’s Office is investigated to its resolution. While some do lead to corrections in care, many are not substantiated upon further investigation.

In some cases, the Ombudsman may issue an official complaint to Public Health related to health care provided to inmates. Through mid-November 2006, we have received 9 official complaints; in 2005, we received 30.

We take all inquiries from the Ombudsman’s Office seriously, and provide them with appropriate information we have on the cases, and responses to any questions they have.  In some cases, providing medical records to the Ombudsman’s Office is needed, and we are required by law to get permission from the person receiving care before sharing this information.

The Ombudsman investigates each case, and makes a determination of finding.  Often, they determine that we handled the situation appropriately. On some occasions, they identify errors in procedure or treatment.

In any health care setting, errors do occur, but we want them to be as rare as possible in the jail environment. We’re committed to continually improving our health care practices for our clients, and review and feedback from the Ombudsman’s Office is an important part of this process.

Accredited health care program