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Facility Profile
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Whatcom County Jail
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Well-deserved
pride. Representing Whatcom Jail at the awards ceremony were
(L-R) Deborah Park, LPN, Sally Andrews, RN, Grant Deger, MD, and
Lt. Mark Raymond. |
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Facility:
The
medium-security jail was built in 1983 and is part of the
downtown county complex. Due to overcrowding a new facility is
being built for minimum-security inmates, and plans are being
developed to replace the main facility in about eight years.
Correctional
Population:
The average daily census is 261. The jail houses
male and female adult detainees whose average length of stay is
23 days, though stays may last up to one year. Annual admissions
exceed 6,000. The jail also houses some federal and Native
American tribal prisoners.
Health
Care Staffing & Services:
Routine
medical, mental health and dental services are provided on-site.
Acute cases are sent to the local hospital as there is no
infirmary. Nursing coverage is provided from 7 am to 9 pm on
weekdays and 7 am to 3 pm on weekends and holidays.
Staffing is secured via contract with agencies and professionals
in the community. Employed by VNPS are the health services
administrator (10 hours per week), medical director (6 hours per month),
8 nurses and 2 medical records clerks. On-site part-time are the
clinical physician, psychiatrist and dentist. Pharmacy,
radiology and laboratory services also are provided via
contract.
Accreditation:
The
jail has been continuously accredited since 1977; it was last
surveyed in 2004.
Quoteworthy:
“Accreditation provides oversight that makes sure health care
doesn’t get lost in the shuffle of custody requirements or the
need to balance the budget. It’s a great check and balance.” —
Lt. Wendy Jones, Chief of Corrections |
Whatcom
County Jail’s Past Guides Its Future
By Jaime Shimkus
The year was
1977. Jimmy Carter took office as president. “Stars Wars”
shattered box-office records. The first viable PCs hit the
market. Elvis kicked the bucket.
In
Bellingham, WA, brave administrators at the Whatcom County Jail
agreed to let outsiders poke around the medical department to
see whether it measured up to brand-new standards from the
American Medical Association.
That
confident act set the stage for what would become an unbroken
29-year (and counting) tradition of accreditation from the
National Commission and its AMA precursor.
While that
feat is admirable, longevity is not the only reason the jail was
honored with NCCHC’s 2005 Facility of the Year Award. According
to the committee that selects recipients, Whatcom is “an
exemplary small, rural jail that has close ties and cooperative
relationships with the community it serves.” (Read about all of
the 2005 award
winners.)
Those close
community ties reach right into the health service department.
When the jail was first accredited, direct health care was
provided by the county health department. But 10 years ago the
county wanted out of the correctional health care business, and
the jail was forced to fill the gap, says Chief of Corrections
Lt. Wendy Jones, who has worked at the jail for 24 years.
Jones
believes that contracting with health care professionals yields
better results than running the service in-house, and already
had providers in place for medical, dental and mental health.
But the solution to daily nursing coverage required a “big
leap”: She engaged Visiting Nurse Personal Services, a
well-established, well-respected not-for-profit that offered
home health and other services in the community.
From the
perspectives of client and contractor alike, it’s been an
unqualified success.
Compliance and Quality
Among the things Jones values most from the VNPS crew is the
intense focus on quality improvement and on meeting the NCCHC
jail standards. In this jail, the two are closely linked: “Each
year we do a QI study for every one of the standards,” says
health services administrator Jean Brock, RN, who leads the
effort. “It’s one of our biggest accomplishments.”
She pores over the compliance indicators
and checks written policies and procedures as well as actual
practices. In this she works closely with nursing supervisor
Shari Holst, RN, CCHP, who follows up to correct any lapses. “I
make sure the nurses know what the standards are, why they
exist, what we must do to meet them on a daily basis,” says
Holst.
Message received: “All health staff are
involved in [QI] work and strive toward positive outcomes for
inmates and good survey results,” Brock says.
One recent improvement spurred by the QI
effort is routine testing for STDs as part of each inmate’s
physical exam, rather than testing only based on patient
complaints or clinical symptoms. “We’re catching a lot of things
in asymptomatic patients that may have ended up back in the
community,” says Holst. “Now we treat it and educate the
patient. We feel good about that.”
Fully
Staffed!
The jail also benefits from the VNPS agency’s staffing
expertise. Despite the difficulties of finding and retaining
qualified nurses (common to jails everywhere), the nursing
roster has no vacancies. “That’s an accomplishment of this past
year,” says Brock.
The jail
setting and clientele deter some candidates, Holst notes, and
the pay and benefits are just “average.” But the nurses who do
sign on find themselves in a supportive environment. “If
somebody is having a personal issue, I work with them to give
them flexibility in scheduling,” Holst explains. “That’s very
important, because they need to take care of their personal
lives before they can do their jobs well.”
Chief
Jones also appreciates something that she says isn’t always the
norm in jail settings: a “high level of collaboration” between
the health care and custody staffs. Brock seconds that
assessment, and goes even further: “These are compassionate,
professional nurses who work well with each other, with the
corrections officers and with consultants.”
As the
jail expands in size (see box above), the plan is to expand the
health services offered, as well, with around-the-clock nursing
care, a full-time physician—and a larger staff. In the face of
such changes, Jones and Brock want to maintain the
collaborative, professional culture. To that end, one of Brock’s
near-term goals is to offer an incentive program for employees
to pursue CCHP certification and to attend NCCHC national
conferences to strengthen their skills and commitment to their
work.
—
About the author: Jaime Shimkus is NCCHC’s
publications editor. To contact her, e-mail jaimeshimkus@ncchc.org.
[This article first appeared
in the Fall 2005 issue of CorrectCare.]
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