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Defining avoidable healthcare-associated harm in prisons: A mixed-method development study.
Richard N Keers1,2,3, Verity Wainwright4, Joy McFadzean5
1Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, University of Manchester, Manchester, United Kingdom.
Researchers developed a new definition for avoidable harm in prison healthcare. This definition accounts for the unique prison environment, aiding future safety studies and standardizing outcome measurements in correctional facilities.
Area of Science:
- Public Health
- Healthcare Quality and Safety
- Criminology
Background:
- Reducing avoidable healthcare-associated harm is a global priority.
- Research on harm in prisons lags behind other sectors.
- A clear definition is needed for prison healthcare safety studies.
Purpose of the Study:
- To develop an operational definition of avoidable harm in prison healthcare.
- To facilitate future epidemiological studies on prison healthcare safety.
- To standardize outcome measurement in correctional health.
Main Methods:
- Sequential mixed methods design.
- Analysis of 151 serious prison incidents (StEIS).
- Nominal group discussions with former service users and prison professionals.
- Validation using National Reporting and Learning System (NRLS) data.
Main Results:
- Identified unique prison factors influencing avoidable harm.
- Developed a two-tier definition of avoidable harm.
- Definition incorporates prison regime and environmental constraints.
- Definition compatible with NRLS data and highlights environmental influence.
Conclusions:
- A working definition of avoidable harm in prison healthcare has been established.
- The definition considers prison-specific environmental and systemic factors.
- Enables standardized outcome measurement for future prison healthcare safety research.
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