title: Health care in small prisons: incorporating high-quality standards.
abstract: OBJECTIVE
  In the past, health management in Geneva's six post-trial prisons had been variable and inconsistent. In 2008, the unit of penitentiary medicine of the Geneva University Hospitals was mandated to re-organize and provide health care at all six prison facilities. The specific aim of this paper is to outline the example as a practical solution to some of the common challenges in unifying the structure and process of health services across multiple small facilities, while meeting European prison health and local quality standards.
  
  
  METHODS
  Geneva's post-trial prisons are small and close to one another in geographical proximity - ideal conditions for the construction of a health mobile team (HMT). This multidisciplinary mobile team operated like a community ambulatory care model; it was progressively launched in all prison facilities in Geneva. The authors incorporated an implementation strategy where health providers partnered with prison and community stakeholders in the health delivery model's development and adaption process.
  
  
  RESULTS
  The model's strategic initiatives are described along the following areas, in light of other international prison health activity and prior care models: access to a health care professional, equivalence of care, patient consent, confidentiality, humanitarian interventions, and professional competence and independence.
  
  
  CONCLUSIONS
  From the perspective of the HMT members, the authors provide the "lessons learned" through this experience, especially to providers who are working on prison health services reform and coordination improvement. The paper particularly stresses the importance of partnering with community health stakeholders and prison staff, a key component to the approach.
authors.affiliation: Unit of Penitentiary Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Rieder
authors.forename: Alejandra
authors.initials: A
authors.lastname: Casillas
authors.forename: Gérard
authors.initials: G
authors.lastname: Mary
authors.forename: Anne-Dominique
authors.initials: AD
authors.lastname: Secretan
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Gaspoz
authors.forename: Hans
authors.initials: H
authors.lastname: Wolff
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D006801:Humans; D033183:Interdisciplinary Communication; D008952:Mobile Health Units; D011330:Prisons; D013557:Switzerland
keywords: Access; Community health network; Evaluation; Health care quality; Health care team; Health services; Interdisciplinary health team; Mobile health unit; Prisons; Switzerland