To improve the quality of the information prison medical staff document in inmate medical records, the Receiver's Office should train its entire medical staff on its policy in the inmate medical procedures related to appropriate documentation in inmates' medical records. This training should be completed by December 31, 2014.
The Utilization Management (UM) Program conducted a webinar training for all schedulers on September 8, 2014 and September 15, 2014, titled "Sterilization of Female Inmates" and covered Gynecological Procedure Checklist/Sterilization Procedures.
In December 2014, a representative of the Receiver's Office of Legal Affairs presented webinar training to medical staff with the primary goal to ensure adherence to the informed consent requirements of Title 22, Sections 70707.1 through 70707.7. Attendees included statewide clinical staff and California Correctional Health Care Services' (CCHCS) headquarter staff. The training emphasized the requirements for obtaining informed consent for sterilization procedures and provided a practical guide for correctly and comprehensively documenting consultation provided to the patient regarding any potential risk and alternatives to support how and when the informed consent process took place. CCHCS intends to provide periodic training.
Medical Services will develop a Continuing Medical Education activity that will address clinical documentation and informed consent. The training will be provided to all medical staff regarding comprehensive documentation about consultation provided to the inmate regarding any potential procedure and its risk and alternatives.
Proposed Action Plan:
Create a training for all medical staff on clinical documentation and informed consent.
Medical Services will develop a Continuing Medical Education activity that will address clinical documentation and informed consent. The training will be provided to all medical staff.
†Response Type refers to the interval in which the auditee is providing the State Auditor with their status in implementing recommendations made in an audit report. Auditees must submit a response regarding their progress in implementing recommendations from our reports at three intervals from the release of the report: 60 days, six months, and one year or subsequent to one year.
*Agency responses received after June 2013 are posted verbatim.