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The case of Arizona inmate medical transport system suggests that planning and effective strategic management is the core of any organizational processes. The evaluator of the case will develop various instruments designed for the change program under study.
It is important to recognize that the medical care problem is one of the most important ones in incarceration as it influences the organization and its clientele. The United States is a nation founded on principles that affirm the supreme worth of each human life. From this idea comes the basis for the common link of all citizens.
Although the general public demands safety and protection actions from criminals and increased police involvement in safety issues. The case of Arizona inmate medical transport systems suggests that a lack of financial support and inadequate transportation process impose an additional burden on the state.
The main problem is that there is resistance to spending money on prisons, but the insistence on the prison system as the main force able to protect the community from criminals. The agency cannot spend so much money on transporting inmates for outside medical care, but it cannot violate their rights and limit medical service provisions.
In order to deliver medical services, the agency should be well aware of medical problems, and conflicts affected its target population (Stillman, 2004). Also, personal differences due to health conditions may have little to do with race. For example, poverty-stricken inner-city criminals suffer from low income more so than racial discrimination.
The main assumptions are that the current transportation and medical provisions are not safe for the population and other patients in hospitals. Low compensation rates and a lack of security measures create additional problems for the Arizona Department of Corrections (Radin, 2000).
The first step to develop a plan for medically competent services is to understand the needs and demands of the target population. It is crucial to explore the complexities of multiple identities, such as when an individual belongs to more than one medically group.
Little attention tends to be given to differences within multiple identity groups. It is important to be aware of the diversity within ethnic groups as well as between them. The proposed solution is to open a hospital for two prisons. It will help to save costs spent on transportation and improve safety and security issues.
Also, it is possible to organize a separate medical service for incarcerated people in the town, but it will require additional transportation costs and security spending (Bardach, 2005).
The prison hospital will help the Arizona Department of Corrections to reduce costs on transportation and ensure adequate medical services for all prisoners. The second step will be to investigate the history of the target population. Understanding the history of a prison group, the current stage of its national and social identities, and its relationships with other groups is critical to recognizing and resolving cross-cultural conflict (Stillman, 2004).
The third step is to hire medical staff able to work with the prison population. The task of the Arizona Department of Corrections is to help employees communicate effectively using the knowledge and skills they obtain during training programs.
There are many causes of conflict, including, but not limited to, language and communication barriers, racism, sexism, and ageism. The main strategies used by medical service professionals are communication and collaboration, listening, and religious competence (Radin, 2000).
The common availability of medical care beds has made this type of medical care the current standard practice in many cases. Many prisoners who are at high risk for experiencing a complication requiring on-time treatment are now admitted to medical care for monitoring.
Medical care, delivered for prisoners, is often considered routine following many complicated surgeries, and it is rapidly becoming the standard for treating sharp exacerbations of chronic and terminal conditions. Since medical care beds have not been available in many hospitals, the criteria for prisoners admission have been lowered (Stillman, 2004).
Therefore, the growing number of beds has influenced medical decision making toward the use of medical care whenever it may be helpful. The data suggest that the majority of inmates require Orthopedics and Detention Ward care. Also, some of them require eye care, X-rays, and admissions. So, the costs spend on transportation and medical services outside the prison can be redirected to the prison hospital and medical care delivery (Bardach, 2005).
Since the ill inmates constitute a large percentage of those imprisoned, questions have been raised about medical care patterns and medical decisions made regarding their care. Though prisoners do not stay in medical care longer than other patients. The case study reflects many of the current concerns about the high cost of medical care relative to outcomes (Radin, 2000).
However, sufficient medical assessment of the cost-effectiveness of medical care involves transportation problems. The data suggests that the majority of runs happened during transportation. During 1991, there were 5,446 runs during transportation. The data that uncover the high costs of medical care for prisoners groups of patients are based on charges for an episode of careusually a hospital admission.
During 1991, the Arizona Department of Corrections spent $1,730,384 on transportation staff, $201,994 on vehicles operations and $1,932,378 medical transportation costs. It is assumed that half of these budget is enough to maintain and finance an inside prison hospital.
There are several flaws in this approach ( Costs and constraints in Arizona, n.d.). First, charges essentially reflect resource consumption, particularly in terms of nursing care. Prisoners receiving both intensive and routine caretake extensively varying amounts of nursing time (Radin, 2000).
The prison will need to high 30 healthcare professions, ten doctors, and 20 nurses for the hospital. Simultaneously, it will buy medical equipment (such as X-ray and laboratory equipment) and open four wardrooms for intensive care.
Because prisoners in intensive care usually have more costly medical services, the prison tends to assume that they are the most costly group of patients in medical care. Yet, researches that concentrate on the patient over time as the unit of analysis have found that the intense care patients cost less per year than people with chronic illnesses who are repeatedly admitted for routine care.
Consequently, while the per diem and per admission costs of medical care patients are high and are areas of additional finance, they should be viewed in the context of the total prison costs, which may be more related to chronic, not critical, illness (Stillman, 2004).
There are no risks created by the prison hospital except in some extraordinary cases when a prisoner requires specialized equipment and consultation. Traditional ways of cost calculation do not take these problems in expenditure into account.
Prevention practices provided by the inside hospital staff will also lead to lowered death from chronic diseases, which will almost certainly require more chronic, rather than critical care. The proposed solution will benefit the state and the population of Arizona as it reduces possible threats (such as runs) and increases overall safety and security.
References
Bardach, E. (2005). A practical guide for policy analysis: The eightfold path to more effective problem solving (2nd ed.). Washington, DC: CQ Press.
Costs and constraints in the Arizona inmate medical transport system. (n.d.).
Radin, B.A. (2000). Beyond Machiavelli: Policy analysis comes of age. Washington, DC: Georgetown University Press.
Stillman, R.J. (2004). Public administration cases and concepts (8th ed.). Boston, MA: Houghton Mifflin.
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