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INDICATORS 2008

MEDICAL - DENTAL Calendar

YTD

Provider Visits

Number of physician visits 15,732

Number of physician assistant/nurse practitioner visits 13,774 Number of emergency visits (add on to scheduled sick call) 1,677

Number of inmates charged a co-payment 2,010

Nursing

Total number sick call requests 32,742

Total number sick call visits (completed) 26,397 Total number of inmates refusing RN sick call visits 632 Number of inmates charged a co-payment for nurse sick call 11,668 Number of treatments (blood pressure, finger sticks, wound

care) 65,550

Segregation rounds completed 15,992

Prenatal Care

Number of pregnancy tests completed 1,644

Number of new positive pregnancy tests 111

Number of pregnant inmates 155

Number of prenatal visits 215

Number of deliveries 15

Mental Health

Total number sick call requests 8,180

Total number routine mental health visits 13,786

Total number segregation rounds 34,226

Total number referrals from medical/other 7,681 Total number mental health detailed screens 5,685 Total number individual psychiatrist visits 7,428

Total number forced medication 57

Total number incidents involving restraints 14 Total number non-scheduled crisis visits 1,642

Total number DOC/parole evaluation 384

Total number Psychology individual visits 1,436

Total number Mental Health groups 1,252

Total number offenders in Mental Health group 17,030

Laboratory

Tests performed on -site (BioReference and state labs) 17,692 Tests sent off site (STAT labs sent to local hospital) 101

EKG's performed on-site 960

Radiology

Appendix A

Overview of Current Health Care Services

Number of Radiology procedures performed on-site 3,723 Number of radiology procedures waiting for on-site>14days 60

Nutritional Services

Total number of therapeutic diets 10,457

Vision

Number of exams by optometrist 1,249

Number of corrective lenses issued by optometrist 672

Number of glasses repaired or re-ordered 182

Chronic Care Clinics

Number of patients identified as seriously mentally ill 11,856

Total number of patients on dialysis 109

Infection Control

Inmate/resident number of initial PPD's placed 17,303 Inmate/resident number of initial PPD's read 11,619 Inmate/resident number of annual PPD's placed 2,272 Inmate/resident number of annual PPD's read 2,325

Current month positive PPD's 292

Current month new positive HIV tests 266

HIV/AIDS offenders released 77

Number of reportable communicable diseases 944

Mortality report 23

Offsite Specialty Consultations

Audiologist 19

Appendix A

Overview of Current Health Care Services

Total Medical Emergency responses within the facility 930 Ambulance emergency responses within the facility 268

Facility vehicle transports 330

Life Flight/Medi-Vac responses

Hospital Admissions

Total number of hospital admissions 315

Total number of inpatient hospital days

Intake

Number of receiving screens 23,831

Number of transfers received 8,702

Number of intake Mental Health assessments 19,515

Number of Boot Camp evaluations 255

Number of completed (7/14) day physicals

Infirmary Care

Admissions to infirmary 2,023

Discharges from infirmary 1,846

Total patient days in infirmary 17,159

Total number of infirmary beds actually useable 988

Other Services

Employee accident/injury 19

Urine drug screens (employee) 129

Use of force exams 33

Number attending staff meeting 1,492

Number of people attending monthly in-service 1,133

Female Admissions 1,340

APPENDIX B

DDOC Organizational Chart

Bureau of Correctional Healthcare Services Delaware Department of Correction

CARL C. DANBERG COMMISSIONER DEPARTMENT OF CORRECTION

JULIE HUGHES COMPLIANCE COORDINATOR

VICTORIA WINDLE QA ADMINISTRATOR JAMES C. WELCH, RN, HN-BC

BUREAU CHIEF (NCCHC HEALTH AUTHORITY)

JESSICA FORAND ADMINISTRATIVE

ASSISTANT

JOHN OLDIGS SR FISCAL ADMIN

OFFICER

SPENCER EPPS MEDICAL DIRECTOR

IMAD JARWAN SUBSTANCE ABUSE ADMIN.

VINNIE FABBER MENTAL HEALTH ADMINISTRATOR VACANT

ADVANCE PRACTICE NURSE

SARA MYERS NURSE TRAINER

JAIME H. RIVERA PHYSICIAN

APPENDIX C

Pharmacy Utilization Data

All Facilities DE

Transactions

Primary Class Secondary Class Nov-08 Dec-08 Jan-09 Feb-09 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09

CARDIOVASCULAR ANTICOAGULANT 56 73 64 80 77 75 81 72 81 82 90 92

CHOLESTEROL 642 709 730 758 717 782 789 817 841 790 746 859

HTN/CARDIAC 2,317 2,464 2,401 2,375 2,290 2,367 2,464 2,564 2,530 2,480 2,390 2,481 CARDIOVASCULAR Total 3,015 3,246 3,195 3,213 3,084 3,224 3,334 3,453 3,452 3,352 3,226 3,432 GENERAL MEDICINE ANALGESIC 2,065 2,203 2,149 2,234 2,341 2,342 2,285 2,373 2,408 2,294 2,312 2,359 ANTIHISTAMINE 561 597 562 576 647 677 721 806 782 656 732 724

ANTI-INFECTIVES 403 390 387 369 411 399 401 435 462 395 472 457

BIOLOGICAL 31 29 33 18 31 39 38 40 32 42 32 32

DERM/TOPICAL 1,169 1,402 1,425 1,480 1,634 1,472 1,565 1,533 1,340 1,132 1,056 1,077 DIABETES 395 464 429 419 425 419 409 451 469 418 446 426

DIALYSIS 29 33 34 24 27 35 30 29 31 33 26 28

HORMONE 22 28 18 23 16 18 20 27 26 24 36 27

MIGRAINE 9 12 6 5 6 6 7 8 11 12 16 11

MUSCLE RELAXANT 227 273 240 237 265 233 241 243 251 247 247 242

OPHTHALMIC/OTIC 106 111 146 104 96 118 123 139 163 116 120 103

OTHER - MISC 118 106 125 123 104 127 104 108 105 105 107 136

PARKINSON 2 2 1 2 2 4 5 7 10 2 7 11

RESPIRATORY/NASAL 909 982 1,058 1,026 1,098 1,025 993 961 1,094 945 960 990

SEIZURE 64 93 71 79 73 84 72 87 94 98 100 87

STEROIDS 48 50 38 41 49 52 51 40 38 43 32 48

THYROID 127 144 132 133 140 148 141 152 164 157 142 147

URINARY/PROSTATE 51 59 63 72 58 61 65 76 81 66 67 70

VITAMIN/MINERAL 414 425 416 424 444 428 450 502 481 482 422 462

GENERAL MEDICINE Total 6,750 7,403 7,333 7,389 7,867 7,687 7,721 8,017 8,042 7,267 7,332 7,437 GI GI 1,579 1,745 1,702 1,650 1,629 1,669 1,609 1,782 1,848 1,738 1,754 1,851 HEPATITIS 17 15 15 12 8 12 9 12 12 11 10 13

GI Total 1,596 1,760 1,717 1,662 1,637 1,681 1,618 1,794 1,860 1,749 1,764 1,864 HIV HIV 212 219 220 177 233 219 214 195 230 186 185 228

HIV Total 212 219 220 177 233 219 214 195 230 186 185 228

PSYCHOTROPIC ATYPICAL ANTIPSYCHOTIC 172 234 244 245 241 220 214 291 321 296 326 356

DEPRESSION - 1ST GEN 589 679 665 680 694 671 612 722 788 666 665 646

DEPRESSION - 2ND GEN 797 1,003 860 905 990 987 931 1,089 1,034 898 1,023 964

MOOD STABILIZERS 560 581 551 602 582 621 654 727 725 651 665 627

OTHER PSYCHOTROPIC 222 240 208 193 182 184 175 176 210 185 182 165

SEDATIVE/HYPNOTIC 35 43 36 46 49 35 31 40 40 39 37 37

TYPICAL ANTIPSYCHOTIC 456 505 401 379 413 392 352 412 395 314 315 298

PSYCHOTROPIC Total 2,831 3,285 2,965 3,050 3,151 3,110 2,969 3,457 3,513 3,049 3,213 3,093 UNKNOWN UNKNOWN 1 2 7 4 9 7 6 15 5 4 7 6

UNKNOWN Total 1 2 7 4 9 7 6 15 5 4 7 6

APPENDIX D

Female inmates 52-69 years of age who received follow-up evaluation for an abnormal mammogram finding

Prenatal Care Births in which prenatal care was begun within the first 4 months of pregnancy and/or who had 5 visits or more if delivered before 37 weeks or had 8 visits or more if delivered after or at 37 weeks of gestation

Checkups After Delivery

Female inmates who had a postpartum visit on or between 21 to 56 days after delivery

Cesarean Section Rate

Female inmates who had a cesarean section resulting in a live birth during the reporting year

Heart Disease Monitoring Hypertension

Inmates enrolled in the HTN chronic care clinic who had at least 1 encounter for hypertension with the provider (nurse or physician) every 3 months

HTN Treatment Inmates enrolled in the HTN chronic care clinic without DM with systolic blood pressure above 140 or diastolic blood pressure above 90

HTN Treatment Inmates enrolled in the HTN chronic care clinic with DM with systolic blood pressure above 130 or diastolic blood pressure above 80

Response to Abnormal Blood Pressure Test

Inmates having 3 or more diastolic blood pressure readings equal to or greater than 90 mm Hg who received a referral to a hypertension chronic care clinic

AMI – Aspirin on Being Sent Out

Inmates having a principle diagnosis of AMI and not identified as having

contraindications to aspirin who received aspirin within 24 hours of arrival or within 24 hours before referral to the hospital in the reporting year

AMI – Aspirin at Return to Facility

Inmates having a principle diagnosis of AMI and not identified as having contraindications to aspirin who were prescribed aspirin at arrival (return) to the facility in the reporting year

Beta-Blocker Treatment After a Heart Attack

Inmates age 35 or older hospitalized and discharged alive with a principal diagnosis of AMI and not identified as having contraindications to beta-blockers who received a prescription for beta-blockers within 7 days after discharge from the hospital with a diagnosis of AMI or within 30 days before the hospitalization for AMI

Cholesterol Management After Acute Cardiovascular Events – LDL-C Screening

Inmates age 18-75 discharged alive in the year before the reporting year for AMI, CABG or PTCA who received an LDL-C screening on or between 60 to 365 days after discharge for an acute cardiovascular event

Cholesterol Management After Acute Cardiovascular Events – LDL-C Level

Inmates age 18-75 discharged alive in the year before the reporting year for AMI, CABG or PTCA having LDL-C level of <130 mg/dL and <100 mg/dL (1st year measure) on or between 60 to 365 days after discharge for an acute cardiovascular event

Infectious Diseases

Tuberculosis Inmates with newly positive TB skin test in the year before the reporting year who accepted the treatment offered by the DOC and therefore completed curative therapy within 12 months of the positive diagnosis

Pneumovax Percentage of chronic care population and patients older than 55 who have had pneumovax vaccination within the past five years

HIV – Viral Load Counts Undetectable

HIV+ inmates in the treatment program with viral load counts that undetectable HIV – Viral Load

Counts Undetectable

HIV+ inmates with viral load counts that are undetectable HIV – Laboratory

Testing

HIV+ inmates receiving quarterly CD4 and viral load tests

HIV – Treatment HIV+ inmates with CD4 counts under 200 or viral load greater than undetectable after