Performance Audit of Jail Health Services Pharmacy Operations and Medication Administration

This audit found that JHS patients were at no greater risk due to mediation errors than patients in other healthcare settings. However, opportunities did exist for JHS to increase the accountability in its medication processes. With regard to staffing, the auditors on this project found that JHS had developed a staffing model for pharmacy shifts and had begun to create a similar model for nursing. Yet, it was found that the pharmacy model was not updated to reflect current processes and workload. At the same time, the limited amount of electronic data accessible to JHS program staff had made the development of the nurse model difficult. Along with the difficulty of creating a nurse staffing model, this audit found patterns of shift worked by fewer nurses than it was specified in the staffing plan at the time.

We recommended that JHS focus on strengthening the inventory controls by transferring some of the medication responsibilities to pharmacy staff. We also recommended that JHS conduct an analysis to evaluate the possibility of centralizing its pharmacy operations and to work with the specific agencies in modifying medication administration practices. Lastly, we recommended that JHS update its pharmacy staffing model to reflect the demands of workload and accounts for staff on vacation or sick leave.

In a 2006 report on Jail Health Medication Errors and State Inspection Results, conducted by the Ombudsman’s Office, raised issues regarding Jail Health Services’ pharmacy operations and medication administration practices. Such issues included inmate complaints on the timeliness and accuracy medication administration, staff concerns regarding working conditions, and state inspection reports citing medication related process deficiencies in previous years.