SHM Converge Scientific Abstract ePoster Gallery-Establishing a Task Force to Address Treatment of Incarcerated Patients

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The document describes an effort to create a task force and learning collaborative to improve care for incarcerated patients and end universal shackling in healthcare settings. The Stop Shackling Patients (SSP) Coalition brings together health professionals, human rights advocates, and policymakers to address shackling as a human rights, medical ethics, and patient dignity issue.<br /><br />The project’s rationale is based on documented harms: shackling can violate nonmaleficence, restrict patient rights and dignity, worsen trust between patients and providers, and contribute to injuries, falls, poor circulation, weakness, delirium, and other clinical risks. The text also highlights racial and ethnic disparities and moral injury among clinicians who are asked to participate in practices they view as ethically wrong.<br /><br />To operationalize change, the team developed a novel protocol for assessing and removing shackles. This includes a recurring shackling assessment, special circumstances guidance, and a shackle removal protocol. Decisions are intended to be team-based and then communicated to hospital security and the correctional facility through a Correctional Facility Contact List (CFCL).<br /><br />The work was implemented with Boston Medical Center leadership and stakeholders, including the CMO, CNO, Public Safety, and the Office of General Counsel. The 2023 revised Boston Medical Center policy reflects this collaboration. A prototype electronic medical record (EMR) flowsheet was also developed to support documentation and workflow.<br /><br />The document outlines both internal implementation steps—staff education, EMR integration, chart review, and auditing—and external implementation efforts, such as coordination with the Department of Corrections and other healthcare facilities. The framework is presented as generalizable so it can be adapted across different healthcare systems and stakeholder groups.

Asset Subtitle

Nisha Mathur

Meta Tag

Author List Judy D. Wang, Neil Singh Bedi, Nisha Mathur

Category Innovations

Concept Shackling

Concept Incarcerated Patients

Concept Human Rights

Concept Ethics

Concept Clinical Harm

Distinguished Non-Finalist

Presenter Organization Boston Universtiy School of Medicine

Presenting Author Nisha Mathur

Track Other

Keywords

shackling

incarcerated patients

patient dignity

medical ethics

human rights

correctional healthcare

shackle removal protocol

electronic medical record

healthcare policy

Boston Medical Center

Shackling

Incarcerated Patients

Human Rights

Ethics

Clinical Harm