In the past, health management in Geneva's sis post-trial prisons had been variable and inconsistent. In 2008, the unit of penitentiary medicine of the Geneva University Hospitals was mandated to re-organize and provide health care at all six prison facilities. The specific aim of this paper is to outline the example as a practical solution to some of the common challenges in unifying the structure andprocess of health services across multiple small facilities, while meeting Eurpean prison health and local quality standards.