Shifting gears – Linking People and Ideas in the Military Health System

1. Shifting gears – Linking People and Ideas in the Military Health System Patricia Collins, BSN, MN September 2007

2. Healthcare Innovations Program • Started in 1998 to showcase innovations in healthy lifestyles at the annual State of the Military Health System Conference • Now includes access to care, quality, military readiness, cost, and effective patient partnerships in addition to healthy lifestyles • Abstracts are reviewed and winners determined in all categories • Posters are displayed at the annual conference • Awardees give oral presentations at the annual conference and receive an engraved plaque

3. Guidance for Five Step Process • Identify Improvement Opportunities • Develop Action Plan • Implement Changes • Evaluate Impact • Transfer Knowledge

4. Evaluation of Submissions • Innovation must be transferable to another ‘like ‘ organization • Evidence-based • Outcome based/measurable with cost avoidance/return on investment; efficiency & effectiveness achieved • Sustainable/Institutionalized to maintain results over time • http://www.tricare.mil/ocmo/innovations.cfm

5. Successful Innovations • Access to care in Okinawa Japan Navy Clinic – improved 400%; wait time reduced by 75%; patient satisfaction rose to above 90% - • Leadership involvement and commitment; front line staff felt their efforts were appreciated; focus on a single clinic allowed resiliency to overcome initial challenges in a small setting; cultural transformation – patient access became a priority from the front desk to the providers. • Patient and Family Centered Approach to Pharmacy Services – expanded hours of operation; created new pickup window at base exchange; developed software algorithm to expedite processing; reduced waiting time from over an hour to 15 minutes; satisfaction improved from 20% to 0ver 70 % • Patient and family involvement in the committee was key to improvements; increased efficiencies resulted in maintaining dispensing of medications for troops who are deployed; cost avoidance of over $200,000; patient feedback sheet routed to the Non-Commissioned officer in pharmacy meant direct communication about any problematic areas

6. Successful Innovations • Military Readiness – Soldier Wellness Assessment at Ft Lewis, Madigan Army Medical Center used a multidisciplinary team to develop a comprehensive assessment program for soldiers deploying and those returning from deployment. They were triaged for 15, 30 or 60 minute behavioral health encounters; 14% were wounded or injured in combat; 35 % reported physical pain affecting their ability to work or exercise. Over 99% completed the voluntary behavioral health interview; 83% agreed that the assessment will help soldiers get the help they need; 27% report they disclosed a personal problem not previously disclosed. • The three star general’s support was critical – and helped de-stigmatize the behavioral health assessment; over 9,000 soldiers assessed from Jan- Sep 2006