scholarly journals Improving Readiness: Preventive Maintenance of the Human Operating System that Drives Readiness and Lethality

2020 ◽  
Vol 185 (Supplement_3) ◽  
pp. 12-16
Author(s):  
George Howell
Keyword(s):  
Health Agency ◽  
Well Being ◽  
National Defense ◽  
Military Health System ◽  
Military Health ◽  
Care Community ◽  
The Core ◽  
Nuclear Propulsion ◽  
Military Health Care ◽  
The Military

ABSTRACT Improving the readiness and lethality of the U.S. fighting forces has always been a key priority, and it received renewed emphasis in the National Defense Authorization Act of 2017. A major rearrangement of the Defense Health Agency and the Military Health System is ongoing with this emphasis. Although revising features to improve our military health service is essential, the health, well-being, and readiness of our people will also rely on the culture created at the Command level where soldiers, sailors, airmen and civilians operate daily. In alignment with our military health care community and in support of our renewed emphasis on warfighting readiness, USS Missouri began a journey to address foundational mindset that drives the core behaviors, training, and procedures of the submarine force and Naval Nuclear Propulsion Principles leading to enhanced readiness, resilience, and accountability.

scholarly journals Change is Hard: Leadership is Harder

2020 ◽  
Vol 185 (Supplement_3) ◽  
pp. 58-62
Author(s):  
Teresa Roberts
Keyword(s):  
Health Agency ◽  
Positive Influence ◽  
National Defense ◽  
Leadership Positions ◽  
Military Health ◽  
Hard Part ◽  
The People ◽  
Constant Change ◽  
Military Treatment Facility ◽  
The Military

Abstract The transformation of the Military Health System to the Defense Health Agency under the National Defense Authorization Act of 2017 is a change of historical proportion. Change can be seen as hard, yet change is always happening. What is actually hard is providing leadership to accomplish the mission and goals for ourselves and our organizations within constant change. Those of us selected for leadership positions often receive standardized preparation and experiences to help us with this challenge. The hard part, though, is not what we often think it is. Leadership is not hard because of the amount of change or the people we are leading. Leadership is hard because, as we increase our rank and responsibilities, there are more people we need to see as people, having an outward mindset toward them, to have a positive influence and impact. In this article, I share the challenge I experienced with an outward mindset in leading the transition of our military treatment facility under the transformation to Defense Health Agency.

Applications of Theory of Bureaucratic Caring in the United States Air Force and Defense Health Agency

2021 ◽  
Vol 25 (3) ◽  
pp. 176-180
Author(s):  
Marcia A. Potter
Keyword(s):  
United States ◽  
Air Force ◽  
United States Air Force ◽  
Medical Service ◽  
Healthcare Professionals ◽  
Health Agency ◽  
The United States ◽  
Military Health System ◽  
Military Health ◽  
The Military

The theory of bureaucratic caring, generated from lived experiences of healthcare professionals and patients, synthesized the thesis of caring with the anti-thesis of bureaucracy (hospital). This author applied the theory in settings within the United States Air Force Medical Service and the Military Health System. Using categories of caring as spheres in which to leverage caring, the author developed projects on communication, self-efficacy, healthcare readiness, evidence-based practice, spiritual health, and education. The article describes applications of the theory across settings in the military. This author encourages others to apply the theory in their organizations as part of their nursing journey.

Evaluation of Ambulatory Care Classification Systems for the Military Health Care System

1990 ◽  
Author(s):  
James M. Georgoulakis ◽  
Atanacio C. Guillen ◽  
Cherry L. Gaffney ◽  
Sue E. Akins ◽  
David R. Bolling ◽  
...  
Keyword(s):  
Health Care ◽  
Ambulatory Care ◽  
Health Care System ◽  
Classification Systems ◽  
Military Health ◽  
Military Health Care ◽  
The Military ◽  
Care System

scholarly journals Curricular Change and Resiliency in the Era of Coronavirus (COVID-19): The Uniformed Services University of the Health Sciences (USU) Experience

2020 ◽  
Author(s):  
Arnyce R Pock ◽  
Pamela M Williams ◽  
Ashley M Maranich ◽  
Ryan R Landoll ◽  
Catherine T Witkop ◽  
...  
Keyword(s):  
Health System ◽  
Health Sciences ◽  
Lessons Learned ◽  
Organizational Response ◽  
Educational Goals ◽  
Military Health System ◽  
Military Health ◽  
Health Crisis ◽  
Core Curricula ◽  
The Military

ABSTRACT Introduction The Coronavirus (COVID-19) pandemic has presented a myriad of organizational and institutional challenges. The Uniformed Services University of the Health Sciences, like many other front line hospitals and clinics, encountered a myriad of challenges in fostering and sustaining the education of students enrolled at the nation’s only military medical school. Critical to the function of any academic medical institution, but particularly one devoted to the training of future physicians for the Military Health System, was the ability to rapidly adapt, modify, and create new means of keeping medical students engaged in their core curricula and progressing toward full and timely attainment of established educational goals and objectives. Methods This article highlights some of the particular challenges faced by faculty and students during the first 6 months of the COVID-19 pandemic and describes how they were managed and/or mitigated. Results Six key “lessons learned” were identified and summarized in this manuscript. These lessons may be applicable to other academic institutions both within and outside of the Military Health System. Conclusions Recognizing and embracing these key tenets of academic change management can accelerate the generation of a cohesive, organizational response to the next pandemic or public health crisis.

scholarly journals Predictors of Veterans Health Administration utilization and pain persistence among soldiers treated for postdeployment chronic pain in the Military Health System

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rachel Sayko Adams ◽  
Esther L. Meerwijk ◽  
Mary Jo Larson ◽  
Alex H. S. Harris
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Chronic Pain ◽  
Veterans Health Administration ◽  
First Year ◽  
Veterans Health ◽  
Health Administration ◽  
Military Health System ◽  
Military Health ◽  
The Military

Abstract Background Chronic pain presents a significant burden for both federal health care systems designed to serve combat Veterans in the United States (i.e., the Military Health System [MHS] and Veterans Health Administration [VHA]), yet there have been few studies of Veterans with chronic pain that have integrated data from both systems of care. This study examined 1) health care utilization in VHA as an enrollee (i.e., linkage to VHA) after military separation among soldiers with postdeployment chronic pain identified in the MHS, and predictors of linkage, and 2) persistence of chronic pain among those utilizing the VHA. Methods Observational, longitudinal study of soldiers returning from a deployment in support of the Afghanistan/Iraq conflicts in fiscal years 2008–2014. The analytic sample included 138,206 active duty soldiers for whom linkage to VHA was determined through FY2019. A Cox proportional hazards model was estimated to examine the effects of demographic characteristics, military history, and MHS clinical characteristics on time to linkage to VHA after separation from the military. Among the subpopulation of soldiers who linked to VHA, we described whether they met criteria for chronic pain in the VHA and pain management treatments received during the first year in VHA. Results The majority (79%) of soldiers within the chronic pain cohort linked to VHA after military separation. Significant predictors of VHA linkage included: VHA utilization as a non-enrollee prior to military separation, separating for disability, mental health comorbidities, and being non-Hispanic Black or Hispanic. Soldiers that separated because of misconduct were less likely to link than other soldiers. Soldiers who received nonpharmacological treatments, opioids/tramadol, or mental health treatment in the MHS linked earlier to VHA than soldiers who did not receive these treatments. Among those who enrolled in VHA, during the first year after linking to the VHA, 49.7% of soldiers met criteria for persistent chronic pain in VHA. Conclusions The vast majority of soldiers identified with chronic pain in the MHS utilized care within VHA after military separation. Careful coordination of pain management approaches across the MHS and VHA is required to optimize care for soldiers with chronic pain.

Comparison of Nurse-Midwife and Physician Birth Outcomes in the Military Health System

2021 ◽  
pp. 152715442199407
Author(s):  
Lynette Hamlin ◽  
Lindsay Grunwald ◽  
Rodney X. Sturdivant ◽  
Tracey P. Koehlmoos
Keyword(s):  
Health System ◽  
Birth Outcomes ◽  
Health Care Systems ◽  
Vaginal Birth ◽  
Data Repository ◽  
Military Health System ◽  
Provider Type ◽  
Pregnancy Risk ◽  
Military Health ◽  
The Military

The purpose of this study is to identify the socioeconomic and demographic characteristics of women cared for by Certified Nurse-Midwives (CNMs) versus physicians in the Military Health System (MHS) and compare birth outcomes between provider types. The MHS is one of America’s largest and most complex health care systems. Using the Military Health System Data Repository, this retrospective study examined TRICARE beneficiaries who gave birth during 2012–2014. Analysis included frequency of patients by perinatal services, descriptive statistics, and logistic regression analysis by provider type. To account for differences in patient and pregnancy risk, odds ratios were calculated for both high-risk and general risk population. There were 136,848 births from 2012 to 2014, and 30.8% were delivered by CNMs. Low-risk women whose births were attended by CNMs had lower odds of a cesarean birth, induction/augmentation of labor, complications of birth, postpartum hemorrhage, endometritis, and preterm birth and higher odds of a vaginal birth, vaginal birth after cesarean, and breastfeeding than women whose births were attended by physicians. These results have implications for the composition of the women’s health workforce. In the MHS, where CNMs work to the fullest scope of their authority, CNMs attended almost 4 times more births than our national average. An example to other U.S. systems and high-income countries, this study adds to the growing body of evidence demonstrating that when CNMs practice to the fullest extent of their education, they provide quality health outcomes to more women.

Survival in Pediatric, Adolescent, and Young Adult Patients With Sarcoma in the Military Health System: Comparison With the SEER Population

2021 ◽  
Vol 43 (6) ◽  
pp. e832-e840
Author(s):  
Lauren M. Vasta ◽  
Richard C. Zanetti ◽  
Ashley B. Anderson ◽  
Kangmin Zhu ◽  
Benjamin K. Potter ◽  
...  
Keyword(s):  
Young Adult ◽  
Health System ◽  
Adult Patients ◽  
Adolescent And Young Adult ◽  
Military Health System ◽  
Military Health ◽  
The Military
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