An Empanelment Model For Use By Medical Treatment Facilities Within the Military Health Services System.

1996 ◽  
Author(s):  
Margaret Rivera
Keyword(s):  
Health Services ◽  
Medical Treatment ◽  
Military Health ◽  
Treatment Facilities ◽  
The Military

scholarly journals Clinical Readiness Program: Refocusing the Military Health System

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 32-39
Author(s):  
Danielle B Holt ◽  
Matthew T Hueman ◽  
Jonathan Jaffin ◽  
Michael Sanchez ◽  
Mark A Hamilton ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Health System ◽  
Care Delivery ◽  
Military Health System ◽  
Military Health ◽  
Orthopedic Surgeons ◽  
Combat Casualty ◽  
General Surgeons ◽  
Treatment Facilities ◽  
The Military

ABSTRACT Introduction The Military Health System serves to globally provide health services and trained medical forces. Military providers possess variable levels of deployment preparedness. The aim of the Clinical Readiness Program is to develop and assess the knowledge, skills, and abilities (KSAs) needed for combat casualty care. Methods The Clinical Readiness Program developed a KSA metric for general and orthopedic surgery. The KSA methodology underwent a proof of concept in six medical treatment facilities. Results The KSA metric feasibly quantifies the combat relevance of surgical practice. Orthopedic surgeons are more likely than general surgeons to meet the threshold. Medical treatment facilities do not provide enough demand for general surgery services to achieve readiness. Conclusion The Clinical Readiness Program identifies imbalances between the health care delivery and readiness missions. To close the readiness gap, the Military Health System needs to recapture high KSA value procedures, expand access to care, and/or partner with civilian institutions.

scholarly journals “We Want to Build a Network”: Professional Experiences of Case Managers Working With Military Families

2019 ◽  
Vol 6 ◽  
pp. 2333794X1986978 ◽  
Author(s):  
Robyn Englert ◽  
Renee Dell’Acqua ◽  
Shannon Fitzmaurice ◽  
Abigail Marter Yablonsky
Keyword(s):  
Military Families ◽  
Qualitative Content Analysis ◽  
Qualitative Interviews ◽  
Well Being ◽  
Case Managers ◽  
Military Health ◽  
Professional Experiences ◽  
Treatment Facilities ◽  
The Military

Optimizing case management (CM) services increases service member readiness at home and abroad. However, little research has been conducted on the experiences of case managers providing services to military families within the Military Health System. Semistructured qualitative interviews were conducted to explore the professional experiences of case managers to identify factors that may affect care to military families. A total of 53 case managers from military medical treatment facilities (MTFs) varying in size, location, and branch of service were interviewed by telephone to explore their perspectives. Qualitative content analysis was performed. Case managers serve a variety of functions, but specific roles vary between MTFs. Factors that affect CM services for military families were identified: (1) need for pediatric specialization, (2) heavy workload, (3) appropriate staff, (4) patient handoffs, and (5) the role of CM. Recommendations for improving CM services to facilitate the well-being of military families are discussed.

Patient Care Outcomes: Implications for the Military Health Services System

1993 ◽  
Vol 158 (5) ◽  
pp. 289-294
Author(s):  
Bonnie Mowinski Jennings
Keyword(s):  
Health Services ◽  
Patient Care ◽  
Military Health ◽  
Care Outcomes ◽  
The Military

scholarly journals Leading the Military Health System Transformation: From Military Treatment Facility to Market Construct

2020 ◽  
Vol 185 (Supplement_3) ◽  
pp. 3-11
Author(s):  
John J Melton ◽  
Jeffrey W Quick
Keyword(s):  
Organizational Performance ◽  
Medical Center ◽  
Health Agency ◽  
System Transformation ◽  
Multiple Stakeholders ◽  
Military Health ◽  
Effective Relationships ◽  
Treatment Facilities ◽  
Military Treatment Facility ◽  
The Military

ABSTRACT The transition of authority to manage and administer all DoD Medical Treatment Facilities from the Military Department Services to the Defense Health Agency is an extremely complex challenge involving multiple stakeholders and systems in an effort to achieve greater force readiness while reducing cost. Womack Army Medical Center at Fort Bragg served as the U.S. Army’s sole prototype for the initial phase of the transition of authority. Starting with a foundational shift to an organizational outward mindset was essential in building effective relationships to exercise Mission Command at echelon to manage risks to mission during this period of uncertainty and ambiguity. This shift in mindset set the conditions for mobilizing Army Doctrine, elicited, and invited collaborative behaviors, and resulted in the improved organizational performance accomplished with velocity to successfully lead the transformation to Defense Health Agency.

Battlefield neurosurgical care in the current conflict in southern Afghanistan

2010 ◽  
Vol 28 (5) ◽  
pp. E7 ◽  
Author(s):  
Markus F. Eisenburg ◽  
Martin Christie ◽  
Peter Mathew
Keyword(s):  
Health Services ◽  
Medical Services ◽  
Military Hospital ◽  
Military Health ◽  
Large Numbers ◽  
Conflict Zone ◽  
Military Campaign ◽  
The Military

An international military campaign involving large numbers of troops is ongoing in Afghanistan. To support the military efforts in the conflict zone, a network of military medical services of varying levels has been established. The largest and busiest multinational military hospital in southern Afghanistan is located at Kandahar Air Field where the only neurosurgeon is based. This report outlines the contribution of multinational military health services and the workload of the neurosurgical service in Kandahar.

scholarly journals Volume as an Indicator for Outcomes for Severe Maternal Morbidity in the Military Health System

2021 ◽  
Author(s):  
Aimee Hunter ◽  
Amanda Banaag ◽  
Monica A Lutgendorf ◽  
Col Barton Staat ◽  
Tracey P Koehlmoos
Keyword(s):  
Health System ◽  
Maternal Morbidity ◽  
Healthcare Systems ◽  
Severe Maternal Morbidity ◽  
Military Health System ◽  
Case Volume ◽  
Military Health ◽  
Treatment Facilities ◽  
The Military ◽  
Military Treatment Facilities

ABSTRACT Background Maternal obstetric morbidity is a growing concern in the USA, where rates of maternal morbidity exceed Europe and most developed countries. Prior studies have found that obstetric case volume affects maternal morbidity, with low-volume facilities having higher rates of morbidity. However, these studies were done in civilian healthcare systems that are different from the Military Health System (MHS). This study evaluates whether obstetric case volume impacts severe maternal morbidity (SMM) in military hospitals located in the continental United States. Methods This cross-sectional study included all military treatment facilities (MTFs) (n = 35) that performed obstetric deliveries (n = 102,959) from October 2015 to September 2018. Data were collected from the MHS Data Repository and identified all deliveries for the study time period. Severe maternal morbidity was defined by the Centers for Disease Control. The 30-day readmission rates were also included in analysis. Military treatment facilities were separated into volume quartiles for analysis. Univariate logistic regressions were performed to determine the impact of MTF delivery volume on the probability of SMM and 30-day maternal readmissions. Results The results for all regression models indicate that the MTF delivery volume had no significant impact on the probability of SMM. With regard to 30-day maternal readmissions, using the upper middle quartile as the comparison group due to the largest number of deliveries, MTFs in the lower middle quartile and in the highest quartile had a statistically significant higher likelihood of 30-day maternal readmissions. Conclusion This study shows no difference in SMM rates in the MHS based on obstetric case volume. This is consistent with previous studies showing differences in MHS patient outcomes compared to civilian healthcare systems. The MHS is unique in that it provides families with universal healthcare coverage and access and provides care for approximately 40,000 deliveries annually. There may be unique lessons on volume and outcomes in the MHS that can be shared with healthcare planners and decision makers to improve care in the civilian setting.

scholarly journals Procedural Volume Within Military Treatment Facilities—Implications for a Ready Medical Force

2020 ◽  
Vol 185 (7-8) ◽  
pp. e977-e981
Author(s):  
Brandon M Carius ◽  
Michael D April ◽  
Steve G Schauer
Keyword(s):  
Retrospective Analysis ◽  
Central Venous Access ◽  
Military Force ◽  
Central Venous ◽  
Data Set ◽  
Military Health ◽  
Procedural Volume ◽  
Treatment Facilities ◽  
The Military ◽  
Military Treatment Facilities

Abstract Introduction Consistent procedural volume is important for emergency physicians (EPs) to maintain opportunities for critical lifesaving skills. While non-EP literature demonstrates improved patient outcomes with higher volumes, few studies examine the optimal number of repetitions needed to maintain procedural competency in EP populations. The largely young, healthy active duty population that constitutes the majority of patients in military treatment facilities (MTFs) decreases the likelihood to utilize emergent procedures. Despite this likelihood, EPs are expected to maintain proficiency and readiness to perform critical procedures in deployed settings. Materials and Methods A retrospective analysis of de-identified data obtained through the Military Health System Mart was performed for procedural codes involving surgical airway, central venous access, and intubation. Data were sought for 2014–2016 calendar years from seven Army hospitals under the Southwest Region Medical Command. Procedural numbers were obtained for both overall volume and those performed per 1,000 encounters. Additionally, we analyzed for volume differences with the highest volume MTF (Brooke Army Medical Center [BAMC]) removed from the data set. Results A total of 1,450 procedures were performed among the MTFs analyzed, including 973 intubations, 473 central venous catheter placements, and 4 surgical airways. MTFs averaged 69.5 intubations and 38.8 venous catheters placed each year, but decreased to 28.1 intubations and 13.0 venous catheters placed annually when BAMC was removed from the data set (a 59.6 and 61.6% decrease, respectively). Monthly averages of 40.5 intubations and 19.7 central venous catheterizations per month among all included MTFs decreased to 14.0 and 6.5 when BAMC was removed. All surgical airways were performed at BAMC. Procedural frequency per 1,000 encounters was highest at BAMC, although ordinal differences were noted in the remaining six MTFs compared with overall procedural volumes. Conclusions This retrospective analysis demonstrates a significant variation in procedural volumes across MTFs, illustrating disproportionate opportunities for procedural skill maintenance among Army EPs. Low procedural volume threatens the maintenance of critical EP skills. These numbers could also suggest low skills for other providers (such as physician assistants), further illustrating decreased skill readiness throughout the force. Further research is needed to examine procedural volumes per individual EP, as well as those performed by other providers to evaluate for overall procedural readiness across the military force.

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