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

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