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Clinical Improvement Priorities for MTF Providers

The Defense Health Agency Director FY21 DHA Campaign Plan identified several priorities for DHA and military treatment facility (MTF) performance during Fiscal Year 2021 (FY21). Of these priorities, several focus specifically on improvements in clinical process and care delivery to achieve top outcomes in readiness and health. The DHA Chief Medical Officer, Dr. Paul Cordts, is responsible for implementation of these priorities in support of the DHA Director and the Assistant Director for Health Care Administration. They include:

FY21 Campaign Plan Projects

Accreditation and Compliance*

This program will provide MTF staff with a comprehensive and systematic process for reviewing their MTF's accreditation and compliance, allowing them to demonstrate their ability to meet Department of Defense (DOD) policy mandates, regulatory requirements, and health care standards.

Dental Universal Protocol

The Dental Universal Protocol will provide MTF staff with a standardized approach, including pre-procedural verification and guidance to ultimately reduce wrong-site surgery, specifically in the area of dental procedures. 

Graduate Medical Education*

The standardization of the MHS Graduate Medical Education (GME) Program will provide the policy, procedures, and direction to ensure continued accreditation of GME programs to support a ready medical force.

Influenza Immunizations

The goal is to increase influenza immunizations for all beneficiaries across the Military Health System.

Postpartum Hemorrhage

The Postpartum Hemorrhage (PPH) Bundle will provide MTFs with a standardized approach to recognize, respond, and report PPH to decrease associated morbidity and mortality across the MHS.

Ready Reliable Care Communications*

The Ready Reliable Care Safety Communication Bundle will provide MTF staff with a standardized approach for team-based communication and other safety communication practices, including: 

  1. Safety Leadership Rounds (WalkRounds™)
  2. Leader Daily Safety Briefs
  3. Unit Based Huddles
  4. I-PASS Tool for Patient Handoffs
  5. Surgical Briefs and Debriefs
  6. Universal Protocol

For More Information:

Stepped Care Model for Pain

The primary care Stepped Care Model for Pain will allow MTFs to standardize and effectively implement evidence-based best practices for management of acute and chronic pain in the primary care setting.

FY21 Quadruple Aim Performance Plan (QPP) Projects

Acute Concussion Pathway

The Acute Concussion Care (ACC) Pathway will provide MTFs with a standard assessment and treatment plan for acute concussion, which includes:

  1. Incorporating an acute assessment MACE2 tool at initial appointment
  2. Follow-up within 72 hours after the diagnosis of mild Traumatic Brain Injury (mTBI)
  3. Complete Progressive Return to Activity process prior to return to full duty.

Behavioral Health Treatments & Outcomes

Increased adoption of the Behavioral Health Data Portal will allow MTFs to track behavioral health treatment and outcomes for all beneficiaries. The portal reduces redundancy for patients, streamlines the screening process, and focuses improvement on outcomes that matter to patients.

Opioid Overdose/Naloxone Distribution

Through standardized management of chronic pain, this program will ensure that patients taking long-term opioid therapy with an elevated risk of opioid-related harm receive overdose education and at least one prescription for naloxone medication in a 12-month window.

Resources

Find other recently published DHA Clinical Guidance on the Policies page.

Note: * Denotes operational improvement priorities

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DHA-PI 6410.02 Dental Universal Protocol

Policy

Establishes the Defense Health Agency’s (DHA) procedures for the Dental Universal Protocol (Dental UP) policy. The Dental UP is designed to improve the quality and safety of dental care provided for beneficiaries within the Military Health System (MHS), including all military Medical Treatment Facilities (MTFs) and Dental Treatment Facilities (DTFs). This DHA-PI focuses on the prevention of patient harm events with an emphasis on wrong site surgery through standardized effective communication strategies, Dental UP, and infection control adherence. The DoD is on a continuous journey to transform the MHS into a high reliability organization, providing exceptional patient care that is consistently safe over long periods of time and across all Services and settings. The purpose of this DHA-PI is to provide guidance to MHS dental healthcare teams through a standardized Dental UP approach. The Dental UP approach includes a Universal Protocol Checklist to ensure conditions for the delivery of the safest care to DoD beneficiaries.

DHA-PI 6490.04 Required Clinical Tools and Procedures for Assessment and Clinical Management of Mild Brain Injury (mTBI)/Concussion in Non-Deployed Setting

Policy

Establishes the Defense Health Agency’s required clinical tools and procedures for management of mTBI/concussion, specifically, the use of the Military Acute Concussion Evaluation, Version 2 (MACE 2) and a progressive return to activity (PRA) framework for the assessment, management, and rehabilitation of all patients with mTBI/concussion.

DHA implements standard practices to improve maternal outcomes

Article
3/24/2021
Military health personnel wearing face mask during medical training

DHA-PI 6025.35 provides guidance for implementation of a postpartum hemorrhage bundle at all MTFs providing obstetrical care.

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Women's Health | Clinical Improvement Priorities for MTF Providers | Postpartum Hemorrhage

Guidance for Implementation of the Postpartum Hemorrhage Bundle

Policy

This Defense Health Agency-Procedural Instruction (DHA-PI), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (n), establishes the Defense Health Agency’s (DHA) procedures for military medical treatment facilities (MTFs) providing obstetrical (OB) care to implement standardized PPHB practices. Note, the use of the name or mark of any specific manufacturer, commercial product, commodity, or service in this publication does not imply endorsement by the Department of Defense (DoD).

DHA FY21 Campaign Plan

Publication
11/17/2020

This Campaign Plan sets the DHA's four critical priorities for Fiscal Year 2021 (FY21).

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Defense Health Agency | Clinical Improvement Priorities for MTF Providers

DHA PI 6025.07: Naloxone in the MTFs

Policy

This Defense Health Agency-Procedural Instruction (DHA-PI), based on the authority of References (a) through (c), and in accordance with the guidance of References (d) through (h), establishes the Defense Health Agency’s (DHA) procedures for prescribing and dispensing naloxone by pharmacists in MTFs to eligible beneficiaries, upon beneficiary request, or when the pharmacist determines the beneficiary meets the established criteria for being at risk for a life-threatening opiate overdose.

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