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DHA IPM 18-012: The DoD Medical Ethics Program (DoDMEP) in the Military Health System (MHS)

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), based on the authority of References (a) through (c), and in accordance with the guidance of References (d) through (k), establishes Defense Health Agency’s (DHA) procedures that: • Apply to Active Duty Service members, namely Active Component members and Reserve Component members on active duty for a period of more than 30 days, who, hereafter, are referred to collectively as Active Duty Service members (References (e) and (f)). • Establish a set of common guidelines, standards, and procedures governing the DoDMEP for military health care personnel in all locations. • Outline implementing procedures for DHA collaboration with the DoDMEP office, to be known as the DoD Medical Ethics Center (DMEC), which is to operate under the direction of the President of the Uniformed Services University of the Health Sciences (USUHS). • Implement guidance for the DoD mission, vision, guiding principles of the DoDMEP (DMEC) as set forth in Reference (g) and delineate areas of responsibility between the DHA and USUHS, including: o The provision of medical ethics education and training (E&T) to health care providers and other health care personnel; o Creation and maintenance of a DMEC portal; and o Medical ethics consultation services to MHS health care personnel across all settings. • This DHA-IPM is effective immediately and will expire effective 12 months from the date of issue.

DHA PM 6010 13 MEPRS Volume 2

Policy

This Defense Health Agency-Procedures Manual (DHA-PM), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (d), establishes the Defense Health Agency’s (DHA) procedures to: - a. Provide a uniform and standardized system of healthcare managerial cost accounting for the Military Health System (MHS) and MEPRS. MEPRS: (1) Provides detailed uniform performance indicators, common expense classification by work/cost center, uniform reporting of personnel utilization data by work centers, and a labor cost assignment methodology. (2) Methodology provides consistent performance data to managers responsible for healthcare delivery in support of dual Warfighter Support Operations and integrated Tri-Service healthcare missions. (3) Defines a set of functional work/cost centers, applies a uniform performance measurement system, prescribes a cost assignment methodology, and obtains reported information in standard formats for fixed Military Medical Treatment Facilities (MTFs) and DTFs. Resource and performance data must reflect the resources used in delivering healthcare services and comply with MEPRS functional work/cost center requirements. Data must be complete, accurate, and timely, and in sufficient detail to permit review and audit by management. - b. Prescribes detailed functional information for the standardized MEPRS Uniform Chart of Accounts Operational Functional Cost Codes (FCCs). - c. Cancels and along with DHA Procedures Manual “Medical Expense and Performance Reporting System (MEPRS) Procedures Manual for Fixed Military Medical and Dental Treatment Facilities: Business Rules, Volume 1,” September 27, 2018 (Reference (e)) reissues DoD 6010.13-M, “Medical Expense and Performance Reporting System for Fixed Military Medical and Dental Treatment Facilities,” April 7, 2008 (hereby canceled) (Reference (f)).

DHA PM 6010 13 MEPRS Volume 1

Policy

This Defense Health Agency-Procedures Manual (DHA-PM), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (ae), establishes the Defense Health Agency’s (DHA) procedures to: - a. Provide a uniform and standardized system of healthcare managerial cost accounting for the Military Health System (MHS) and the MEPRS. MEPRS: (1) Provides detailed uniform performance indicators, common expense classification by work center/cost center, uniform reporting of personnel utilization data by work centers, and a labor cost assignment methodology. (2) Methodology provides consistent performance data to managers responsible for healthcare delivery in support of dual Warfighter Support Operations and integrated Tri-Service healthcare missions. (3) Defines a set of functional work centers/cost centers, applies a uniform performance measurement system, prescribes a cost assignment methodology, and obtains reported information in standard formats for fixed Military Medical Treatment Facilities (MTFs) and fixed Military DTFs. Resource and performance data must reflect the resources used in delivering healthcare services and also comply with MEPRS functional work/cost center requirements. Data must be complete, accurate, and timely, and in sufficient detail to permit review and audit by management at all levels of the Health Affairs (HA) and DHA organizations. - b. Prescribes the standardized procedures, business rules, service units, allocation factors and guidelines for the uniform reporting of expense, labor/personnel, and/or output data for fixed military medical and DTFs. - c. Cancels and along with DHA Procedures Manual “Medical Expense and Performance Reporting System (MEPRS) Procedures Manual for Fixed Military Medical and Dental Treatment Facilities Uniform Chart of Accounts, Volume 2,” September 27, 2018 (Reference (e)) reissues DoD 6010.13-M, “Medical Expense and Performance Reporting System for Fixed Military MTFs and DTFs,” April 7, 2008 (hereby canceled) (Reference (f)).

DoD Instruction 6025.13: Medical Quality Assurance (MQA) and Clinical Quality Management in the Military Health System (MHS) Instruction

Policy

This Department of Defense Instruction (Number 6025.13) establishes DoD policy on issues related to MQA programs and clinical quality management activities.

Good Catch Recognition Award Process

Policy

This memorandum describes the annual Navy Medicine "Surgeon General Good Catch Annual Recognition Award". A "Good Catch" signifies a near miss, unsafe condition, or error(s) (environmental, IT, process, system design) that was identified early to prevent and/or minimize preventable harm to patients.

Trusted Care – Patient Centeredness Vision

Policy

This memorandum from the Air Force Surgeon General describes the "Patient Centeredness Vision" which encompasses the six aims of health care: safe, effective, patient centered, timely, efficient, and equitable.

Patient Centered Practice Hours

Policy

This memorandum encourages Air Force military treatment facilities to establish more patient-centered clinic hours.

Management and Reporting of Clinical Adverse Actions and Professional Misconduct for Privileged Health Care Providers and Non-Privileged Clinical Support Staff

Policy

The purpose of this directive is to update and establish policy, assign responsibility, and prescribe procedures for the management and reporting of clinical adverse actions and professional misconduct for privileged health care providers and non-privileged clinical support staff for the Department of the Navy.

Prevention of Retained Surgical Items Standard Operation Procedure

Policy

The purpose of this memorandum is to provide guidance to perioperative personnel for prevention of unintended retained surgical items during operative or other invasive procedures.

National Surgical Quality Improvement Program

Policy

This memorandum describes the American College of Surgeons (ACS) National Surgical Quality Improvements Program (NSQIP) - a risk adjusted, outcomes-based program which measures and assists in improving the quality of surgical care.

MEDCOM Regulation Number 40-54: Medical Services

Policy

This regulation provides a standard process and procedure for surgical and procedural site verification of patients undergoing operative or other invasive procedures. This regulation supersedes MEDCOM Regulation 40-54, 23 Feb 2009.

First Call Resolution and Do Not Call Back Policy

Policy

This policy requires first call resolution for all patients requesting appointments at all Air Force medical treatment facilities. Under this policy, beneficiaries will not be asked to call back for an appointment.

First Call Resolution and Expeditious Reply to Patient Policy

Policy

This policy requires first call resolution for all patients requesting appointments at all National Capital Region Medical Directorate medical treatment facilities. Under this policy, beneficiaries will not be asked to call back for an appointment.

First call Resolution and Do Not Call Back Policy

Policy

This Army OTSG/MEDCOM policy identifies responsibilities of MTF commanders, primary care, specialty care and other stakeholders identified in the appointing process to ensure patient satisfaction for our beneficiaries; outlines use of alternative portals such as Army Medicine Secure Messaging, Nurse Advice Line and TRICARE Online; specific procedures are also identified to correctly transfer calls in accordance with existing access to care standards, referral management protocols, and proper use of managing clinic schedules to ensure appointing success the first time one of our patients seeks access.

Credentialing and Privileging Program

Policy

This instruction updates and reissue policy and procedures for the Credentialing and Privileging Program for the Department of the Navy (DON) as part of the DON Clinical Quality Management Program (CQMP).

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