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Access, Cost, Quality, and Safety

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Air Force Instruction 44-102: Medical Care Management

Policy

This instruction implements Air Force Policy Directive (AFPD) 44-1, Medical Operations, and provides guidance for the organization and delivery of medical care. It implements various publications of Department of Defense (DoD), recognized professional organizations, the Joint Commission (TJC), the Accreditation Association for Ambulatory Health Care (AAAHC) and appropriate health and safety agencies

Non-Availability of Patient Appointments at Medical Treatment Facilities

Policy

This policy is to be implemented immediately to ensure patients are not told to call back the next day for an appointment.

MEDCOM Regulation 40-49: Medical Services Surgical Counts

Policy

This regulation provides guidelines for accountability of items used during operative and other invasive procedures (inclusive of minimally invasive procedures) to ensure they are not retained in a patient. This regulation addresses which items will, at a minimum, be counted, as well as when, how, and by whom the surgical count will be performed.

Air Force Instruction 44-176: Access to Care Continuum

Policy

This publication implements AFPD 44-1, Medical Operations. It provides guidance and procedures for Access to Care (ATC) operations within the Air Force Medical Service (AFMS). It establishes the roles, responsibilities, definitions and requirements for implementing, sustaining and managing ATC for AFMS Medical Treatment Facilities (MTFs).

Army OTSG/MEDCOM Policy Memo 14-085: Prevention of Catheter Associated Urinary Tract Infections (CAUTI)

Policy

This policy memo provides standardized definitions, standardized guidelines for insertion and maintenance of urinary catheters, and standardized processes for data collection and reporting of CAUTIs.

Army OTSG/MEDCOM Policy Memo 14-083: Prevention of Ventilator-Associated Pneumonia (VAP)

Policy

This policy memorandum directs Commanders to incorporate health care delivered to patients placed on ventilators at the patient's bedside whose measures that have been shown to prevent or reduce VAP as described in the current scientific literature.

Army MEDCOM Regulation 40-57: Trial of Labor for Patients Attempting Vaginal Birth After Previous Cesarean Delivery

Policy

This regulation provides standardized guidance to promote maximum effectiveness and safety to the maternal-fetal unit during trial of labor (TOL) for vaginal birth after cesarean (VBAC) section delivery and to provide an optimal environment and psychosocial support to the patient.

Army MEDCOM Regulation 40-59: Standardization of Inpatient Falls Risk Assessment and Documentation Falls Prevention Program

Policy

This regulation directs standardized implementation of endorsed evidence-based falls risk assessment tools: the Johns Hopkins Hospital Fall Risk Assessment© (adult) and the Miami Children’s Hospital’s Humpty Dumpty Scale© (pediatric). In addition, this regulation requires incorporation of falls assessment documentation into the inpatient (Essentris) electronic medical record (EMR).

Army MEDCOM Regulation 40-48: Fires Associated with the Performance of Surgical Procedures

Policy

The purpose of this regulation is to provide policy and recommendations that will help ensure minimal risk of fires associated with the performance of surgical procedures in any healthcare setting to include, but not limited to, the following: operating room (OR), office-based, ambulatory surgery, and intensive care unit type.

Culture of Safety in Navy Medicine

Policy

This memorandum encourages commands to create "safe zones" around the patient experience where any staff member can speak up and patient safety comes first.

Army MEDCOM Regulation 40-41: Medical Service – The Patient Safety Program

Policy

This regulation outlines the activities of the Army Medical Department (AMEDD) Patient Safety Program (PSP) to identify and centrally report actual and potential events in medical/dental systems and processes and to improve patient safety and healthcare quality throughout the AMEDD.

Expansion of the Chiropractic Program 13-001

Policy

Chiropractic services may now be added at Military Treatment Facilities (MTFs) that do not offer the service, subject to Military Department approval procedures and available funding. This change recognizes several requests from MTFs to add chiropractic services and the incorporation of chiropractic care in various pain management programs. Each Military Department shall establish its own policy for their MTFs to request approval to add chiropractic services or to transfer chiropractic authorizations to other MTFs.

Guidelines for Suspension and Reinstatement of TRICARE Reserve Select Coverage 12-009

Policy

This memorandum clarifies the procedures under title 32 of the Code of Federal Regulations, section 199.24(d)(3) for suspending TRICARE Reserve Select (TRS) coverage for up to 12 months and, upon request from a TRS member/survivor request, lifting the suspension, which will reinstate coverage with no break.

Navy BUMED Instruction 6000.2E: Accreditation of Fixed Medical Treatment Facilities

Policy

This instruction establishes policy, publishes procedures, and assigns responsibility for the accreditation of Navy Medicine's (NAVMED) medical treatment facilities (MTFs). This instruction is a complete revision and must be read in its entirety.

Reporting Infection Prevention and Control Data to the Centers for Disease Control and Prevention using the National Healthcare Safety Network 12-005

Policy

The purpose of this memorandum is to update Health Affairs Policy 08-020, which implemented the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) within the Military Health System (MHS).

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