Skip to main content

Military Health System

Ready Reliable Care Framework is Improving MHS Patient Care

Image of Ready Reliable Care is the Military Health System's framework for ensuring high-quality health care across the force. Ready Reliable Care is the Military Health System's framework for ensuring high-quality health care across the force.

Recommended Content:

Research & Innovation | Health Care Technology | Readiness Capabilities | Ready Reliable Care | Defense Health Information Technology Symposium | MHS GENESIS

The Military Health System relies on high-reliability practices to improve patient care and ensure its mission of sustaining a medically ready force and a ready medical force. This means improving patient outcomes through more reliable processes to provide safe, high-quality care for all patients and their families.

The Ready Reliable Care framework is the Military Health System’s (MHS) effort to become a high-reliability organization (HRO). With a goal to achieve zero harm while remaining committed to continuous learning and improvement, it abides by four domains of change: The leadership’s commitment to prioritize the effort at all levels of leadership; a culture committed to safety and preventing harm; continuously improving to advance innovative solutions and spread leading practices; and a patient-centered focus on safety and quality of care.

This entails innovation, a key characteristic of HROs. Through its transformation process to assume responsibility over the administration of all military medical treatment facilities (MTFs), the Defense Health Agency “takes a deliberate approach to innovation by optimizing through standardization and identifying innovative approaches that could benefit the DHA strategy,” said Regina Julian, chief of DHA’s Healthcare Optimization Division.

As a result, new and standard processes based on these innovations are continuously assessed for implementation to improve the overall system’s performance.

Once the MHS transformation is completed, the overall system Julian described will include 19 direct-reporting markets within the United States, 18 small markets, and many stand-alone MTFs across the country (which will report to a small market and stand-alone organization), and two overseas Defense Health Region, making standardization that much more significant.

“The MHS is constantly balancing research, innovation, and risk to deliver the highest-quality, safe, and reliable care to beneficiaries,” said Army Col. (Dr.) Sean Hipp, director of the DHA’s Virtual Medical Center.

Everyone Has a Role

MHS leaders, staff, and patients all have a role in contributing to high reliability by implementing seven principles in their daily work:

  • Preoccupation with Failure: Drive zero harm by anticipating and addressing risks.
  • Sensitivity to Operations: Be mindful of how people, processes, and systems impact outcomes.
  • Deference to Expertise: Seek guidance from those with the most relevant knowledge and experience.
  • Respect for People: Foster mutual trust and respect.
  • Commitment to Resilience: Leverage past mistakes to learn, grown, and improve processes.
  • Constancy of Purpose: Persist through adversity towards the common goal of zero harm.
  • Reluctance to Simplify: Strive to understand complexities and address root causes.

“DHA is making progress to embody all principles,” said Julian. Since beginning its journey to become an HRO in 2014, “DHA has made great progress towards the goal of implementing these principles and continues its journey in support of continuous process and system improvement.”

As an example of the commitment to preoccupation with failure, Julian explained the DHA established a centralized Clinical Quality Management program in the Medical Affairs division under its authority to “standardize processes and ensure a systems approach to performance improvement to improve quality and safety.”

Likewise, DHA leaders “developed and implemented centralized industry-standard performance measures to drive zero harm,” she said. They then assess those with MTF and market directors to establish accountability, she added.

“Overall, DHA takes a systems approach to the enterprise by establishing standard processes for all programs and codifying those standard processes and workflows in clear, comprehensive, and easy-to-understand guidance by studying what works and then identifying in guidance who is going to do what by when,” she said. “All standard processes are assessed by how well they support, directly or indirectly, system performance and outcomes, which include clinical, operational, and business outcomes.”

Hipp explained they do this by following the metrics on the progression of virtual health throughout the MHS, surveying patients and staff to assess the program and improve the experience.

Julian also discussed examples of programs that establish DHA’s commitment of deferring to experts.

“DHA’s standard processes are informed by leading practices from both high-performing MTFs and industry,” she said. “Each area of responsibility at DHA includes a community of practice with MTFs and markets to establish bi-directional communication with leaders in the field.”

Hipp added that these programs are developed by subject matter experts so that clinical leaders can shape the solution and lead the change. “This supports getting buy in for the program,” he said.

With respect to fostering respect for people through mutual trust, Julian said DHA is developing robust programs to support MHS staff members to grow in personal development, such as Individual Development Plans for each employee, workforce development activities, and formal education programs.

“DHA also demonstrates respect for people by supporting the department’s anti-discrimination and anti-harassment programs as well as to eliminate extremism in the force, which is antithetical to unit cohesion,” she said. “Finally, DHA is communicating at multiple levels with counterparts in the field, including through visits by senior DHA leaders and weekly email updates.”

Hipp added the DHA also does this by “working across the military departments and the DHA to create programs that people believe in and are compatible with daily workflows, bringing all leaders into the conversation and not just imposing a product or plan without understanding.”

As part of the commitment to resilience, Julian explained the DHA is committed to establishing standard processes.

“Through transparent, bi-directional communication, it is willing to revise DHA guidance to correct any processes resulting in negative, unintended consequences and, even more so, to improve current processes based on validated feedback from the MTFs.”

For example, Hipp said, “the DHA also does this by communicating with leaders in the Department of Veterans Affairs and the civilian world to learn from their experience.”

One example is the MHS Video Connect telehealth platform: “It is built on VA experience and is being integrated into the MHS electronic health record based on the experience of successful civilian telemedicine programs,” he said.

“DHA’s authority and commitment to issuing standard guidance for all MTFs is critical to inculcating a constancy of purpose throughout the Direct CareDirect care refers to military hospitals and clinics, also known as “military treatment facilities” and “MTFs.”direct care system,” said Julian. “Standard processes are focused on improving readiness and enhancing outcomes, which include a goal of zero harm.”

With respect to being reluctant to simplify, Julian said: “DHA’s commitment to issue easy-to-understand and clear guidance on standard processes, which identify intent, goals, and who does what to whom by when simplifies processes, focuses staff on priorities, and leads to strong, consistent performance across the system.”

You also may be interested in...

Genome Sequencing Assists Research at Naval Health Research Center

Article
1/24/2023
Lab technicians doing genome research

Learn how unique samples from naval vessels, US-Mexico border populations, and DOD beneficiaries aided in the Naval Health Research Center’s sequencing efforts.

Recommended Content:

Research & Innovation | Coronavirus & the MHS Response | Coronavirus

U.S. Military HIV Research Lends Lessons Learned to COVID-19

Article
1/19/2023
Gloved hands working in laboratory

The U.S. military has engaged in HIV research for three decades, contributing critical lessons learned, knowledge, and expertise during the COVID-19 research and vaccine development effort.

Recommended Content:

Coronavirus & the MHS Response | DOD HIV/AIDS Prevention Program | Research & Innovation | Coronavirus

Naval Medical Research Center Uses Genome Sequencing for Variants

Article
1/12/2023
Military personnel pose for a group photo

NMRC’s efforts provided important support for sequencing and viral isolation to the Department of Defense and Military Health System.

Recommended Content:

Research & Innovation | Coronavirus & the MHS Response | Coronavirus

“Call for Abstracts” Opens for 2023 MHS Research Symposium

Article
1/10/2023
Attendees enjoying the 2022 MHSRS scientific poster presentation

Preparations for the 2023 MHSRS are currently underway! Learn how you can qualify to present at the DOD's premier scientific meeting for the unique medical needs of the warfighter. (Deadline for abstracts: Feb. 19th)

Recommended Content:

Research & Innovation | MHS Research Symposium

USAMRIID Focuses on Genome Sequencing to Detect Variants

Article
1/5/2023
Military medical personnel in laboratory

A connected family of laboratories across the MHS allows a more rapid response to the outbreak.

Recommended Content:

Research & Innovation | Coronavirus & the MHS Response | Coronavirus

Whole Genome Sequencing at Tripler Army Medical Center

Article
12/29/2022
Dr. Keith Fong reviews data with other lab technicians

The third installment in a 6-part series highlighting the efforts of the Military Health System laboratories and the technicians who worked to identify COVID-19 variants using special sequencing technology.

Recommended Content:

Coronavirus & the MHS Response | Research & Innovation | Coronavirus

Walter Reed Army Institute of Research Implements SARS-CoV-2 Genome Sequencing

Article
12/23/2022
Military medical personnel in laboratory

This is the second article in a 6-part series that highlights the work of technicians and scientists in Military Health System laboratories who worked to identify COVID-19 variants using special sequencing technology.

Recommended Content:

Global Health Engagement | Coronavirus & the MHS Response | Research & Innovation

DHA Leaders Accept Prestigious Award on Behalf of NATO Working Group

Article
12/19/2022
Mark Goodge, DHA Division Chief, accepts award

Recommended Content:

Global Health Engagement | Health Care Technology | Building Partner Capacity and Interoperability | Global Health Security Agenda

Military Labs Use Whole Genome Sequencing of COVID-19 Variants

Article
12/16/2022
Lab technician at work

The first in a 6-part series highlighting the work of technicians and scientists working in support of the MHS who identified COVID-19 variants using special sequencing technology.

Recommended Content:

Research & Innovation | Coronavirus & the MHS Response | Coronavirus

Blast Overpressure Research Brings NATO Group to DHHQ

Article
12/13/2022
Military personnel fire mortar rounds

DOD and NATO experts recently met to continue their work on warfighter brain health to protect soldiers from the overblast pressure of their weaponry.

Recommended Content:

Research & Innovation | Brain Injury Awareness | Traumatic Brain Injury Center of Excellence

Air Force Veteran Honored Posthumously at Medical Research Symposium

Article
11/29/2022
Steven Rodriquez (left), and wife, Christine Rodriquez (center), accept a posthumous award for Dario Rodriguez from Seileen Mullen, the acting Secretary of Defense for Health Affairs.

U. S. Air Force Chief Master Sergeant (Ret.) Dario Rodriquez is posthumously awarded the Distinguished Service Award at MHSRS 2022

Recommended Content:

Health Care Technology | Health Readiness Support

Operating at Speed of Relevance, Key to Great Outcomes, DHA’s Maturation

Article
11/21/2022
Photo of U.S. Army Lt. Gen. (Dr.) Ronald Place, Christianne Witten, and DHA Senior Enlisted Leader Command Sgt. Maj. Michael Gragg

DHA’s reputation built on speed of relevance in COVID pandemic, which helped it mature as an operational combat support agency.

Recommended Content:

MHS GENESIS: The Electronic Health Record | Ready Reliable Care

Military Health Symposium Research Shapes Future of Warfighter Health

Article
10/5/2022
U.S. Army Col Jennifer Stowe presents her research from behind a podium at the MHSRS meeting 2022.

Scientific session at the Military Health System Research Symposium highlights research addressing critical military medical issues.

Recommended Content:

Research & Innovation | MHS Research Symposium

Cutting-Edge Science Featured at Military Health System Research Symposium

Article
9/15/2022
Ms. Seileen Mullen, the acting assistant secretary of defense for health affairs, makes opening remarks during the Military Health System Research Symposium at the Gaylord Hotel in Kissimmee, FL on Monday, September 12, 2022. MHSRS provides a collaborative setting for the exchange of information between military providers with deployment experience, research and academic scientists, international partners, and industry on research and related health care initiatives, such as Combat Casualty Care, Operational Medicine, Clinical and Rehabilitative Medicine, Medical Simulation and Information Sciences, and infectious Diseases.

The 2022 Military Health System Research Symposium, held in Kissimmee, Fla., opened this week after a two-year pandemic hiatus. The audience was enthusiastic as MHS leaders shared their opening remarks.

Recommended Content:

Research & Innovation | MHS Research Symposium

Research Symposium Recognizes 2022 Award Winners

Article
9/15/2022
Dr. Sumil Shah accepts the Outstanding Program Management (Team) Award, along with some members of his team from Ms. Seileen Mullen, the acting secretary of Defense for Health Affairs. MHSRS provides a collaborative setting for the exchange of information between military providers with deployment experience, research and academic scientists, international partners, and industry on research and related health care initiatives, such as Combat Casualty Care, Operational Medicine, Clinical and Rehabilitative Medicine, Medical Simulation and Information Sciences, and infectious Diseases.

The 2022 Military Health System Research Symposium highlighted and honored innovative researchers dedicated to help the warfighter on and off the battlefield.

Recommended Content:

Research & Innovation | MHS Research Symposium
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 6
Refine your search
Last Updated: January 25, 2023
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery