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...

Frontline Expeditionary Dental Care is Near-Time Reality

Article Around MHS
1/26/2023
Field Portable Dental System

U.S. Army Medical Materiel Development Activity’s Warfighter Deployed Medical Systems is working to modernize several field deployable dental treatment systems to provide dental treatments to warfighters in a not-so typical way.

Recommended Content:

Dental Health | Research & Innovation

U.S. Army Medical Laboratory Forges Relationship with Australian Defence Force Institute

Article Around MHS
1/25/2023
Military personnel in medical laoratory

American soldiers from the 1st Area Medical Laboratory were hosted by their counterparts at the Australian Defence Force Malaria and Infectious Disease Institute in Brisbane, Australia. Find out what was discussed at this meeting to strengthen critical relationships, save lives, and enable both sides' mission readiness.

Recommended Content:

Building Partner Capacity and Interoperability | Health Readiness & Combat Support | Research & Innovation

Army Medical Logistics Command Focuses on Medical Readiness of National Guard Reserve Units

Article Around MHS
1/11/2023
Military personnel at workshop

U.S. Army Medical Logistics Command leaders meet to tackle the challenges of ordering medical equipment and supplies. Find out about the strategies behind "Medical Logistics in Campaigning" that will poise Army medical personnel to transition quickly from peacetime at home station to an active operational environment.

Recommended Content:

Readiness Capabilities | Medical Logistics

DOD Aims to Shield Warfighters From Novel Biological Agents

Article Around MHS
1/11/2023
Military personnel in chemical cloud

Newer and more complicated biological battlefield threats are prompting the need for stronger countermeasures. We explain the DOD's new advances in medical countermeasures - including cutting edge technology and artificial intelligence - to keep the warfighters operational and combat ready.

Recommended Content:

Research & Innovation | Chemical and Biological Exposures

Uniformed Services University Professor Develops Self-Diagnosis, Treatment Kit for Common Female Infections

Article Around MHS
1/4/2023
USU infographic with Dr. Elizabeth Kostas-Polston

It's a major research advancement in women's health and females serving in the U.S. military may soon have access to it. See how a new, self-diagnosis and self-treatment kit can help deployed women overseas or in austere environments.

Recommended Content:

Uniformed Services University of the Health Sciences | Research & Innovation | Women's Health

Air Force Research Laboratory Launches Wearable Biomolecular Sensors Program

Article Around MHS
12/29/2022
Military personnel demonstrating a wearable human performance monitoring device

It's like an aircraft's "black box" - that Soldiers wear. Learn about the research collaboration that will literally "arm" warfighters with a sensor to track their well-being during critical missions, predicting performance and health issues before they occur.

Recommended Content:

Research & Innovation | Health Care Technology

Tele-Critical Care Brings New Capability to Womack Army Medical Center

Article Around MHS
12/27/2022
Military medical personnel demonstrating new tele-critical care medicine

This groundbreaking new tool gives critically ill patients access to 24/7 monitoring by deploying medical experts who can get them help immediately. See how it works, and why military medical experts are calling it the fail-safe mechanism that cannot be underestimated.

Recommended Content:

Telehealth Program | Health Care Technology | Research & Innovation

Defense Threat Reduction Agency Celebrates Opening of New Training Center

Article Around MHS
12/27/2022
Defense Threat Reduction Agency members

It's been eight years in the making! Now, learn more about this ceremonial culmination of a large, global collaboration toward preventing future disease outbreaks and biological threats.

Recommended Content:

Research & Innovation | Building Partner Capacity and Interoperability | Biological Threat Reduction Program | Ebola

New “mCurriculum” Launched to Help Surgeons Worldwide Sharpen Skills, Improve Clinical Readiness

Article Around MHS
12/23/2022
Military personnel holding new device developed by USU

Imagine surgeons honing their skills using their smartphone, tablet, or computer. Thanks to a collaboration between the Uniformed Services University, the American College of Surgeons, the Military Health System Strategic Partnership American College of Surgeons, and the University of California, Davis, it's happening. See how this groundbreaking "mCurriculum" is helping surgeons around the globe save lives.

Recommended Content:

Uniformed Services University of the Health Sciences | Education & Training | Health Care Technology

U.S. Army Medical Team Helps Smithsonian National Zoo to Protect Endangered Red Pandas

Article Around MHS
12/23/2022
Red panda at the Smithsonian’s National Zoo

A U.S. Army medical team contributed to an investigation into the cause of death of a red panda at the Smithsonian’s National Zoo and Conservation Biology Institute. The findings will ultimately help to protect the endangered species.

Recommended Content:

Research & Innovation

New Simulation Lab Comes to 22nd Medical Group

Article Around MHS
12/14/2022
Military medical personnel training on CAE apollo mannequin

The 22nd Medical Group unveiled a new simulation lab to provide airmen with hands-on training for future emergency situations on Nov. 30. At the source of the lab is a high-fidelity mannequin with a wide range of life-like features such as breathing, circulation, bleeding, fluid secretions, and speech to deliver realistic simulation-based emergency health care.

Recommended Content:

Health Readiness Support | Research & Innovation

Medical Center of Excellence Publishes Its Medical Company Doctrine Publication

Article Around MHS
11/20/2022
Infographic for Army Techniques Publication 4-02.6

As the U.S. Army’s culture shifts from counterinsurgency or limited contingency operations to large-scale combat operations, medical forces must optimize Army Health System support for maximum effectiveness.

Recommended Content:

Readiness Capabilities

Physicians Perform First Surgery with New Robotics System

Article Around MHS
11/18/2022
Military medical personnel performs surgical procedure

Physicians with the 96th Medical Group completed the first robotic-assisted surgery at Eglin Air Force Base on Nov. 2 Using the unit’s new DaVinci Robotics System, the team performed a successful hernia repair operation.

Recommended Content:

Research & Innovation

Collaboration Ensures Focus on Sustainment for New Army Medical Devices

Article Around MHS
11/4/2022
Military medical personnel testing vet x-ray device

Collaboration between U.S. Army medical materiel developers and sustainers means that new devices fielded to the warfighter not only provide the required capabilities, but also longevity and durability in the field, as well as value to the American taxpayer.

Recommended Content:

Research & Innovation | Health Care Technology Management/Medical Devices

History of Navy Medicine's Research and Development Global Enterprise

Article Around MHS
11/2/2022
Historic image of the Naval Medical Research Institute

Before there was the Naval Medical Research Center (NMRC) there was the Naval Medical Research Institute (NMRI).

Recommended Content:

Our History | Research & Innovation
<< < 1 2 3 > >> 
Showing results 1 - 15 Page 1 of 3
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