E-Book Overview
This guide describes a process that will help your MTF successfully achieve evidence-based practice, a major priority of the DoD
E-Book Content
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PREFACE
The DoD and the VA have placed a priority on the standardization of care in the military and VA health systems to achieve greater consistency, quality, and cost-effectiveness in the delivery of health care services for active duty personnel, dependents, and retirees. In this context, the Army Medical Department (AMEDD) has been working in partnership with RAND to implement DoD/VA clinical practice guidelines proactively across the Army health system. One of the key products of this AMEDD/RAND partnership is an Implementation Guide designed to assist Army medical treatment facilities (MTFs) in guideline implementation. The response to the guide was so enthusiastic within the Army that it was decided the guide should be adapted for use across the DoD. This Implementation Guide is designed as a resource for those key staff members charged with carrying out the guideline implementation effort within an MTF. The guide contains information, instructions, and examples for each of the major steps in implementing a practice guideline: establishing supportive conditions and an implementation structure, building an effective Implementation Action Team, developing and executing an implementation action plan, and monitoring and feedback on implementation progress. In preparing the guide, RAND has drawn upon current knowledge from both research and field experiences, including many valuable lessons learned from the field in the AMEDD/ RAND Guideline Implementation Project (see Introduction for a description). This project is being sponsored by the U.S. Army Medical Department and is being conducted jointly by the Arroyo Center’s Manpower and Training Program and RAND’s Center for Military Health Policy Research. The Arroyo Center is a federally funded research and development center sponsored by the United States Army.
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For more information on the RAND Arroyo Center, contact the Director of Operations, (310) 393-0411, extension 6500, or visit the Arroyo Center’s Web site at http://www.rand.org/organization/ard/
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ACKNOWLEDGMENTS
The preparation of this Implementation Guide has drawn upon theory, published literature, and field experience in the AMEDD/RAND demonstrations for guideline implementation. We have used the theory and published literature to ensure that the guide is evidence-based, but we believe the most important contribution to this document has been the valuable information the AMEDD/ RAND Guideline Implementation Project (see Introduction) has generated on implementation practices in the military environment. We extend our appreciation to the numerous individuals, from commanders to front-line clinic staff, who have put forth an extraordinary amount of commitment and hard work in the AMEDD demonstrations. We are particularly pleased to be able to distribute this guide to MTFs across the DoD. The content of the guide has benefited from the hands-on experiences of front-line guideline implementers at Army MTFs and we are confident that the implementation process described will be readily applicable to MTFs in the other DoD services. Many individuals have been involved in the production of the Implementation Guide, helping to make it a more useful product. We wish to thank Dr. Jill Yanchick, LTC Kathryn Dolter, MAJ Geralyn Cherry, and other AMEDD personnel for their helpful feedback in reviews of an earlier draft. We also acknowledge the efforts of the leadership team at MEDCOM who have guided this project and have worked in active partnership with RAND in conducting the demonstrations and developing tools to assist the MTFs in their implementation activities. Their collective commitment to effective application of