By Donna Farley

This briefing offers the demonstrations findings, which rfile successes and demanding situations, how difficulties have been addressed, and systemic concerns.

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Additional info for Implementing the Post-Deployment Health Practice Guideline: Lessons from the Field Demonstration

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Sites need to know that they will get timely and efficient responses to their inquiries. , for appointment systems, use of diagnosis codes, DoD forms). Second, the central monitoring of implementation progress and the PDH metrics is a specialized function that is key to assessing implementation progress and ensuring ongoing use of desired practices. This function tends to be overlooked and understaffed, which can compromise long-term success in institutionalizing the desired new practices. An early decision should be made regarding where this function is to be housed for monitoring of the PDH guideline, and it should be staffed as soon as possible.

Decisions also need to be made regarding which, if any, information or metrics the local facilities will be required to report to OSD/HA. In response to this issue, OSD/HA has turned to the TRICARE Management Activity’s National Quality Management Program, which is monitoring the PDH guideline’s deployment in FY 2002 and those projected for FY 2003. Routine reporting of selected process measures also might be useful to stimulate actions and document progress. Examples of measures include the percentage of visits for which the screening question is asked, rates at which patients report PDH concerns, the type of concerns identified, and rates of referrals to the DHCC for further actions.

For this demonstration, none of the sites provided specific dedicated time to members of their implementation teams with the exception of the time provided to attend the kickoff conference. The champions reported that dedicated time was not a major issue, in part because each team had been applying the guideline in only one clinic. Time demands are likely to become more important when the teams begin to introduce the new PDH practices across all clinics and other facilities at their sites. ) # 13 Ongoing and visible monitoring: Achievement of effective monitoring requires use of consistent coding of health care encounters followed by regular and consistent measurement of the guideline metrics and other monitoring indicators.

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