Back to Top Skip to main content Skip to sub-navigation

Ready Reliable Care Framework is Improving MHS Patient Care

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 and Innovation | Technology | Readiness Capabilities | Ready Reliable Care | 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...

DHA’s Mobile Apps Can Help You with Overall Wellness

Article
9/30/2021
A smartphone user using the DHA's Air Force MissionFit app

Healthcare and wellness apps developed by the DHA are proliferating.

Recommended Content:

Technology

Introduction to the Safety Communication Bundle

Video
9/30/2021
Still of the 6 Standardized Practices Support High Reliability video

This video clip provides the viewer with a brief overview of the Ready Reliable Care Safety Communication Bundle.

Recommended Content:

Ready Reliable Care

Since 9/11, These 8 Military Medical Advancements are Saving Lives

Article
9/14/2021
Retired U.S. Army Sgt. Derek Weida jokes with a physician during his prosthetic leg fitting at a prosthetics clinic in Las Vegas in April 2018.

Years of military conflict in Iraq and Afghanistan brought innovations that completely transformed the Military Health System's approach to combat casualty care. Here's a list of just a few ways military medicine has evolved in the two decades since the 9/11 attacks.

Recommended Content:

Research and Innovation | Technology | MHS Remembers 9/11 | 20th Anniversary of 9/11: Call-to-Action

Federal leaders highlight electronic health record changes at HIMSS

Article
8/31/2021
Federal leaders being interviewed

The new Federal electronic health record delivers data to healthcare teams wherever a patient receives treatment.

Recommended Content:

Technology | Federal Electronic Health Record Modernization (FEHRM) Program Office | Electronic Health Record: MHS GENESIS

DOD's Whole of Government Approach to COVID is Working, Says Adirim

Article
8/13/2021
Dr. Terry Adirim, acting assistant secretary of defense for health affairs, right, speaks during a panel discussion.

Dr. Terry Adirim, said she has been impressed by the DOD’s COVID-19 response since taking over as ASDHA, and that adaptation and innovation have played key parts in that response.

Recommended Content:

COVID-19 Vaccine Efforts | Technology | Telehealth Program | Military Health System Transformation

Ready Reliable Care Carousel Slide

Infographic
8/3/2021

Builds brand awareness and reminds staff of the MHS commitment to high reliability.

Recommended Content:

Ready Reliable Care | Ready Reliable Care Communications Toolkit

DHA-PI 8400.02 Financial Management of Information Technology Systems and Services

Policy

Establishes the Defense Health Agency’s (DHA) procedures to provide overarching guidance, implement procedures, and manage aspects of the Defense Health Program’s (DHP) Financial Management of Information Technology (IT), Systems and Services for the Military Health System (MHS) enterprise. The established procedures apply across the DHA components to include Military Medical Treatment Facilities (MTFs) and Other Lines-of-Business (OLB). Directs the use of Ektropy, the Information Operations (IO) web-based IT planning ledger, to identify all DHP-funded IT personnel and IT-related expenditures, across all Budget Activity Groups (BAGs) and across the Future Years Defense Program (FYDP).

  • Identification #: 8400.02
  • Date: 8/2/2021
  • Type: DHA Procedural Instruction
  • Topics: Technology

Ready Reliable Care Communications Toolkit

Publication
7/29/2021

This digital Ready Reliable Care Communications Toolkit provides resources to help you brief, educate, engage, and celebrate Ready Reliable Care across your team or facility.

Recommended Content:

Ready Reliable Care | Ready Reliable Care Communications Toolkit | Ready Reliable Care Communications Toolkit

Revamped Virtual Med Center Makes Health Care Feel Like a Video Game

Article
7/26/2021
Picture of the Virtual Medical Center

The Virtual Medical Center, a joint Department of Defense/VA incentive, is relaunching by the end of summer, leveraging emerging technologies to increase and improve accessibility, convenience, and efficiency of medical care for all registered users.

Recommended Content:

Technology | Research and Innovation

DHA releases App to Support Service Member Recovery

Article
7/26/2021
Infographic for the Antidepressant Adherence app

To ensure that military beneficiaries receive the support they need to continue on their mental wellness journey, the Antidepressant Adherence app supports those taking medication

Recommended Content:

Psychological Fitness | Depression | Technology

Military Medical Research Leads to 18 New Cancer Drugs, other Devices

Article
7/14/2021
a patient prepares for a PET scan

A hub of cutting-edge healthcare innovation financing since the early 1990s, the CDMRP is well known among medical researchers around the world.

Recommended Content:

Research and Innovation | Medical Research and Development

Military Health System Transformation Will Improve Care & Innovation

Article
7/6/2021
Infographic about Health Innovation Month

MHS Innovation Must Be Backed by Best Practices, Standardization

Recommended Content:

July Toolkit | Health Innovation – Pathways to Ready Reliable Care | Health Innovations across the MHS Enterprise | Health Innovation Month | Research and Innovation | Military Health System Transformation | MHS Research Symposium

DHA Spearheads Effort for Working Dog Research Collaboration

Article
6/25/2021
Picture of three different dogs

Working Dog Forum explored research to keep dogs in top form.

Recommended Content:

Combat Support | Veterinary Service | Public Health | Research and Innovation

Medical Advances Since Gulf War Boil Down to Increased Lives Saved

Article
6/25/2021
Medical personnel training on how to treat a neck wound

Not all medical advances since the first Gulf War are highly technical.

Recommended Content:

Combat Support | Research and Innovation | Health Innovation Month

Connected Health Hosts First DHA Digital Health Virtual Summit

Article
6/16/2021
Graphic about the DHA Digital Health Virtual Summit

The Defense Health Agency Connected Health branch hosted the inaugural DHA Digital Health Virtual Summit that provided insight on the accelerated world of digital health in the Military Health System.

Recommended Content:

Technology | Defense Health Agency
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 20

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.