Surgeons use a surgical robot to perform a procedure. Management of surgical practices often varies from Army MTF to MTF. To ensure a consistent patient experience, quality and safety of care, and surgical teams that are ready to deploy, Army Medic...
The need for health care systems to create effective change has led many to adopt the service line concept to improve efficiency and safety. A service line is an organizational team responsible for developing a strategy for ensuring accountability, increasing efficiency, and improving and sustaining standard processes in a clinical area.
Army Medicine has been developing service lines for seven clinical or administrative functions: surgical services, telehealth, women's health, behavioral health, primary care, physical performance, and the Integrated Disability Evaluation System.
One of the first service lines implemented is for surgical services. Its program designer, Lt. Col. Matthew Welder, Office of the Surgeon General, explained that, for surgery, the service line concept grew out of the recognition that there was no easy way to centrally manage and standardize surgical processes.
Welder said three factors needed emphasis to implement a service line for surgery: a consistent patient experience, quality and safety of care, and surgical teams that are ready to deploy. Furthermore, one central management point was needed in the Army Medical Department, he added.
To help provide guidance to managers at medical treatment facilities (MTFs), the surgical service line team has also created an implementation manual for surgical services.
Central management becomes very important when cost oversight is considered. Currently, 25 Army MTFs have surgical capability, and the cost for surgical services was about $1 billion in FY 2013.
The Surgical Services Line team, however, already reports a projected cost savings of $39 million as a result of process and practice changes.
Telehealth, the use of telecommunications to connect clinical personnel and patients across great distances, is another critical service line well on its way to being fully implemented. Although the Telehealth Service Line supports a number of clinical areas, for example, radiology, dermatology and cardiology, nearly 90 percent of patient encounters using telehealth are for behavioral health.
Behavioral health and telehealth capabilities are two clinical areas that significantly enhance the value of the other. Dr. Colleen Rye, Chief, Telehealth Service Line, pointed out that providing behavioral health services using telehealth following the Fort Hood shootings helped to shift workload and make additional crisis counseling series immediately available.
The Women's Health Service Line is getting ready, too. In 2011, the Women's Health Task Force produced a white paper on various female-specific health issues. While the Women's Health Task Force focused on deployment health, the Women's Health Service Line will extend that focus and include adopting best practices that emphasize women's health management and readiness in all clinical environments. The service line will promote wellness in female patient care across the entire range of care settings, develop and execute perinatal initiatives, and standardize provider capability and capacity.
The Physical Performance Service Line aims to enhance Soldier physical readiness, health and fitness. Injury prevention, identification and management of injuries, and rehabilitation and reintegration programs for Soldiers and their Families will help promote optimal human performance and improve health and resilience of the Force. In order to accomplish these goals, the Physical Performance Service Line will work to synchronize efforts by medical providers and unit leaders to promote healthy decision making. Ultimately, force readiness will improve as a result.
One target of all service lines is to ensure consistency of service from MTF to MTF for all clinical areas. In the past, no two MTFs or Regional Health Commands have operated exactly the same way, and even the data that are available to measure performance may vary.
Because data to assess improvement is critical to the service line process, a central data collection and management tool, the Army Strategic Management System, or SMS, is used to interpret and assess data. Accurate data will lead to more informed decision making in the future.
The service lines will help Army Medicine transform into a high-reliability organization, improving productivity, increasing efficiency, and ensuring prudent financial management. The end product will increase emphasis on both health readiness of the Force and patient safety.
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