Book Description

The Office of the Secretary of Defense/Office of Health Affairs (OSD/HA) is working with the Deployment Health Clinical Center, the Army Quality Management Directorate, and the Army Center for Health Promotion and Preventive Medicine in the implementation of the Department of Defense (DoD) / Department of Veterans Affairs Veterans Health Administration (VA) practice guideline for primary care management and evaluation of patients with post-deployment health (PDH) concerns. This guideline was implemented throughout the Military Health System beginning in January 2002. Under a contract with the Army Medical Department, RAND contributed to preparation for this initiative by (1) providing technical support to the leadership team, (2) guiding design of a demonstration in which the practice guideline and implementation approaches were field-tested, and (3) performing an evaluation of the demonstration. The evaluation was designed to provide information from the field to help DoD establish policy and practices for effective use of the PDH guideline across the Military Health System. Work on this project began in December 2000 under the policy direction of OSD/HA and its collaborating agencies. A tool kit of materials to support use of the guideline was prepared and key metrics were selected for monitoring implementation progress. Three military treatment facilities (MTFs) agreed to participate in the six-month demonstration, which began in March 2001 with a two-day conference at which the MTF teams prepared implementation action plans. This documented briefing presents the results of the RAND evaluation of the field demonstration for implementation of the PDH practice guideline. The primary audience for the document is the leadership of the Military Health System, but the findings also should be of interest to policymakers and practitioners interested in effective use of practice guidelines to achieve clinical practice.