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Implementation Science Success Stories

walk-in Walk-In Contraceptive Services

  • Partner: Women’s Health Clinical Management Team
  • Need: Establish walk-in contraception services across the MHS to optimize warrior readiness and pregnancy planning throughout the reproductive years.
  • Knowledge Product/Practice: Defense Health Agency Administrative Instruction 6025.09 required 130 military hospitals and clinics to launch WiCS at their facilities within a three-month timeframe.
  • Process: Assisted in development of compliance standards; created a standard training module, implementation guides, and communication resources; supported biweekly WiCS champion workgroup meetings.
  • Results: 100% of the hospitals and clinics successfully established WiCS by the target date.

hiv HIV Pre-Exposure Prophylaxis

  • Partner: Tri-Service Infectious Diseases Working Group
  • Need: Increase in awareness of HIV pre-exposure prophylaxis among MHS providers and Active Duty Service Members at risk for HIV infection.
  • Knowledge Product/Practice: PrEP is a daily pill that lowers risk of HIV infection by up to 99% when taken as prescribed.
  • Process: Facilitated development of stakeholder group with wide range of experience in HIV prevention, awareness, and treatment. Developed dissemination and implementation materials, including provider-facing trainings, toolkits, and reference guides, and patient-facing infographics.
  • Results: The HIV PrEP stakeholder group continues to execute communications and implementation plans with a goal of increasing the PrEP prescription rate in the MHS by 25% by 2025.

colorectal Colorectal Cancer Screening

  • Partner: Primary Care Clinical Community
  • Need: Increase in awareness of new colorectal cancer screening guidelines for the 200,000 additional beneficiaries now eligible for screening.
  • Knowledge Product/Practice: The Fecal Immunochemical Test is a non-invasive, stool-based at-home test to screen for colorectal cancer in those at average risk.
  • Process: Developed and executed communications campaign, created Patient Toolkit, and designed provider resources.
  • Results: Increased colorectal cancer awareness efforts to reduce performance gap resulting from COVID-19 pandemic on preventive wellness screenings.

direct Direct Access to Physical Therapy

  • Partner: Neuromusculoskeletal Clinical Community/Rehabilitation Clinical Management Team/Enterprise Solutions
  • Need: A standardized process to implement Direct Access to Physical Therapy across the MHS to decrease burden on primary care and improve outcomes for patients with acute NMSK injuries.
  • Knowledge Product/Practice: DAPT is the ability to obtain physical therapy evaluation and treatment without a referral from a physician or other provider after screening criteria are met.
  • Process: Collaborated with a team of physical therapists at Madigan Army Medical Center who developed a DAPT procedure selected as the winner of the 2020-2021 Clinical Quality Improvement Leading Practices Program. Developed a standardized appointing algorithm, provided coding solutions, and gathered extensive stakeholder group to spread and scale DAPT.
  • Results: DAPT was successfully piloted in the Puget Sound Market in 2022 and is now being implemented across the MHS through a phased approach.

postpartum Postpartum Hemorrhage Bundle Campaign

  • Partner: Women and Infant Clinical Community/Women's Health Clinical Management Team
  • Need: A standardized process for identification and treatment of PPH.
  • Knowledge Product/Practice: A Defense Health Agency Procedural Instruction standardized a clinical framework for PPH prevention and treatment and served as the basis for the PPH Bundle Campaign.
  • Process: Supported implementation of the DHA-PI at 12 military hospitals and clinics through the identification of local champions, hosting of peer-to-peer workgroups, development of educational materials, and tracking of compliance data.
  • Results: Campaign exceeded its target compliance rate of 80% by achieving 97% compliance overall. The bundle was then implemented across all 42 military hospitals and clinics with inpatient obstetrics services; as of January 2023, the MHS-wide average compliance rate was 93%.

opioid Opioid Overdose Education and Naloxone Distribution Program

  • Partner: Defense and Veterans Center for Integrative Pain Management
  • Need: Increase co-prescriptions of naloxone to improve patient safety.
  • Knowledge Product/Practice: Provide OEND training via sustainable, scalable model.
  • Process: Refined VA OEND training for MHS population; drafted key messaging for dissemination campaign; provided OEND training to interdisciplinary group at pilot site; embedded training in TeleECHO and annual pharmacy trainings; and utilized train-the-trainer model of implementation.
  • Results: 11% increase in naloxone co-prescriptions at pilot site following training implementation.

damage Damage Control Resuscitation

  • Partner: Joint Trauma System
  • Need: Standardized, systematic methodology for collating clinical recommendations across clinical practice guidelines.
  • Knowledge Product/Practice: Standardize subcategories of clinical recommendations to highlight the most important guidance.
  • Process: Developed strategies for efficient implementation of CPGs, including a CPG deconstruction tool and a summary of CPG updates; conducted successful dissemination campaigns of Damage Control Resuscitation and COVID-19 CPGs through infographics and pocket guides.
  • Results: Improved translation of research recommendations into condensed, actionable formats to ease clinical applications across the MHS.

 

  

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Last Updated: August 10, 2023
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