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Leading Practices Program

Banner says Clinical Quality Improvement Leading Practices Program

The Leading Practices Program (LPP) is a new DHA awards initiative with the goal of finding local leading practices and supporting their spread and scale to other facilities. A “leading practice” is a measurable health service, process or solution that efficiently and consistently improves targeted outcomes while maximizing value.

2020-2021 LPP Winner Spotlight

Picture of Army Maj. (Dr.) Eliza Szymanek Congratulations to Army Maj. Eliza Szymanek and the team at Madigan Army Medical Center for winning this year’s LPP!

Their practice, “Implementation of Direct Access Physical Therapy within the Military Medical System (LPP_42),” uses an algorithm to identify service members for “direct access” physical therapy sick calls. Results show decreased long-term disability and placement on permanent profile as well as a reduction in imaging, medications prescribed, and number of physical therapy visits scheduled.

About the LPP

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2020-2021 LPP Finalists

Learn more about the finalists by downloading the Winner and Finalists Guide.

Program Summary
A Musculoskeletal Triage Decision Support Tool Improves Readiness Outcomes

Implements a dynamic system for musculoskeletal disease (MSD) management in outpatient rehabilitation and orthopedics, including a classification/triage system, decision support tool, and outcomes collection through the Military Orthopaedic Tracking Injuries and Outcomes Network (MOTION) to quality-assure care and inform readiness decisions.

Transforming Military Primary Care to a Value-based Model through QUiC Clinics (Quality, Urgent, internet and phone Care)

Improves access to care, improves health outcomes, and lowers cost by incentivizing patient experience and prevention through a value-based operating model as opposed to traditional "Fee for Service" models.

Stemming the Hidden and Harmful Practice of Preemptive and Inappropriate ED Transfers in an Army MEDCEN

Implements a policy to reduce the number of inappropriate transfers from the facility emergency department to civilian hospitals by requiring physicians to admit all patients for which CRDAMC has the capacity and capability.

Implementation of PACT-Together, a brief cognitive behavioral group therapy targeting suicidal ideation and behaviors

Implements a targeted cognitive behavioral treatment in a group setting for suicidal ideation/behaviors within the Intensive Outpatient Program, as opposed to traditional outpatient treatment which targets the primary diagnosis alone.

No Show Rescue

Primary Care Providers were encouraged to contact patients at the time of no-shows, converting to virtual visits where appropriate, reducing facility cost by reducing the number of no-show appointments.

Colorado Pain Initiative Leads to increased provider awareness of opiate prescription risk, decreased chronic opiate use & chronic pain awareness

Establishes a Primary Care Pain Advisory Committee, Sole Prescriber Agreement (SPA), and Advanced Pain Management Course (APMC) training to improve primary care and specialty care awareness of appropriate chronic pain management.

Technology (Tech) into Care

Implements training and bi-weekly facilitation calls to promote provider use of behavioral health mobile apps in clinical care as well as surveys to monitor the implementation effort.

Systems-Based Strategies Improve Positive Screening FIT Follow Up and Reduces Time to Diagnostic Colonoscopy

Implements a protocol for automatic gastroenterology referral following positive non-invasive colorectal cancer screening.

Mass Immunization Clinic Operations During a Pandemic

Revises vaccination processes with additional locations, appointment setting, COVID-19 screening prior to entry, limited capacity and social distancing, efficient clinic flow, adequate PPE for all staff, daily temperature checks and proactive monitoring of exposures for all staff, and contact tracing logs for all patients.

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