If you've ever twisted your ankle and seen it swell up size of a softball, you know that having it examined quickly by an experienced professional is important to prevent further injury.
But that doesn't necessarily mean seeing a medical doctor in the emergency room.
Getting service members back in mission-ready shape quickly and efficiently can help save time and money, reduce the need for medication, and minimize the time lost at work or for training. That's why a project at the Madigan Army Medical Center, located at Joint Base Lewis-McChord, Washington, employing an algorithm aimed at speeding up the process of soldiers needing to see a physical therapist, has won an inaugural innovation award through a program at the Defense Health Agency.
The award-winning algorithm is like a checklist that helps hospitals and local clinics sort through its potential patients and identify those individuals with ailments or injuries that will benefit most from immediate access to medical care.
The Clinical Quality Improvement (CQI) Leading Practices Program (LPP) is a new awards program that aims to improve care across the Military Health System (MHS). The DHA's LPP initiative has a goal of finding local innovative practices and supporting their spread and scale to other facilities. The winning leading practice, called "Implementation of Direct Access Physical Therapy Within the Military Medical System," along with the other top 10 finalists, was selected at the end of April.
"We wanted to make sure our patients could get in to see us sooner," explained Army Maj. Eliza Szymanek, a physical therapist (PT) who led the winning team at Madigan. Her team implemented the performance improvement project to provide timelier care for acute musculoskeletal conditions in the active-duty population.
"Typically for a specialty care clinic, the referral process can be up to 28 days," she said. "Creating that availability in our schedules was important to us - to see somebody with an acute ankle pain on the same day versus four to six weeks later is super important."
Szymanek and her team at Madigan presented their project along with an algorithm used to identify service members for "direct access" physical therapy sick calls. Results show a host of tangible benefits, including a 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. A Soldier with a permanent profile is limited on the amount of physical activities that they can do.
The spread and scale of the winning Madigan practice will also be supported by Irwin Army Community Hospital at Fort Riley, Kansas. Irwin's own submission took second place with a musculoskeletal triage decision tool called the "Military Orthopedic Tracking Injuries and Outcomes Network (MOTION)," to monitor the improvement of readiness outcomes.
"Out of 76 total submissions this year, various subject matter experts selected these practices as having the greatest potential to make a critical impact on health care delivery and patient outcomes while maximizing value across the MHS," the DHA announced.
Every PT at Joint Base Lewis-McChord's five clinics is a provider with a doctoral level degree and both diagnostic and prescriptive capabilities.
The submission "went through a multi-phase, multi-faceted, rigorous evaluation process," said Dr. Chin Hee Kim, chief of the Clinical Quality Improvement Program at DHA, who is responsible for the development and execution of a sustainable program to identify and implement locally led leading practices (CQI LPP).
"Maj. Szymanek's submission contained strong pilot data to support the impact, and was feasibly replicable and scalable," Kim said.