A Message from the Navy Surgeon General: Okay, Here’s The Deal – MHS Review

By Vice Adm. Matthew Nathan

Vice-Nathan-Cutout-no-cover-for-web-271x300On May 28th, Secretary of Defense Hagel ordered a comprehensive 90-day review of the Military Health System (MHS).

This very comprehensive review examined access, patient safety, and quality of care primarily in military treatment facilities. This review provided us the opportunity to compare ourselves to national benchmarks as well as against systems currently considered to be leading edge. The review findings, recommendations, and the SECDEF’s memo articulating the way forward were released on October 1st.

Bottom Line Up Front: The consensus of both the external and internal review experts found that “the MHS is comparable in access, quality, and safety to most major health care systems in the United States.”

In some cases we are outperforming the nation’s best.  In some cases we are on par, and in some areas we are lagging. The review also found performance variability compared to national benchmarks . This type of critical self-assessment is essential for our continuous improvement. There will be more to come as we aggressively implement changes to address the review’s recommendations and meet all our expectations.  Not the least of which is a more collective enterprise approach across the Services as to how we all measure, improve, and display our performance. In addition the DOD will need more visibility of those same measures where we purchase care from the private sector.

The review and our metrics indicate that every single one of our facilities perform above standard in some areas and also lag in others, no two are the same.  But as Secretary Hagel told the press, the review found that every one of our MTF’s has the foundation for safe and effective care. We were asked in that press conference how we would message this to our personnel; that our system was found to be “average” in light of the SECDEF stating that average is not acceptable for the most precious patients in the world, those that serve our nation, their families, and those that served before.

As the SECDEF stated in regard to the variability and opportunities to improve,  “Our military health system has responsibilities beyond the battlefield, and our review focused on noncombat care. The review found pockets of excellence – significant excellence, which we’re very proud of -and extraordinary doctors, nurses and staff who are deeply dedicated to the patients they serve.”

I answered on the record there is no doubt we are recognized as second to none in combat casualty care.  Our success and dedication to performance in the battlefield will serve as our model.  We will strive to match that reputation across our entire MHS, so when someone is asked to name a world famous healthcare name, they will think of us first. We will take our entire MHS system from good, to great, to greatest. I acknowledged  that was ambitious but we have the key ingredient necessary…you!

And Shipmates, here is what makes YOU extraordinary and why I am so proud to be numbered among you. While you serve in the smallest clinic to the largest medical center, you stand up when called and step forward when needed. You have moved seamlessly, yet often with great sacrifice, into war, disaster, and human suffering across the seas and on them. Yes, we will energize our system to be the envy of all others not only in our access, quality, and safety; but we will continue to garner the respect of all Americans as we stand the watch on a labor deck, a battlefield, a stormy sea, or those suffering where we bring hope.

I’ve said it before, and I will say again. If I am asked to give a few reasons why I am so sure we will deliver on this commitment I always answer, “I will give you 63,000 reasons, and each one will make a difference every day.” Never, ever, under estimate the difference you make to so many. Take care of those who rely on us, take care of each other, and take care of yourself.  Ship, Shipmate, Self.