The purpose of the current study was to identify and describe the skills required of future health care leaders in the U.S. Department of Defense, Department of Veterans Affairs, and the Department of Health and Human Services. The identified skills should also be relevant to leaders of nonfederal agencies or nonmedical disciplines, such as education, human services, and similar public sector‐oriented disciplines, where the leaders are challenged to engage with a multitude of local, state, federal, and not‐for‐profit entities. The study employed a focus group methodology during a 2‐day leadership summit. The participants were 47 senior health care leaders representing various federal agencies and the private sector. During facilitator‐guided sessions, six focus groups consisting of seven or eight randomly selected participants identified 165 skills that are required of leaders. Subsequent to the summit, content analysis was used to group the skills into 12 overarching skill sets. The 12 skill sets were the ability to build partnerships, develop trust, thrive in complex and ambiguous environments, listen actively, think with agility, create conditions for success, assert aspirational future‐based leadership, develop present moment awareness, create an interagency learning network, develop network leadership, develop network goal setting, and maintain resilience. It appeared that only the first six skills were noted in the literature. Further research is recommended to validate the findings including further investigation into the leadership competencies that are most effective at driving health and non health outcomes in communities.

The purpose of this article is to propose a model for reengineering military community hospitals, as well as medical centers, to adapt to the extraordinarily rapid and complex changes that are being made to the Military Health Services System. This article analyzes the changes taking place and discusses how a particular organizational model, the Medical Group Practice Model, can enhance quality and patient satisfaction in a capitated managed care environment. The phased implementation, structure, and performance management of the model are described, as is the model's advantages and disadvantages.

This case study describes the Military Health System's (MHS) patient-centered medical home (PCMH) initiative and how it is being delivered across the MHS by the Army, Navy, and Air Force. The MHS, an integrated delivery model that includes both military treatment facilities and civilian providers and health care institutions, is transforming its primary care platforms from the traditional acute, episodic system to the PCMH model of care to maximize patient experience, satisfaction, health care quality, and readiness and to control cost growth. Preliminary performance measures are analyzed to assess the impact of PCMH implementation on the core primary care processes of the MHS. This study also discusses lessons learned and recommendations for improving health care performance through the PCMH care model.

This research identifies the perceptions of U.S. military service members regarding the Department of Defense Anthrax Vaccine Immunization Program (AVIP). The service members' perceptions were addressed in the dimensions of ethics, effectiveness, and safety, as well as the overall perceptions of the AVIP. The study, conducted in October 2004, randomly selected active duty service members from the uniformed services assigned to a Caribbean military base who participated in the AVIP during the period of 1998 to 2000. Their perceptions were measured with a survey instrument with 14 closed-ended, Likert-scale questions. The research demonstrated that a substantial number of service members disagreed with issues regarding the ethics, safety, and efficacy of the AVIP. We recommend enhanced training and education to increase understanding of the benefits of the AVIP.

This case study describes the innovative and unique U.S. Army Wounded Warrior Program (AW2), which provides nonmedical case management to the most severely wounded, injured, and ill soldiers and their families. The study describes the program and identifies the features for a successful nonmedical case management program of an identified population who has complex medical needs. Although the article focuses primarily on the role of the AW2 advocate, key components of the program are discussed, including successful initiatives as well as areas that required adjustment. The lessons learned are identified as well as recommendations for future nonmedical case management initiatives.

This paper reports results from a Delphi study conducted among the Commanders and Deputy Commanders for Administration of 37 Army medical treatment facilities (MTFs), who identified the most important issues challenging their institutions for the remainder of this decade, and the skills, knowledge, and abilities required by MTF leaders to deal successfully with those challenges. A Delphi mail-out was conducted in two iterations. Respondents identified 187 health care issues which were divided by content into nine domains by a panel of health care experts. The domains, ranked by importance, were cost-finance, health care delivery, access to care, quality and risk management, technology, professional staff relations, leadership, marketing, and ethics. In the second Delphi iteration, MTF leaders agreed upon the necessary skills, knowledge, and abilities of future leaders. Results indicated that future leadership will require enhanced financial, quantitative, and technical skills, as well as competence in a broad array of interpersonal and communication skills. Implications for military medical leader development initiatives are discussed.

Increasing patient financial responsibility and patient-physician shared decision making can impact patient engagement. Understanding the predictors of patient engagement and the factors that influence financial behaviors may allow for the development of interventions to enable patients to make better healthcare decisions, and ultimately, improve health outcomes.

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