Clinical Readiness Program: Refocusing the Military Health System

Abstract

Introduction The Military Health System serves to globally provide health services and trained medical forces. Military providers possess variable levels of deployment preparedness. The aim of the Clinical Readiness Program is to develop and assess the knowledge, skills, and abilities (KSAs) needed for combat casualty care. Methods The Clinical Readiness Program developed a KSA metric for general and orthopedic surgery. The KSA methodology underwent a proof of concept in six medical treatment facilities. Results The KSA metric feasibly quantifies the combat relevance of surgical practice. Orthopedic surgeons are more likely than general surgeons to meet the threshold. Medical treatment facilities do not provide enough demand for general surgery services to achieve readiness. Conclusion The Clinical Readiness Program identifies imbalances between the health care delivery and readiness missions. To close the readiness gap, the Military Health System needs to recapture high KSA value procedures, expand access to care, and/or partner with civilian institutions.

Checklist Framework for Surgical Education Disaster Plans

“…To meet this need, the DoD in partnership with the ACS has developed the Clinical Readiness Program (CRP) which provides an innovative approach to measuring, evaluating, and sustaining individual clinical proficiency, with a focus on the expeditionary environment. 18 Many of the elements developed J o u r n a l P r e -p r o o f within such a program have relevance outside of the military mission, especially in the response and management of disasters and mass casualty events within the country, as these emerging environments are essentially equivalent to 'expeditionary' scenarios. KSAs form the basis of the CRP used by expeditionary (military) clinicians to monitor and maintain both clinical competency and currency.…”

The 2020 Pandemics: Lessons Learned in Academic Surgery and Beyond

“…The type of comprehensive planning and execution required to revamp the team's deployment preparation had been previously well described by CAPT (ret.) Eric Elster with the roll out of the military-wide assessment of individual operational readiness, known as “Knowledge, Skills, and Abilities,” 22 executed following the Harvard Business Review's steps for transforming an organization. 23 Finally, the integrity and prioritization of patients and crew members demonstrated by the medical departments aboard the USS Carl Vinson during the 2010 earthquake in Haiti and the USS Theodore Roosevelt during the COVID-19 outbreak in 2020—reminded our colleague that above all the team must be ready to “always do the right thing for the patient.” 24 Developing a training program during the height of a viral pandemic to care for trauma patients in an austere environment was worth challenging the established paradigm and refuting the status quo despite resistance and challenges.…”

Acquisition and retention of military surgical competencies: a survey of surgeons’ experiences in the UK Defence Medical Services

“…The UK Defence Medical Services (DMS) and our allies recognise the difficulties associated with acquisition and retention of militarily relevant surgical knowledge, skills and abilities among their surgical cadres 3–6. Training opportunities have been limited by factors such as the limited penetrating trauma workload in non-deployed roles,4 interruptions to training during the COVID-19 pandemic,7 and reduced deployed experience since the cessation of combat operations in Iraq and Afghanistan.…”