Historically, in military medicine, failure to align leadership priorities with clinical metrics and expectations has resulted in inefficient work processes, poor access, and decreased staff and patient satisfaction.
The 86th Medical Group on Ramstein Air Base, desired to change this culture by transforming healthcare in the military and developed a new concept of operations called Reward Efficiency, Set priorities, Empower Teams – or RESET.
“The aim of RESET is to improve access and satisfaction for our patients while simultaneously putting passion back into practice for the healthcare team,” said Col. Michael Roberts, 86th MDG commander. “This program has allowed our patients to receive care much sooner and has completely changed the way we deliver that care by capitalizing on features never utilized in our electronic medical record, providing various pathways to care, and rewarding teams for cutting waste in their workflows and increasing their efficiency.”
RESET allows for transparency and accountability, providing better and sooner patient care, all at no cost to the Air Force. Teams are rewarded with autonomy and flexibility.
“Empowering the (primary care manager) team creates a shared sense of accomplishment, a cohesive team concept, and increased job satisfaction,” said Col. Susan Bowes, 86th Medical Operations Squadron commander.
The results of RESET at the 86th MDG have been dramatic. In addition to a significant increase in patient and staff satisfaction and improved access to care, there has also been a decrease in emergency room utilization and no-show rates.
Due to the introduction of the virtual visits, something that has been the norm in the civilian sector for quite some time, the 86th MDG saved more than 8,000 mission man hours for the line of the Air Force.
“Virtual appointments have greatly increased my availability to my patients,” said Capt. Daniel Hubbard, 86th MDG physician assistant. “Before RESET, my patients had to go through a long string of people before reaching me to discuss a complaint, often with an appointment scheduled weeks out. Now, patients have unlimited same-day virtual access to me and increased face-to-face appointment availability as well. Often, I can take care of their needs with a conversation over the phone and, if needed, a quick walk-in physical exam. Prior to RESET, I was rarely on the phone with patients as the appointment line, technicians, and nurses would relay messages to me. The efficiency of my patients having direct access to me when they need something has been incredible. I didn’t realize how much time we were wasting for everyone in the old model.”
“Since starting RESET, the number of available same-day appointments has increased 40 percent, and the most a patient will wait for an appointment now is normally less than three days, compared to up to 15 days prior to RESET,” said Maj. David Lutz, 86th MDG group practice manager. “The patients love this and the provider teams are excited to be providing the kind of care they always envisioned when going into medicine. Working on this project has been immensely rewarding, as it creates a much more team-oriented approach to care, which has improved morale.”
In just over six months, RESET has spread to more than 75 percent of all Air Force medical groups, is being put forward as a best practice for the Department of Health Affairs, and could become the standard of care for the entire military health system.
“We are thrilled with the success that we have seen so far with RESET, but I think that the best is yet to come,” said Lt. Col. Stacy Fletcher, 86th MDG staff family physician. “We envision that as this model matures, it will broaden in scope and incorporate even more innovation in nursing, health optimization, readiness, specialty care and medical training. That is truly exciting territory, and we look forward to continuing to raise the standard for what patients really want and need…high-quality, efficient, comprehensive, preventative healthcare.”