DoD’s New Trauma Care System Plans Do Not Fully Implement Leading Practices

A GAO report found that DoD’s plans for a new Joint Trauma Care System do not fully incorporate leading practices.

The Joint Trauma System is being planned in response to DoD research that found that about 24 percent of military service members who died in combat from 2001-2011 could have survived if better and more timely trauma care had been available.

DoD’s plan, which was presented to Congress in August 2017, includes a description of the four elements required by the National Defense Authorization Act (NDAA) and an overview of implementation activities.

However, it does not full incorporate leading practices for planning, which GAO has previously identified. The JTS should serve as the reference body for all trauma care provided across the military health system, but while DoD has planned for consolidating data from multiple trauma registries it has not specified how it will address risks or assess progress.

DoD documents also include a goal to develop, publish, and assess clinical practice guidelines that serve as standards of trauma care, but again they do not state how risks will be addressed.

DoD’s planning does not incorporate any leading practices for how it will coordinate the translation of research from DOD centers of excellence into standards of clinical trauma care or how it will coordinate the incorporation of lessons learned from trauma education and training partnerships into clinical practice.

“By not fully incorporating leading practices in its planning documents, DOD may be missing opportunities to ensure that the JTS is effectively implemented, to provide more effective trauma care across the military, and to help reduce trauma-related deaths and disabilities,” GAO said.

The report recommends that the director of the Defense Health Agency fully incorporate leading practices — including establishing goals, planning strategies to achieve goals, identifying and addressing risks, and assessing progress — in its planning to guide implementation efforts.

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