NMFP’s continuous process improvement competition drives innovations in warfighter health readiness

16 July 2024

From Arsenio R. Cortez Jr

Naval Medical Forces Pacific (NMFP) announced the winners of its annual Captain Cheryl R. Ringer Memorial Award, a Continuous Process Improvement (CPI) project competition, during a series of regional meetings held at its headquarters between July 3 and July 16.

The CPI project competition is designed to encourage, showcase and share improvement efforts from Navy Medicine Readiness and Training Commands across the region. This year’s competition yielded an increase in participation with 48 entries from 16 different organizations, compared to 33 entries last year.

From one side of the vast Pacific to the other…Cmdr. Katharine Mangan, a Barrington, Illinois native, (far left) currently assigned back in the Pacific Northwest for her second time at NHB/NMRTC Bremerton as director of medical services, distinguished herself when stationed at U.S. Navy Medicine Readiness Training Command Yokosuka for her Continuous Process Improvement submission in the Define-Measure-Analyze-Improve-Control (DMAIC) category, “Reduce Delay in Vitamin D Deficiency Diagnosis.” Her efforts led to identifying and correcting several issues which contributed to delays for surgery patients, including an inefficient surgical consent process, delays in surgical site preparation, and lack morning safety huddle time standards. With Mangan implementing needed corrections to streamline their process safely and effectively, first patient surgical suite results in room time compliance increased from 34 percent to 90 percent (Official Navy photo by Douglas H Stutz, NHB/NMRTC Bremerton public affairs officer).

Demonstrable service before self, on the job and in their CPI project…For Patrick W. Graves, Naval Hospital Bremerton Tobacco Cessation Facilitator and part of the command’s Mental Health clinic, advocating Suicide Prevention is a crucial component of his efforts, whether it’s explaining on the associated danger of smokeless tobacco, helping someone quit their nicotine habit or providing needed guidance, care and understanding to those in behavioral health service need. Graves, a Winona, Minnesota. native, helped the clinic last year alone provide a wide array of primarily outpatient services, to include individual psychotherapy, operational and readiness-related psychological evaluations, and Personnel Reliability Program personnel evaluations to Sailors, Marines and Coast Guard across 299 tenet commands in the Pacific Northwest and Naval Air Station Lemoore. Graves and others handled approximately 2,200 adult psychiatry visits, over 7,100 adult psychology visits, more than 4,500 Substance Abuse Rehabilitation Program visits and 150 tobacco cessation patients. Their additional attention to Suicide Prevention helped facilitate a Suicide Prevention Awareness presentation to command and region Sailors, highlighting recognizing warning signs of suicide and how to seek out resources for help; as well as two hours of diverse workshops and consultation (Official Navy photo by Douglas H Stutz, NHB/NMRTC Bremerton public affairs officer).

Helping those in need with all she does…assigned to NHB/NMRTC Bremerton Mental Health Clinic during her active-duty, Hospital Corpsman 2nd Class Letesa Espina was a whirlwind of providing capable assistance, from mass casualty training in responding to a mock earthquake or managing the command Diversity Committee program, for which she was recognized by the BUMED Medical Inspector General survey in 2023. Her efforts were also acknowledged, along with Patrick Graves, NHB/NMRTC Bremerton for their CPI submission, “Suicide Prevention’ in the Define-Measure-Analyze-Design-Verify (DMADV) category. Their additional attention to Suicide Prevention helped facilitate a Suicide Prevention Awareness presentation to command and region Sailors, highlighting recognizing warning signs of suicide and how to seek out resources for help; as well as two hours of diverse workshops and consultation (Official Navy photo by Douglas H Stutz, NHB/NMRTC Bremerton public affairs officer).

Rear Adm. Guido Valdes, NMFP commander, expressed his pride in the participants’ efforts and achievement.

“The dedication and innovation demonstrated by everyone who participated are truly inspiring,” Valdes said. “Their efforts not only enhance the efficiency and effectiveness of Navy Medicine, but also significantly contribute to the overall readiness and health of our warfighters.”

Christian Crifasi, director of Improvement Science, highlighted the importance of the CPI project in advancing NMFP’s critical mission in maintaining a medically ready force.

“Holding a CPI project competition at the regional level raises awareness of CPI activities at NMRTCs and supported operational commands, while supporting tenets of High Reliability Organizations (HROs),” Crifasi said.
HROs are organizations operating in complex, high-hazard domains for extended periods without serious accidents or catastrophic failures.

The competition recognized outstanding projects in four categories: Define-Measure-Analyze-Improve-Control; Define-Measure-Analyze-Design-Verify; Rapid Improvement Event; and Other Process Improvement Initiatives.

This year’s winners demonstrated innovation and improved processes centered in Fleet and Fleet Marine Force readiness initiatives.

“The Region continues to support traditional health care delivery improvements, but over the past few years, more resources are being dedicated to improving medical assets at the waterfront and in the field,” Crifasi said, further explaining the portfolio of projects also aligns with the Navy Surgeon General’s lines of effort - deliver Expeditionary Medicine systems; increase Sailor and Marine deployability; provide quality healthcare and patient safety programs across the Naval force; recruit and retain Navy Medicine shipmates.

Winners and Projects

In the Define-Measure-Analyze-Improve-Control (DMAIC) category, USNMRTC Yokosuka, led by Cmdr. Katharine Mangan, a Barrington, Illinois native, won for their project aimed at reducing delays in diagnosing Vitamin D deficiency. By screening fracture patients and educating providers about the risk factors, the team reduced diagnosis time from an average of 89 days to as few as four days for orthopedic providers and 14 days for all providers.

The Define-Measure-Analyze-Design-Verify (DMADV) award went to NMRTC Bremerton’s team, including former Hospital Corpsman 2nd Class Letesa Espina and Patrick Graves, a Winona, Minnesota native, for their suicide prevention project. They established the Next Step program to support transitioning service members, which resulted in 15 percent increase in resilience scores and had a 50 percent attendance rate among referred individuals. This measurable improvement highlights the impact the team’s work has had on the well-being of the service members.

Lt. Mark Boyd from NMRTC Twentynine Palms won in the Rapid Improvement Event (RIE) category by addressing delays in the surgical suite for the first patients of the day. Through process improvements like refining the surgical consent process, improving surgical suite preparations, and enforcing morning safety huddle standards, Boyd, a Jacksonville, Florida native, increased compliance from 34 percent to 90 percent. This improvement translates directly to better patient care, a more efficient surgical suite, and a happier staff.

NMRTC Yokosuka also claimed the Other Process Improvement (OPI) category award, led by Lt. Jonathan Wilson, a Simi Valley, California native, for enhancing the U.S. 7th Fleet Ship Repair Facility’s Hearing Conservation Program (HCP). By implementing clear guidance, adding HCP items to the command check-in process, developing an HCP tracker, and creating an internal SOP, they raised compliance rates from 17 percent to 97 percent.

“These projects reflect the unwavering commitment of our teams to continuous improvement and excellence,” Valdes said. “By tackling critical issues head on and implementing effective solutions, they ensure that we remain at the forefront of military care. Congratulations to all the winners for their exceptional work.”

The Captain Cheryl R. Ringer Memorial Award, inspired by the late Capt. Ringer’s 22-year career of persistent quest for excellence, aims to inspire NMFP personnel to embrace innovation and continuous improvement in Navy Medicine and health care delivery.

NMFP’s CPI projects also align with the Chief of Naval Operation’s Get Real Get Better (GRGB) Initiative. The GRGB is a call to action to apply a set of Navy-proven leadership and problem-solving practices that empower people to achieve breakthrough performance. The various CPI methodologies employed throughout the region are driving improvements leading to NMFP assets “Getting Better”.

Naval Medical Forces Pacific (NMFP) provides oversight for 11 Navy Medicine Readiness and Training Commands (NMRTC), on the West Coast and Pacific Rim that train, man, and equip medical forces, primarily in military treatment facilities. Globally, NMFP oversees eight research laboratories that deliver research expertise in support of warfighter health and readiness.

Story originally posted on DVIDS: NMFP’s continuous process improvement competition drives innovations in warfighter health readiness

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