• Military medicine · Nov 2023

    Review

    Standardizing Evidence-Based Practice Review Processes Across the Defense Health Agency Enterprise.

    • Rachel Newnam, Laurie Migliore, and Jeffrey C Ransom.
    • Daniel K. Inouye Graduate School of Nursing, Uniformed Services University, Bethesda, MD 20814, USA.
    • Mil Med. 2023 Nov 10; 189 (Suppl 1): 394439-44.

    BackgroundThe Defense Health Agency (DHA) Campaign Plan identifies Ready Reliable Care (RRC) as one of the eight strategic initiatives. A critical aspect of RRC is standardizing evidence-based practice (EBP) across Military Health System to include training, technology, equipment, and processes. The TriService Nursing Research Program hosted an EBP Summit to address this expectation.MethodsThe EBP Summit evaluated capabilities and gaps critical for implementing EBP into the DHA. This article summarizes the capabilities and gaps associated with administrative processes and infrastructure standardization, specifically EBP review and approval support processes, as well as utilization of the electronic Institution Review Board (eIRB) software platform.ResultsThe environmental scan across services revealed consistency in procuring Exempt Determination Official reviews and garnering formal determination letters before the start of EBP initiatives. The Army and Navy Nursing Centers for Clinical Inquiry report variability in the utilization of eIRB, although the Air Force centers consistently utilize eIRB to submit proposed EBP. However, there is variability across all services in how the proposal is categorized (EBP, process improvement, and quality assurance) and in the availability of mentoring support for the submission.ConclusionStrategic recommendations to address the identified gaps are establishing a TriService Clinical Inquiry Working Group for process and product standardization, identifying EBP champions for each DHA market to educate and facilitate EBP review and submission processes, and establishing EBP review forums led by EBP subject matter experts. The authors suggest funding for program development and evaluation.Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2023. This work is written by (a) US Government employee(s) and is in the public domain in the US.

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