Putting Practice Guidelines to Work in the Department of Defense Medical System

A Guide for Action

by Will Nicholas, Donna O. Farley, Mary E. Vaiana, Shan Cretin


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The DoD and the VA have placed a priority on the standardization of care in the military and VA health systems to achieve greater consistency, quality, and cost-effectiveness in the delivery of health care services for active duty personnel, dependents, and retirees. In this context, the Army Medical Department (AMEDD) has been working in partnership with RAND to implement DoD/VA clinical practice guidelines proactively across the Army health system. One of the key products of this AMEDD/RAND partnership is an Implementation Guide designed to assist Army medical treatment facilities (MTFs) in guideline implementation. The response to the guide was so enthusiastic within the Army that it was decided the guide should be adapted for use across the DoD. This guide draws upon current knowledge from both research and field experiences.

Table of Contents

  • Preface

  • Acknowledgements


  • Chapter 1


  • Chapter 2

    Overview of Guideline Implementation and Keys to Success

  • Chapter 3

    Effective Teamwork for Guideline Implementation

  • Chapter 4

    Planning for Action

  • Chapter 5

    Making Change Happen

  • Chapter 6

    Measuring Effects

  • Appendix A

    Guideline Implementation Strategies for MTF Commanders

  • Appendix B

    DoD/VA Key Guideline Elements

  • Appendix C

    Planning Preparation Worksheets (Low Back Pain Example)

  • Appendix D

    Action Plan Worksheets

  • Appendix E

    Group Process Methods

  • Appendix F

    The AMEDD Guideline Implementation Toolkits

  • Appendix G

    Sample Implementation Action Plan: DoD/VA Low Back Pain Guideline

  • Appendix H

    DoD/VA Guideline Metrics

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