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GAO-21-160R 1 (2020-12-01)

handle is hein.gao/gaobaecbg0001 and id is 1 raw text is: U.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Washington, DC 20548 December 1, 2020 The Honorable James M. Inhofe Chairman The Honorable Jack Reed Ranking Member Committee on Armed Services United States Senate The Honorable Adam Smith Chairman The Honorable Mac Thornberry Ranking Member Committee on Armed Services House of Representatives Military Health Care: Defense Health Agency Processes for Responding to Provider Quality and Safety Concerns The Defense Health Agency (DHA) within the Department of Defense (DOD) supports the delivery of health care to servicemembers and their families at military treatment facilities (MTF), which include 51 military hospitals and hundreds of health and dental clinics. These health care services are delivered by physicians, dentists, and other providers and range from routine examinations to complex surgical procedures. DHA, through its clinical quality management program, is responsible for ensuring the quality and safety of health care delivered at MTFs by military and civilian health care providers, including contractors. As in all health care delivery settings, concerns may arise about the quality and safety of care delivered by individual health care providers at MTFs. For example, patient safety events- incidents that could have resulted or did result in harm to a patient-may occur during the course of providing health care services.1 Concerns about a provider's care may also arise in other circumstances-for example, from routine performance monitoring or from patient complaints. Examples of concerns about a provider's clinical care range from insufficient clinical documentation to practicing in a manner that is unsafe or inconsistent with industry standards of care. The National Defense Authorization Act for Fiscal Year 2020 included a provision for GAO to review aspects of DOD's clinical quality management program, including its processes for reviewing the quality and safety of providers' care.2 In this report, we describe DHA's processes 1According to DHA policy, the term patient safety event includes adverse events, no-harm events, near miss events, and unsafe conditions. Adverse events are events that resulted in harm to the patient, and may occur by either the omission or commission of medical care. DHA defines no-harm events as events that reach (or involve) the patient, but did not cause harm. Near miss events are events that did not reach the patient. Unsafe conditions are conditions or circumstances other than a patient's own disease process or condition that increases the probability of an adverse event. 2Pub. L. No. 116-92, § 747, 133 Stat. 1198, 1473-1474 (2019). GAO-21-160R Provider Quality and Safety Page 1

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