Case Study

A Roadmap to High Reliability in Military Health

How we helped improve safety, quality, and access to care for millions

When organizations face the risk of public scrutiny for high-profile failures and the potential to cause serious personal harm to consumers, they have two choices: wait for failures to occur and react in the moment, or create an organization that can better prevent failures and reliably adapt to emergent circumstances. The primary challenge is creating a comprehensive roadmap to strategically move the culture towards becoming a high-reliability organization, or HRO.

Booz Allen’s consultants are working with the U.S. Military Health System (MHS) to overcome these challenges. By devising and implementing a plan that accounts for every step, every layer, and every contingency, they’re helping one of the world’s largest and most complex healthcare organizations reliably exceed industry benchmarks and ensure our servicemen and women, as well as their dependents, obtain the quality care they deserve.

Our transformation teams include the world’s foremost experts not only to map the journey, but implement it. We act urgently to streamline processes and instill accountability and then we dive in shoulder-to-shoulder to put large-scale safety and reliability programs in place.

“Building high-reliability organizations from the get-go helps bypass public scrutiny, instead of waiting for a failure and reacting.”

The Challenge

An organization’s structure can complicate its very mission—over time, multiple chains of command, unclear governance and inconsistent protocols, processes and practices can weaken health care safety and reliability protocols. These conditions set the stage in 2014 for then Defense Secretary Chuck Hagel to order a comprehensive review of the MHS and demand it move towards a high-reliability model.

The goal: Improve safety, quality and access to care for more than 10 million people, inspire a staff of 137,000, and scale solutions to more than 400 different treatment facilities across three branches of the military.

“We needed a new culture from boardroom to bedside reflecting leadership’s vision,” says Scott Barr, a Booz Allen senior vice president and the firm’s military healthcare lead. “It takes relevance, clarity, energy and ideas to achieve and it had to be done while the bus was moving.”

The Approach

Booz Allen’s understanding of military operations and culture, and our insights into the complexity of driving change, helped us produce results, not just facilitate processes. After all, transformation doesn’t lend itself to a cookie-cutter approach like filling out forms or facilitating meetings.

Working with MHS executives, our transformation team is applying proven safety science and culture tools to reduced safety events across the military health system. We developed an innovative HRO operating model with the MHS that articulates a framework for the DHA and Services to work together to and continuously improve quality healthcare to patients. We put boots on the ground to solve problems, drive processes, increase communications, and analyze performance data, to improve care, access and reliability. Based on our experience implementing electronic health records, conducting large scale transformation, and applying system and process change management disciplines, combined with MHS domain insights create advantages and reduce risks during implementation.

The Solution

Today, MHS leaders direct safety science and high-reliability principles across the system. Mindful, aware, trained, and pointed in the same direction around a common vision, the culture of safety can be felt throughout the organization.

And with new levels of employee pride and patient trust, the MHS can better attract top talent. While some might see this as an opportunity to increase profitable procedures, the MHS remains steadfastly focused on building its heritage as a leading health care organization that saves lives.

The Future

The roadmap to high reliability never reaches an end. But with an improved operating model, change management tools and a deference to expertise instead of hierarchy, Booz Allen can help change champions be successful. We’ll do it together. The keys are experience, knowledge and data. They pave the road when failure isn’t an option.