 Welcome to Conversation with His Shipmate, I'm Petty Officer Jonathan Pankall and I'm here with Vice Admiral Matthew Nathan to talk about the recent findings from a review of the military health system. Admiral Nathan, I understand that this year the Secretary of Defense Chuck Hagel conducted a comprehensive review of the military health system including our naval hospitals. What were the findings from this review? Well, I think the review in itself, the genesis of it was that we were going through a lot of inspection and uncertainty with the VA health care system. And at the same time we were looking at scrutiny of the military health system as far as how we take care of and review and account for our quality or safety or access. So the Secretary said, hey, let's do a very comprehensive review, I need it done well, I need it done quickly, and I want outside reviewers as well to help broker the findings. The review basically came back and said, look, you operate on a par with the major medical systems in this country. Your care is basically safe, it's basically accessible and effective. That said, like many systems, you do some things better than average, you do some things worse than average. And those things that you do worse than average, we want brought up, and those things that you do average, we want those brought up as well. We want to be a health care system that's looked at as a marquee health care system, not only in combat casualty care, which clearly we are second to none in the way we can care for those in the wounds of war. But in our garrison and peace care health settings, our military treatment facilities, how can we raise the bar to be exceptional in every category? So why are these reviews important? Well, I think any organization, any learning organization, regardless of the industry or the sector, needs to evaluate itself and constantly be scrutinizing itself on how it can improve. Health care, of course, is an emotional issue and is one where we can't afford any lapses of opportunities for improvement, be that for safety, be that for access, be that for quality. So continual self-improvement, continual self-survey, continual self-inspection, I think is truly a raison d'etre of healthcare. What were the findings from this review? Were there any specific faults that they pointed out that need to be addressed? Well, as the Secretary of Defense reported in his press conference, every single MTF was found to be safe and provide effective care. That said, every single MTF performed better in some respects than the average and even marquee organizations, and every MTF performed under-performed or had areas for improvement needed in some areas. We've already started concentrating on those. We are an organization that looks closely at where we need to improve. We use national benchmarks, not only the benchmarks of the average system, but in our system we also use benchmarks set about by marquee healthcare systems and measure ourselves against those. We also subscribe to the Joint Commission for Accreditation. So every one of our facilities is inspected and or surveyed by the Joint Commission and accredited. Were you surprised by any of the findings, sir? Well, I'm not surprised that hospitals, be it military hospitals or private sector hospitals, will have variations in how they perform in some areas compared to others. But I will tell you, that's my job and every healthcare leader in the nation to drive that variation out. Nobody wants to see any categories of care where you may not rank with or above an average. So I will tell you that we already had an environment where we were assessing and looking and we constantly do monitor those things that we do well and those things that we need to improve. Our regional commanders who are the immediate superiors in charge of our regional facilities are well-versed with these and have a daily accounting of which hospitals are looking at areas where they need improvement. So what are the next steps, sir? Well, the next step is to really look at creating a more enterprise solution across the military health system. Here's what I mean by that. One of the legitimate findings of the review was that, hey, Army, Navy, Air Force, you all provide pretty good care. As a matter of fact, your care is comparable to major healthcare systems in the United States. That said, you have areas that you can improve in each, but you also do some things differently in each. And if you really are a military health system, then you should have a military health system enterprise approach to how you treat quality access and data. So we already do many things alike in the services, but not all things alike. So if somebody, a patient were to walk up to me and say, is everything that you do in a Navy hospital exactly the way they look at these things in an Air Force or Army hospital? I'd say many things are, but not everything. And they could say, well, isn't there probably just one best way to do things? And I'd have to agree with them. And so we're going to work at the direction of the Secretary of Defense. We're going to work at finding a much more congruent, a much more enterprise approach to how we analyze, how we improve, and how we approach quality, safety, access, and how we display it. I want to show off what we do. I want our patients to be able to see how we perform, not only as an enterprise, but as individual facilities. So who can sailors and their families contact if they want to know more about the military treatment facilities in their area? Well, every military treatment facility has a webpage. On every home page for Navy military treatment facilities, we have either a contact link or we have a patient representative link or we have a customer service link. We have links on there that will eventually get you either by direct telephone or by email to patient representatives who can answer your questions, answer your concerns, both before you visit and after you visit. What do you want sailors and Marines to know about the care that they are receiving at the military treatment facilities? I think it's important that a sailor, a Marine, their family, and those that have served before and who have left a legacy for us to follow, understand that we look at them as family. And just as we want their total confidence when they deploy forward into a dangerous environment or into a combat situation or into a humanitarian assistance or disaster relief scenario, that we want to enjoy their full confidence. We want to enjoy that same confidence when they walk into one of our hospitals in Conus, one of our clinics in O'Conus, or any military treatment facility. I want them to understand that we believe we are family taking care of family. My family gets care in that system and I want that to be the best in the world, nothing less for my family. My family includes every Marine, every sailor in uniform who's been in uniform and their family and those who they love. We are honored and privileged to have the right to take care of them. I would just like to add that we want to hear from our patients. We want to hear from those beneficiaries who utilize our services. I'd encourage them to let us know what they think we do well, what they think we need to improve upon. I want to be a total customer service organization. I want to be responsive to our people. And I want to reinforce the fact that I recognize there is no negotiation when it comes to your healthcare or the healthcare of those who you love. We want to be your provider of choice. Well, sir, thank you for your time. It's been a pleasure, sir. Thank you for the opportunity to talk to shipmates.