Referral Coordination in the Next TRICARE Contract Environment: A Case Study Applying Failure Mode Effects Analysis

摘要

The next iteration of TRICARE contracts will bring changes to now military treatment facilities (MTFs) conduct business concerning the referral of Prime enrolled patients to civilian contracted providers. Madigan Army Medical Center (MAMC) is forming a Referral Coordination Center (RCC) to manage these referrals in a manner most beneficial to the MTF and the patient. This project examines the RCC in light of the new TRICARE contracts, utilizing Healthcare Failure Mode Effects Analysis (HFMEA) as the analysis tool. HFMEA is normally used on mechanical or well-established healthcare processes. Application to a proposed administrative process is a new use of the tool, which shows promise in its ability to keep a process team on track in a changing environment.