An exhaustive 2014 review into the quality of health care delivered by military treatment facilities found there were no systematic problems across the military services, although there were a few “outliers.” Four years later, the Defense Department has essentially eliminated those specific deficiencies.

The findings, part of a newly-published progress report by the Pentagon’s inspector general, showed that the Military Health System has already completed 22 broad action plans MHS put into place to address the 2014 quality of care review, but still needs to finish four others before the IG considers the matter closed.

But the IG said the military treatment facilities that were specifically called out for substandard care in various practice areas had generally fixed their problems.

For instance, as of 2014, eight separate hospitals had significantly worse rates of post-surgical health problems than a national average of civilian hospitals, as determined by the National Surgical Quality Improvement Program. By this year’s review, seven improved their ratings from “needs improvement” to “as expected,” and an eighth — Mike O’Callaghan Military Medical Center in Nevada — was marked as “exemplary.”

By another measure — the ability of patients to consistently see a single medical provider — four DoD facilities were marked as needing improvement in 2014. But primary care provider “continuity rates” had improved markedly at three facilities by 2018, and a fourth (the Air Force’s former Menwith Hill Clinic in the United Kingdom) has since been closed.

The 2014 study also found that more than two dozen of DoD’s facilities were “outliers” on some measures of care quality relating to child delivery and the care of newborn babies and their mothers.

But 25 that had been identified as worse than the national average for postpartum hemmoraging, according to measures maintained by the National Perinatal Information Center, had “met or exceeded” NPIC’s benchmarks by this year. The IG reported similar results for seven hospitals that had reported higher-than-average rates of birth trauma and 11 previous outliers for shoulder dystocia.

Read more of the DoD Reporter’s Notebook.

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