improvements so that care in the future will result in a higher degree of quality. Quality assurance activities reflect what patients and providers expect of each other. In past years various means of reviewing and evaluating patient care have been introduced by JCAH. In 1979 the JCAH Boards of Commissioners imposed the requirement for hospitals to coordinate quality assurance activities and to use an ongoing monitoring system to review and evaluate the quality and appropriateness of care. This approach is effective in identifying important patient-related problems and is applicable in every health care delivery situation. Many of the principles, standards, and organizational requirements of JCAH have been adopted and are contained in NAVMEDCOMINST 6320.7 (Quality Assurance Program Guide) as required elements for quality assurance programs of naval hospitals, medical clinics, and dental clinics.
Navy health care professionals have long understood the need for good communication and rapport between the patient and the medical department staff. The atmosphere in which patient care is given has a tremendous effect on the patients perception of the quality of care. The quality of medical care rendered to Navy beneficiaries is superb; however, too frequently the medical care is perceived by the patient to be poor because personnel manning critical patient contact points are not adequately trained in interpersonal relations. Good patient rapport is an essential element of health care delivery. Many complaints voiced by patients would not occur if personnel manning critical patient contact points presented a courteous, positive, and knowledgeable attitude, an attitude that reflects a genuine concern for the patient. To this end, the Patient Contact Program was instituted. The programs primary goal is to provide assistance by intervention in and resolution of patients complaints or problems. As a covert to this goal, the program strives to enhance the channels of communications between the hospital and our patient population, as well as our own internal lines of communication.
The purpose of the Family Advocacy Program is to identify, treat, and monitor Navy personnel engaging in spouse or child abuse/neglect or sexual abuse, whether physical or psychological. The program, a responsibility of the Navy Military Personnel Command, is guided by SECNAVINST 1752.3. In each geographical location, a Family Advocacy Representative (FAR), usually a Naval hospital staff member, manages the local program. A basewide committee composed of medical, line, chaplain, and Family Service Center personnel reviews abuse cases and determines whether each case is established, suspected, or unfounded. Established cases are reported at the central registry at the Headquarters, Naval Medical Command, where service statistics are compiled and the future assignment of established abusers monitored and controlled.
The Navy has established a zero tolerance standard for drug usage. The major emphasis is on detection and deterrence of illicit drug use. This involves the use of urinalysis, drug detection dogs, and physical inspections of personnel and property on military facilities. The general categories of drugs are marijuana, cocaine, amphetamines, PCP, LSD, barbiturates, and heroin. While treatment is occasionally offered to the individual drug abuser, the most likely outcome is appropriate disciplinary action and separation from the service, especially after the second offense. Individuals with alcohol abuse or alcoholism are viewed as having a disease. They are often offered treatment at a variety of settings, ranging from local outpatient care to a 6-week residential program at one of the Navy-run facilities. However, all individuals, either with alcohol or drug-related problems, are totally accountable for their actions and the consequences of them in accordance with UCMJ and other relevant federal, state, and local laws.
The Navy Weight Control and Physical Fitness activities are a responsibility of the Health and Physical Readiness section of the Naval Military Personnel Command (NMPC). The policies governing this program are outlined in OPNAVINST 6110.1B. Currently physical fitness testing is required for all personnel on at