Evaluation of RESET: An Evidence-Based Primary Care Delivery Model Quality Improvement

Abstract

The Department of Defense Military Health System has a multilayered mission to deliver medical support to military operations, as well as provide primary care services to over 9.4 million beneficiaries (Smith, Bono, & Slinger, 2016). Many believe there is a challenge in balancing the demands of access to primary healthcare and supporting the military medical readiness needs of the uniformed service members. For years, the Military Health System (MHS) has explored multiple models to meet the primary healthcare demands for active duty, dependent, and retired beneficiaries. The MHS currently utilizes the Patient Centered Medical Home Model (PCMH) model for primary care delivery (Christensen et al., 2013). There is no current evidence to support that PCMH has improved and sustained access to care within the MHS (Hudak et al., 2013). Due to a decline in job satisfaction and the inability to meet the care needs of patients, a Military Treatment Facility (MTF) in Germany developed and implemented, RESET, a model that addresses these concerns. The purpose of this project is to provide a comprehensive evaluation of RESET, an evidence-based quality improvement, in particular the effects on provider satisfaction and access to care metrics. The Iowa model, Lewin’s 3-Step model, and the Institute for Healthcare Improvement (IHI) Quality Improvement Plan-Do-Study-Act (PDSA) model were framed to guide the program evaluation. Inferential and descriptive statistic procedures were used to evaluate access to care metrics and provider satisfaction for comparison of PCMH and RESET. The results revealed RESET was associated with improvements in access to care; job and career satisfaction; and control at work.