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Naval Hospital Jacksonville using innovative 4DX projects to improve readiness and health

JACKSONVILLE, Fla. (Aug. 23, 2018) Lt. Emily Crowell, a registered nurse at
Naval Hospital Jacksonville’s family medicine clinic, discusses cervical cancer screening rates at a “4 Disciplines of Execution” planning meeting at the hospital. The 4DX system enables organizations to achieve their most important goals, by focusing on and relentlessly measuring core daily activities. Crowell, a native of Jacksonville, Florida, says “Creating these small groups helps us work together to reach our daily goals for a better patient experience.” (U.S. Navy photo by Jacob Sippel, Naval Hospital Jacksonville/Released).

Story by Rodney Foushee
Naval Hospital Jacksonville

Naval Hospital Jacksonville has launched a “bottom-up” approach to improving readiness and health, building on ideas from the front-line staff who encounter patients every day at the hospital and its branch health clinics.

NH Jacksonville has begun using The 4 Disciplines of Execution® (4DX), to achieve higher levels of performance. This Franklin Covey program launched at the command in August.

“It’s one thing to give a directive to improve an aspect of the patient experience,” said Cmdr. Duneley Rochino, 4DX project leader at NH Jacksonville. “It’s the clinicians and staff down at the deck plate who best understand what it takes each day, to meet and exceed our goals.”

As the 4DX name implies, there are four disciplines. It begins with focusing on the most important organizational goals (also known as “wildly important goals”). Then, front-line teams define a few “lead measures,” which show early (while there’s time to act) whether the team is likely to achieve the goal. Teams develop a visual scoreboard, to track progress. And teams meet weekly, with each member sharing what they’ve done this week and committing to actions for the next week, to influence the lead measures and achieve the goals.

Clinics and units across NH Jacksonville focus on different 4DX projects, depending on the type of care provided in each area, and all in support of the patient experience. Current projects include: increasing active duty patients’ medical readiness to deploy, increasing the rate of women getting mammograms and pap tests, and increasing the rate of diabetic and pre-diabetic patients who come in for blood sugar monitoring.

“All of these projects have real-world implications that enhance the health of the entire population we serve (active duty, retirees, and families), while also improving the medical readiness of our sailors and Marines to deploy around the world to defend our nation,” Rochino said.

Naval Hospital Jacksonville and Navy Medicine Readiness and Training Command Jacksonville deliver quality health care, in an integrated system of readiness and health. NH Jacksonville includes five branch health clinics across Florida and Georgia. It serves 163,000 active-duty and retired sailors, Marines, soldiers, airmen, guardsmen, and their families, including 84,000 patients who are enrolled with a primary care manager. To find out more, visit www.med.navy.mil/sites/navalhospitaljax.

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