title: The Bremerton enrollment capacity model: an enrollment capacity model supporting the military health system optimization plan.
abstract: The Department of Defense has launched several initiatives to improve efficiency and quality of care in the military health system. The goal of empaneling 1,300 to 1,500 patients per primary care manager did not correlate well with Naval Hospital Bremerton's experience and did not accurately account for military-specific requirements. The Bremerton Model Task Force was chartered to assess current business practices, identify areas for improvement, and develop a capacity model reflecting military readiness and residency training requirements. Methods included a 12-month review of patient visits and staff surveys of how providers spent their day, with time-and-motion analysis to verify assumptions. Our capacity results (average, 791 enrollees per primary care manager) demonstrated that objective measures at the local level do not support enrollment to Department of Defense-specified levels. Significant changes in "corporate culture" are necessary to accomplish the military health system goals.
authors.affiliation: Orthopedic Surgery Department, Naval Hospital, HPO1 Boone Road, Bremerton, WA 98312, USA.
authors.forename: S
authors.initials: S
authors.lastname: Helmers
mesh_terms: D006801:Humans; D008887:Military Medicine / Q000458:organization & administration*; D008962:Models, Theoretical; D011320:Primary Health Care / Q000458:organization & administration*; D014481:United States; D016526:Workload