Med-KSA Descriptive MZ.docx

Appendix 1:

Medical Knowledge, Skills, and Abilities metrics and associated methodologies are foundational to supporting the clinical readiness and interoperability of select medical specialties in the Department of Defense (DoD) Military Health System (MHS). The MHS is unique in that it must provide expertise in both stateside hospitals as well across the globe in support of military operations. The MHS sustains the clinical readiness of its military medical personnel through routine medical practice in military medical treatment facilities (MTFs) and, when not attainable in MTFs, through Military-Civilian Partnerships (MCPs). The key for the MHS is identifying which aspects of care are relevant to “Skill sustainment & clinical currency” and ensuring military providers are proficient in those areas. Although there are many components that comprise “clinical currency,” the basis of the DoD’s expeditionary medical systems rests on individual clinical proficiency. The MHS Medical (Med) Knowledge, Skills and Abilities (JKSA) Program provides an innovative approach to measuring, evaluating, and sustaining clinical proficiency.

Med-KSAs are the specialty-specific Knowledge, Skills, and Abilities used by expeditionary clinicians that reflect both clinical competency and currency. The DoD’s Clinical Readiness Program is based on a continuous cycle (Clinical Readiness Lifecycle) covering periodic knowledge assessment, clinical practice (JKSA metric), and skills assessment, leading to the deployment-ready medical force. Med-KSAs create the ability to evaluate the wartime medical readiness value derived from each clinician’s peacetime workload as well as provide detailed descriptions of the knowledge and skills needed in the expeditionary environment.

Military-civilian partnerships (MCPs) create opportunities for military teams or individuals to embed part-time or full-time in civilian trauma centers. JKSA Metrics, in turn, are leveraged to assess the effectiveness of these partnerships over time. For comparison purposes, med-KSAs are specific to clinical workload and case types that support clinical currency, while RVUs are specific to workloads that support the institution’s billable reimbursement. While they both emerge from a “common trunk”, they may be thought of as different branches on the tree. For generating KSA metrics, complexity and relevance are based off of CPT codes while acuity is based off ICD-10 codes, with more points awarded for ICD-10 codes implying ill patients (e.g. sepsis or hemorrhagic shock) or by having multi-medical comorbidities (e.g. congestive heart failure, diabetes mellitus, end stage renal disease).

We would recommend the following American College of Surgeons (ACS) website link: https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.facs.org%2Ffor-medical-professionals%2Fmembership-community%2Fmilitary-health-system-strategic-partnership%2Fblue-book%2F&data=05%7C01%7Cleslie.beck%40hhs.gov%7Ca8690186057c42fee0a008da7f0473bd%7Cd58addea50534a808499ba4d944910df%7C0%7C0%7C637961954478148559%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=pJ6ldYVdpI0cMeAOgmn%2ByIJrCt%2FU9duhvLHFoyo1RZA%3D&reserved=0. as the Blue Book describes the Clinical Readiness Program, how KSAs are generated based on specialty, and how they are applied in the sustainment and assessment of Readiness.