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 Moving from In-Progress to In-Practice360 – The Next Curve in the Road for AmericaServes 

By Colonel (Ret., U.S. Army) Jim McDonough, Managing Director, IVMF

The past five years’ worth of efforts to build sustainable, community-based coordinated networks of care, resources and services within AmericaServes has been a real highlight of my personal and professional life since separating from military service. Nowhere has such an impactful organization committed to improving upon the post-service lives of America’s military connected members and their families – blessed with some of the most talented and committed teammates anywhere – done so much to improve upon the way military connected members and their families access services while ensuring those who serve them do so to the highest possible standard.

What an honor, and for those who know us best, they’ve witnessed our efforts to do it with a high degree of accountability, transparency and stewardship to ensure the best possible return on the commitments we make; and we will continue to do so. Along the way, there have been many successes, a few failures (likely more of each), and a ton of in-between’s. Presenting this body of work to everyone involved has always been our nature, and a practice we borrowed from our time in-service, with the recognizable ‘In-Progress Review (IPR)’ embedded deeply in the AmericaServes DNA. Through them, we have held ourselves accountable for the progress required to succeed. IPR’s have become a commodity, essential to demonstrating to all the authenticity of our approach, the sincerity to act as coach vs. referee, and fortitude to gut it out to the very end, wherever and whenever that might be.

In 2018 we will reach a very important pivot point with this work as we gently move away from solely tracking progress to facilitating and improving upon the practice itself. At this point in our evolution we’re very confident that the first imperative within our underpinning theory of change – to deliver a

community-based solution that sees its ability to deliver the right client to the right provider in the least amount of time – is well established through the nearly 25,000 cases managed by almost 700 providers based throughout 14 AmericaServes networked communities (and growing) serving almost 13,000 unique military connected members and their families, of which, every seven of ten clients has seen their issues resolved favorably.

Taking brief stock of these accomplishments at this moment in time, coupled with a growing capacity to ensure sustainable rates of performance locally, to professionally develop partnering communities regionally, and to convene stakeholders nationally, allows us room to reflect upon the next turn in the road. The approach, known as Practice360, focuses on re-committing ourselves to excellence in supporting a nationally-facing practice setting new standards of coordinated care. All-hands will be required, just as was the case with building these transformative approaches, and we’ve tweaked our model a bit to be in a better position to accelerate into this curve without downshifting.

Most importantly, moving from simply tracking progress to facilitating practice involves making a mental shift first to see ourselves as practitioners in the art and science of delivering compassionate, coordinated care and services vs. simply providers in a network. To do so takes positive reinforcement of our position in the marketplace of veterans’ services, one that values what each other does to the extreme and trusts our AmericaServes backbone organizations to smartly match needs with the most appropriate resources through the network vs. around the network. While we will continue to add providers into each network, we must cement the relationships we have using trust as our mortar between us.

To do that best, our communities now have unprecedented access to data to inform, to improve, to discipline their efforts, and to care for clients with transparency and accountability throughout. These insights will help tell better stories while helping the practice serve individuals best. Having unprecedented access to near real-time data also allows us the space to reimagine In-Progress Reviews and transition them to In-Practice Reviews, focused on accelerating the change curve by offering monthly, digital In-Practice Reviews co-led by IVMF Leads and their Coordination Center Lead counterparts.

12 times the value! Beginning this year for markets that are older than a year – and instead of the old model of quarterly In-Progress Reviews – we’re going to begin offering 12, digital In-Practice Reviews per year, one of which will model our established and successful annual, in-person version, bringing the practice together in-community. For all new and affiliated markets less than a year old, the same monthly digital In-Practice Reviews will occur between two, in-person In-Practice Reviews for their first year, then they too will drop to the same annual cadence described above for markets older than a year.

Using the combat multiplier analogy, our communities gain increasing smart touches with their providers, month-over-month, basing local direction and practice improvements in coordinated service delivery on insights derived from data itself. Network providers will be able to gain insight on the impact that they are having more frequently than quarterly, allowing for continued and accelerating improvement in the way they serve. Exciting times for sure, and long overdue in human services and patient care.

Likewise, the nature of our practice focus begins to shift this year to outcomes vs. outputs, to take the seven of every ten clients who saw their issues resolved favorably (an impact measurement) to new heights; to eight, nine, etc. of every ten, beginning in 2018. This shift continues to reinforce and extend the established theory of change that sees the right client getting to the right provider (accuracy) in the least amount of time (speed) to enable the provider to do what they do best immediately (deliver positive impact upon people’s lives).

In the end, we seek to sustain a practice that specializes in navigating clients to the right provider in the least amount of time, thus favorably resolving their issues at never-seen-before rates of success. That’s the curve we are driving into this year. And while the curve itself will be difficult to navigate at high speed, we can do it through the same hard work that built these approaches in the first place.

Buckle up and wear your helmets, it’s going to be a sweet ride.

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