jko_20230129232054 Flashcards
DSCA
Defense Support of Civil Authorities
NIMS
National Incident Management System
RDD
Radiological Dispersal Device
aka dirty bomb
RDD = radiological dispersal device
scenarios of high consequence to help preparedness activities
National Plannign Scenarios: developed by a working group coordinated by HSC & DSS*CBRNE, natural disasters…
J5
Planning
Joint Intelligence Process
Planning & Direction
Processing & Exploiting
Analysis & Production
Dissemination & Integration
Evaluation & Feedback
what is JIPOE
“Joint INtelligence PReparation of the Operational Environment*analytical process used by joint intelligence orgas to produce intelligence estimates and other intelligence products in support of the commander’s decision making process
J2 as a key actor
J2 is a key actor ibn leveraging intelligence capabilities from strategic to tactical level
*those in J2 must understand how to provide appropriate support across the battle rhythm
primary role of J2
Intelligence
*provide information and assessments to provide information/assistance to facilitate mission accompolishment
JP
Joint Publications
source for “Joint Intelligence”
JP 2-0
purpose of CCIR
support the Commander in focusing activities to better support their decision making process across current & future operations
information requirement identified by commanders as beign critical to facilitating timely decision making
3 major activities supported by CCIR
understand complex environments
commander decision making
prioritize limited decision making
information requirement identified by commanders as being critical to facilitating timely decision making
CCIR
process by which organizations develop international influence or start operating on an international scale
globalization
intelligence broader security inplications beyond the military
open economic system on the global marketreadily accessible communicationubiquitous media presence
present everywhere
ubiquitous
`changes created by the Information Revolution
unprescedented ability to transmit/receive data
critical information can be hidden by volume
2 components to CCIR
PIR & FFIRPIR = priority intelligence requestFFIR = friendly force information requirements
PIR
priority intelligence report| CCIR component that focuses on adversaries & the OE
CCIR component that focuses on adversaries
PIR = PRiority Intelligence Report
FFIR
Friendly Force Info Requirement| *friendly forces & supporting capacities
CCIR component that focuses on friends
FFIR
ad hoc
when necessary or needed
when necessary or when needed
ad hoc
how can you empower subordinates
decentralize CCIR
what specifics does the CCIR process lay out
CCIR process lays out specific responsibilities for
*development
validation
dissemination
monitoring
reporting
maintence
who develops PIR & FFIR
J2 does PIR| J5 does FFIR
DIME
diplomatic informational military economic
how are most operational level decisions made
most operational level decisions aren’t “snap” decisions focused at the tactical level but rather require detailed analysis and assessment of th broader enviornment tied med to desired effect and stated objectives
MOE
measure of effectivenesss
PMESII conditions
political,
military,
economic,
social,
information, infrastructure, physical environment, time**battlefield is more than just a battlefield”
SWOT
analysis = strengths, weaknesses, opportunities, and threats
PESTLE
framework to assess key factors influencing an orgnization from outside*political, economic, socialolgical, technological, legal, environment
how to think about the external factors impacting yoru organization
PESTLE = political, economic, sociological, technological, legal, environmtn
QUEST
Quick ENvironmental Scanning Technique Analysis
*environmental scanning technique designed to assist w/organizational strategies by keeping adherents to change and its implications
3 tools to evaluate external factors on your organization
SWOTPESTLEQUEST
SIR
Serious Incident REport
SIGACT
significant activities
Decision Support Matrix
tool to help maintain situational awareness of hte various CCIR criteria that the staff and stakeholders are monitoring
how to ensure the right people are aware of developing CCIR
Notification Criteria Matrices
what drives design & planning
understanding the environmental & assessment
Q’s to ask when thinking about CCIR
why
So what
what if
what next
JOC
joint operations center
stovepipe information
transmit information directly through levels of a hierachy
effects of CCIR on operations
Shift main effort
change in priority
refocus information operations & public affairsr
distribution of forcescommand relationships & task org
changes
force rotation/withdrawl
change phasing
what happens when you close a SIGEVENT
archive for record purposes and to assist the intelligence &* assessment functiongn
result of a SIGEVENT
might not require a decision but report to HQ/press
COS
chief of staff
definition of CONOPS
clear & concise explaination the joint force intends to accomplish and how to do w/available resources
defense coordinatoing officer
DOD signle POC for domestic emergencies and forward mission requests through proper channels
DOD single POC for domestic emergencies. forwards mission requests through proper channels
defense coordinating officer
HQ of JOint FOrce Commander
HQ established to plan, monitor, guide the execution of commander’s decisions = Joint Operations Center
military operations intended to help deicsion makers anticipate change, mitigate risk and help shape outcomes
ISR = Intelligence, Surveillance, & Reconnaissance
3 things the OE considers
conditions
circumstancesin
description of MOE
indicator of hte current state as changes over time
JMESI
Joint Medical Executive Skills Institute
Materials Managemnet
Systematic conbtrol of flow of supplies fromt point of identification of need to acquision to point of receipt by the customer”right thing @ right place@right tie @place
% of hospital budget that goest to materials managemtn
23%| *order/procure, move, store, use, & staff to support function
how does material management get a product
procure products via contracting & acquisytion
how does materials management decide to continue to purchase a product
utilization study
FAR
Federal Acqusition REgulation
5 major functions of materials management
acqusition
warehousing
inventorymanagement
distribution/transportation
processing
MIlitary & contracts
militaryt purchase goods/services from private contractors over 1 trillion
medical services military medicine contracts
Providers
consultants
training
laundry
housekeeping
special tools
medical waste
labs
DFARS
defense federal acqusition regulation supplement
govermnent purchasing agent for most supplies & services
General Services Administraiton
FAR
rules and regulations for government buys and private vendoirsq
how does DOD make large purchases
via either negotiation or solicitation of bids
how does the DOD make large purchases via solititation of bids
Purchasing Officer sends bid invitations to firms listed| *members on teh solicitations list show they ahve been able to fill contracts for items int eh past
what is on the “Invitation for Bids” sent out via the solititation of bids method when tgeh DOD intends to make a large purchoase
solititation of bids is a way the DOD makes large purchases*specificationsinstructiosn to prepare bidsconditions to purchse, deliver, pay
how does the DOD make large purchases via the negotiation method
send request for proposals to offors who are on the solititation mailing list
cost plus fixed fee
CPFF = provides payment of a fixed fee to the contractors in addition to any allowable costs
pay a fixed fee + allowable costs
cost plus fixed fee contract
cost plus incentive fee
pay contractor but adjust based on measurable levels of performance (meets deadline, complete early…)
pay contractor but adjust based on measurable levels of performancer
cost plus incentive fee
most important rule of contracting
contract local contracting officer for guidence first
DO NOT DO when contracting
no obligation to pay money you don’t have accept gift
simply you WILL buy
waste that can cause disease if not treated properly
Regulated Medical Waste
what takes away waste from MTF hospitals
Regulated Medical Waste is removed by a waste disposal contractor
who regulates medical waste
state governmetbs
Angelina Jolie kids
w/Brad Pittmaddoxpaxzahahashilohtwins = knox and vivienne
LEADS
leadership, education, analysis, development, sustainment
aka autonomy
self determination
protocol
written detailed [lan by which a clinical investigatyion is conducted
written detailed plan by which a clinical investigation is conducted
protocol
who creates the protocol for a reseach project and is responsible for throughout
Prinmary Investigator
who has the power to end a clinical investigation at a MTF
CO
aka nonmaleficience
primum non nocere
grant
legal instrument to enter a relationshiop[ in order to transfer a thing of value
HIPAA
healthg insurance portability and accountability| 1996
role of the Principle Investigator
reserach design
submit protocols
asssess data
present
protect human subjects
5 things that should be on the Protocol submitted by the Primary Investigator when submitting a research proposal
background
rationale
objective
design
methods
military officer responsible for ensuring human subjects in military research are protected
Medical Monitor: military healthcar provider qualified by trianing and experience to monitor human subjects during clinical investigations
Medical Monitor
military healthcare p rovier qualified by training and experiebce to monitor human subjects during clincial investigations
boards that agree to clinical investigations
IRB = air forceHUU (?)- ARmyIRB/IRO for Navy
MHS
Military Health System
HRO
High Reliability ORganization
What is a HRO
organization wher the entire workforce shares a single minded fcus on identifying potelntial problems and increase risk situations before they liead to an aderse event
ultimate aim of the Military Health System
Quadruple Aim
better care
better health
lower costs
readiness
JMESI
joint medical executive skills institute
OFRP
Optimized Fleet Response Plan
prolonged strike group deployment example
Lincoln strike Group deployed for 11 months in 2019 after Truman has an electrical problem that prevented them from being relieved
problem of the USN “can do” attitude
barrier to succes
cost of deploying a strike group
$5M per day
sending out the same ship for close interval deployments
double pumped
put a lid on a campaign
try to starve story as long as possibel untikl you are put in a situation where you have to be forfed to answer
supreprescendent
so ingrained that it isn’t debated anyorebrown vs board of edumarbury v madison
a court case so ingrained that it isn’t debated anymore
superprescedent
nominal group technique
method to get all ideas out of hte group| *silent brainstorm then present in round robin
role of the facilitator
responsibel for group progreess| *keep the meeting on track, manage conflict, ensure participation, synchronize ideas
benefit of effective questioning
- lets you get at root causes
- test assumptions
- invite participation
- gather information
- probe for hidden points
testing assumptions
bring assumptions of peopel out into the open so they can be clearly understood by all(e.g. John, on what basis are you saying that Deb’s ideas are too narrow in focus?)
benefit of summarizing ideas
summarize ideas to proviede concise/timely
key to having a successful meeting
preparation by using the 5W’s* Why: are we meeting/goals & purposes/what tasks are planned* WHo: is invited, are the right people present, how does attendence affection completion of goals, do participants know each other, do I need to coordiante issues w/participants prior to the meeting (grease the skids)* when: time, neeed lunch/breaks? how long total? how long per agenda item* where: what type/size/capabilities of hte space? do I need to give directions? can/should we rearrange the room?* what: what group dynbamic issues mgiht occur?what tools do I need to use (voting procedures…)
prior to meeting shceduling
agenda setting| beneficial to send ahead to participatnts can prepare fo the meeting so more time can be devoted to problem osolving
fish bowel technique
last resport technique to break an impass or to ventilate hot topics* 1. 10 minute tine out. each side picks one member to represent their ideas2. st up room so that one chair for each perspective plus the facilitator iare in teh middle plus one empty chair. the rest of the charis are aroudn the inner cicile3. say the representatives will reach a consensus in 20 minutes. no inner or outder circle communication. open chari can be anyone who wants to talk and they get 1 minute
what must happen in order for consensus to exist
all participants must provide input, ciriical/thorough evaluation, all members can live with the final decision
what don’t people believe about planning but should
planning isn’t seen as the easiest and quickest way to solve problems
what do changing conditions need
changing conditions often requires reversal or revision of previous decisions
only 2 sailors in my experience never ran aground…
“only 2 sailors in my experience never ran aground. one never left port and the other was an atrocious liar”
1916 court marshall for not taking care of ship
1916: a commander was convicted/court marshalled for not taking care of his ship when an earthquate and tsunami and moved his ship ont a beach. back then they dind’t know how to recognize tsunamis
qualities of a watch officer
forehandednessvigiliancecommon senseleadershiptech knowledgeexperienceknows relative importance of responsibilities
who has responsibility for the safety of a ship
Nimitz said the safety of ship is always the primary responsibility of hte CO
died in the Cole attack
17 died in 2000
what is navigation
the art of approximation and is about reducing uncertainty and error
what is propulsion for ship
propulsion for shipos is a search for endurance and reliability*oar, sail (wind/current), steam, coal, oil, turbines, diesel, gas)
other warfare hare kari effort by WW2 era japan
suicide boats but they wern’t effective b/c too slow
what is paramount on ships
safety b/c you live in your house
what did Nimitz say to Spruance
“You will be governed by the principles of calculated risk
proved antarctica is a continent
Charles Wilkes
Charles WIlkes
proved Antarctica is a continent| collections for the smithsonian
what do navies do
establish control of the sea dn exploit/extend control fromthe sea to land
control of seas
early potent step in establishing control over opponentsgrants strategic/operational freedom of movmentsecurity for lines of operations
what is the ocean
the ocean is a body of water occupying about 2/3 of a world made for men who have no gills
characteristics of the Naval operatating environment
vast and increased distances3D = air, surface, underwaterhistorically outside claims of nation statesharsh on personnel and equipmenttrackless = greatest of all fighways
what do youi need to know about a body of water
climateweathertidesgeography/topographysoundproperty of water
9 Methods to Test for Consensus
- thumbs up/down (good initial check)- finger count (use 1-10 fingers to show level of support for a measure)- assign a devil’s advocate to ward off groupthink- all say 1 think they like & dislike- “it seems the group has reached a consensus. am I right?”- go around the room and ask for input. lets you expllore the resaons for disagreement- looks like we have reached a consensus. on a scale of 1-5, what is your level of agreement- before we implement this decion, what reservations do we have- when you return to your office, what will you say about the decision we have made today (ultimate test of consensus)
ultimate test of consensus post decisions made during a meeting
“When you return to your office, what will you say about hte decision we have made today?
what is usually the cause of lack of consensus
lack of consensus is usually from a lack of understanding
what is often cruial to an effective interaction
the right wording1. nonjudgemental describe what you see2. state impact - tell member how their actions affect the group/process3. ask for suggests/tell what to do. what can be done to make sure ti doesn’t happen again and
3 steps for creating a process improvement statement with regards to a staff member’s actions
- describe what you are seeing2. make an impact statement3. redirect the member’s behavior-action step
tool to ensure all tasks get done
use a responsibility matrix
clinical pathway
map of the optimal sequencing/timing of interventions by med staff for a particular dx/procedure/conditin*designed to minimize treatment delays, maximize quality of care, reduce length of stay
6 levels of care within the integrated healthcare system
preventativeprimary = preventative/wellness/treatment of common illnessessecondary = referral from PCM/same day surgery/urgent caretertiary = specialtyrestorative = rehabcontinuing care = long-term care, hospice,
HMO
health maintenance organization* type of health insurance that limits coverage to care from doctors within the network. generally won’t cover out of network unless emergency* may need to live/work in a certain place to be eligible* provides integrated care and wellness/preventin
PPO
preferred provider organization* health plan that contracts with providers/doctors to create a network.* pay less if you use the network and more if you go outside the network
CAM
complementary and alternative medicine
TeamSTEPPS
Team Strategies & Tools to Enhance Performance & Pt Safety| *evidence based communication
CRMT
crew resource management training
Tricare regions
CONUS = Tricare West & EastOCONUS= Latin America & Canada, Eurasia & Africa, Pacific
MILCON
military construction
environment of care
variety o0f key elements/features that contribute to the way a healthcare space feels and functions for pt/family/visitor/staff
role of facilitator managers -6
- coordiante all facility management matters- identify what is not within compliance with standards/codes and inform the command- guide submission of work orders & funding- keep leaders informed on progress of renovations/key products- facility work groups dealing w/ renovations- monitor status of work orders
preventative management
ensures the readines (it works when you need it) & operating efficiency of hte item. goal is to save money in the long run
HVAC
heating, ventilator, and air conditoin ing systems
FAR
Federal Acquision Regulations
frequent violation of FAR
Federal Acquisition Regulations| *breaking a single project into smaller pieces in order for funding approval can be obtained at the local level
balances to consider when deciding to submit for removation/new construction
construction costs
time constraints
pt care needs
architectural designs
staff preferences
what must seniors leaders assure construction contractors have achieved
“complete useable facility”aka…gov got what it paid for. a fully functional facility that has passed all tests for hte usability of ther space/equpment/HVAC/utility
facilities projects under $2,500
Credit card or purchase order (PO)| approval level: local (healthcare organization commander or director of public works)
facilities projects $2,500 to $25K
Credit Card (depending on approval limit( or Purchase order w/three possible vendors or pre-negotiated contract vehicleapproval level: local health care org or director of public works)
facilities projects $25K to $300K
approval by the regional medical command
facilities projects $300K to $2M
approval by the medical command
cost of projects that need congressional approval
over $500,000 (falls under the MILCON “military construction” program)
cost of projects that need congressional approval
over $500,000 (falls under the MILCON “military construction” program)
life-cycle management
considers the expected lifespan of equipment with the target to replace it before that date so there is not interruption in service r/t in operatability
accrediting organizations in healthcare
Joint ComissionAAAHC: Accreditation Association for Ambulatory Health CareCAP = college of American PathologistsNCQA= National Comittee oin Quality Assurance
AAAHC
accreditation association for ambulatory health care
NCQA
national committee on quality assurance
accreditation
objective performance review
is Joint Commission mandatory
voluntary
2 nonprofit affilation orgs associated w/Joint Comission
Joint Commission Center for Transforming Healthcare = solve the most critical safety and quality problemsJoint Commission Resources = consulting services, education services, and publicatins
webside for medicare and medicaid
cms.gov
annual self-assessment hospitals can do to ensure they are within Joint Commission standsards
FSA = Focused Standards Assessment
what happens if the Focused Standards Assessment identified noncompliance
must identify a plan of action
RFIS
requirements for improvements
EP (as part of the Joint Commission scoring process)
EP = Elements of Performance*statements taht detail the specific performance expectations and/or structures/processes that must be in place for an organization to provide high quality treatment and services
SAFER Matrix
part of joint commisssion preparation*Survey Analysis for Evaluating Risk likelihood of harm = high, moderate, lowscope = limited, patterned, widespread
decisions of joint commission
limited/tempoary accreditation (survey prior to opening. then full survey in 6 months)accreditationaccreditation w/follow up surveypreliminary denial of accreditationdenial of accreditation
what does it mean to be accredited by Joint Comission
either complies w/all requirements at the time of first survey OR successfully addresses all RFI in an Evidence of Standard Complicance
where is Khandahar
SE Afghanistan
P2KG
providences in Afghanistan that include: Pakita, Paktya, Ghazini, Khosa* one of hte msot ho0tly contested areas of Afghanistan
border of P2KG
P2KG are 4 hotly contested providences of Afghanistan that share a 450 border w/Afahanistan
border between Afghanistan & Pakistan
Durand Line| *often not recognized by tribesmen on either side of hte border
Durand Line
border between Afghanistan & Pakistan| often not recognized by tribesmen on either side
Afghanistan gov
GIORA
Haqqani Netork
independent insurgent grup in Afghanistan *& Pakistan closely aligned w/Taliban
connects all major points in Afghanistan
Ring Road
importantce of P2KG
location of P2KG makes them the crossroad for goods/people| *Ring Road & Highway 75
Ring Road
connects all major points in Afhhanistan
connects Khandahar to Quetta, Pakistan
Highway 75
Khost, Afghanistan
city famous for being beseiged by Soviets for 8 years