1. CASE STUDY
The story you are about to see is true. Only the names have been changed to protect the innocent.

2. Decision-Making Cycle
What’s Happening & So What?
Objectives & Criteria
Alternatives?
Compare/ Select
Make it Work!
Monitor Results
And?
The
Decision-Making
Cycle 2

3. Informational Data Requests
And?
Clarify Requirement & Sources
Deliver Results
The
Data Request
Cycle
How to Present?
Extract Data
Descriptive Stats & Problem Data Detection/ Correction
Results Make Sense? 3

4. Six-Step Approaches 4

5. ENVIRONMENTAL SCANNING
Many metrics, organizations, dashboards, etc.
M2 has a wide array of “Standard Reports” for this More later!
M2 also allows “on the fly” scanning – simply asking a question about operations for which and answer is not already available.

6. Are the Military Departments Alike in Inpatient Mortality?
Do you know? Want to hazard a guess?

7. Results from and M2 Query of Dispositions by Service for FY 2011

8. MTF Dispositions by Service, FY 2011
Source: M2, SIDR Detail

9. FY 2011 INPATIENT DEATHS (By Military Department of the MTF)

10. FY 2011 INPATIENT MORTALITY (Deaths per 1,000 Dispositions)

11. Question Why would the Navy have a mortality rate
about 20% less than the other
two military departments?

12. Mix of Diseases and Disorders?
Are differences concentrated in certain kinds of cases?
A later block will explain “Major Diagnostic Categories” (MDCs) — there are 29 of them
Using M2, we checked mortality rates in all 29 MDCs and found 6 of them with relatively high death rates per 1,000 (over 10.0)

13. Results for Selected MDCs

14. Results for Selected MDCs

15. MDC EXCURSION
The Army had more dispositions in MDCs with mortality rates greater than 10.0 per thousand.
Air Force had fewer dispositions in these MDCs
Dispositions for Burns and Multiple Trauma were disproportionately high for the Army
May explain part of higher overall mortality rate
In 3 of 4 remaining high-mortality MDCs, Navy had lowest mortality rates.
Why is this?

16. What if the “age-sex mix” of the military departments varies widely?
A Theory. . .
What if the “age-sex mix” of the military departments varies widely?
Do the mortality rates look as
different when adjusted for age-sex differences?

17. There are Significant Differences in Age-Sex Make-up of Dispositions by Service

18. What if Navy Age-Sex Distribution were Applied to Army and Air Force Mortality Rates?

19. Can some of the remaining differences be explained by OCO?
Regardless of how we identify OCO, at most there are only 8 or 9 total deaths.

20. Might “Extra Admissions” in the de- nominator affect differences in mortality rates?
“Potentially Preventable Admissions” is covered later in this course.

21. Distribution of Navy Child Mortality

22. Why is child mortality higher at a few big MTFs?
. . . The next excursion is left to you!