SUMMARY OF CHANGES

The Summary of Changes comes right after Table of Contents. The section is helpful for readers familiar with the previous CPG version; it provides them with a quick reference for what’s new and improved in this new CPG version.

List any substantial changes and/or new material to the CPG in this section. Address issues such as:

- Why is the CPG being updated?
- What are the new additions and changes?
- Has the practice changed (i.e. TXA 1 gram vs 2 grams,) or has new information been learned?

INFOGRAPHIC

This is a JTS responsibility and will be developed by the JTS infographic team. Any of the authors who wish to assist/contribute to the creation of the CPG Infographic can do so. Contact the JTS CPG team (POC: Kathy Robbel) to be linked with the infographic team.

BACKGROUND

Most CPGs start with a Background and Relevance section. Consider what is the WHY of the CPG - include both military and clinical relevance (or future threat).

- Please include the CPG’s importance to combat casualty care and any changes since the last CPG in this section. Be sure ‘The Why’ is clear.
- Review past references from previous versions. Remove old/irrelevant references and add/cite new or current literature. The references should include operationally/military relevant data. If there are none available, look to civilian sources. Cross reference with national and international guidelines (if available and appropriate).
- Describe current military experiences, scenarios, studies that support the CPG topic.
- Include relevant JTS data if appropriate (JTS CPG team will assist and the JTS data scientists will review).

EVALUATION AND TREATMENT

Add any other section headings as appropriate for the CPG topic.

If this portion of the CPG is substantial and contains multiple paragraphs of considerable length, please add key points in bullet format at the beginning of each section under this heading. Determine key points and highlight any sentences or key points that should be emphasized in the call out boxes or tables. If there are highly important points, communicate with the JTS CPG team to include them in the Infographic.

PERFORMANCE IMPROVEMENT (PI) MONITORING

Please use current PI metrics in the CPG and highlight anything that should be added, updated, or removed. Please ensure that the metrics enumerated in this section are addressed/mentioned/explained in the body of the CPG as appropriate.

The PI metrics play a crucial role in each CPG and should be carefully considered. If something is a PI metric, then it will be tracked by not only the JTS PI team, but also in the DoDTR. So, for example if the CPG states: “it is crucial to receive _______therapy within ______amount of time,” then both the PI team (for compliance/variance reports) and the DoDTR team will need to track that metric. There should be no less than two and no more than 10 CPG compliance metrics.

REFERENCES

Conduct an updated literature review to determine if any new data has been published on the CPG topic and update all references accordingly.

DOTMLPF-P CONSIDERATIONS (IF APPROPRIATE)

This section has been added to all new and updated CPGs to ensure the JTS CPGs can be used as a guide for leaders/commanders so that clinical care in the operational environment has the appropriate attention and gaps are identified. This section is primarily for commanders, including non-medical commanders. It is to support medical units and can be used as a communication tool to list the resources needed to care for the patient addressed by the CPG. This section will not address clinical care, but rather the needs of the unit in order to perform the clinical care described in the CPG.

DOTMLPF-P is a tool which allows leaders to analyze organizational capabilities from the perspective of “Doctrine, Organization, Training, Materiel, Leadership, Personnel, Facilities, and Policy” when making decisions and resource determinations. This section is meant as a communication tool for teams, units, and command surgeons to ground medical units, clinical care, and clinical standards in an operational framework. This will be challenging and require thought. Not every domain element will be relevant for a CPG and may be left blank. This framework as a CPG appendix is to initiate administrative, training, personnel, material, and acquisition efforts to support best practices for the specific combat casualty clinical scenario addressed in the CPG. DOPTMLPF-P is mission focused, whereas the mission of the CPG is to address the clinical needs of the combat casualty. This section is meant to support what is necessary and drive any changes for gaps that are identified in the clinical care that the CPG addresses.

In summary, this section is meant to define a ‘capability need’ or the ‘capability gap’ to accomplish the mission, which is the care of the casualty, and identify the needed capabilities to treat the casualty according to the clinical guidance described in the CPG.

See the DOTMF-P components descriptions on the next page.