JTS RESPONSIBILITIES
The following list outlines the responsibilities of the JTS during the CPG creation process.
LEAD / FIRST AUTHOR RESPONSIBILITIES
The following list outlines the responsibilities of the lead author or first author for a new or updated CPG:
Either option is acceptable, and the division of the workload is ultimately at the first author’s discretion, but all authors must have substantial contribution.
SECTIONS - GUIDANCE
Refer to the guidance below for developing each section of a new or updated CPG.
Note: Authors should not spend time formatting the CPG! JTS technical writers are responsible for formatting the CPGs.
Note: This is an example table of contents. The technical writer will format the CPG, including the table of contents which is a custom table of content based on custom style headings.S
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:
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.
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).
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.
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.
In this column place any doctrinal requirements for the CPG. What needs to be indoctrinated to use the CPG to improve the care of combat casualties.
In this column place organizational requirement to execute the clinical care recommended in the CPG. Does there need to be an OR? A Blood Bank? See description.
In this column place the training implications and training requirements to execute the mission outlined in the CPG. Is the training just CPG training or are there requirements that should be executed in the MHS?
This column could get unruly. In this column list the materiel requirements needed to execute the CPG. This will be mostly medication and stuff.
In this column put the leadership qualities and support that is needed to manage the type of patients being discussed in the CPG.
In this column state any necessary personnel to execute what you have written in the CPG (i.e. trained nurses, lab tech, radiology techs)
In this column list any facility requirements to be able to implement the care discussed in the CPG. Examples: ORs, Burn ORs, pathology lab, instrument throughput.
In this column state what policy is needed to implement best practices:
- A PI policy
- The Golden Hour Policy
SUPPLEMENTAL H&P (IF APPROPRIATE)
Creation of this form is the responsibility of JTS. Please identify specific items in the CPG that must be captured in this form for performance improvement/research of the clinical entity the CPG is addressing. The H&P Clinical Supplement is to help document the relevant care and ensure good PI can be done with the intent of improving battlefield care. This can simply be in an email to JTS CPG team or in the comments of the word document. The JTS adjudication team will cross reference with documentation tools (forms, EHRs, etc.) and assemble a form, if appropriate.
Include updated forms if they have changed. If the CPG is verbose, move extra information to the appendix. See First Author Responsibilities #8. The appendix section can contain extra background and information that is academically relevant but not needed to immediately care for the casualty. Appendices can be used liberally (for example, Burn Care CPG ID: 12) to add information that does not need to be in the ‘guidance body’ of the CPG.