Ask the Experts: Military Treatment Facilities FAQs

Ruth Cantu

Ruth Cantu, BSN, RN, AACC
Accreditation Program Manager

Ruth Cantu is one of the key Accreditation team members who has supported the Military Treatment Facility service line known as Operation STEMI Care. We interviewed her on the focus for this program dedicated to standardizing care for nine million active, retired and dependent beneficiaries.

Q: Talk a little bit about this project. It was a labor of love, wasn't it?
A: Absolutely, when we were approached to help out Military Treatment Facilities (MTFs) we were very honored that they would come to us for support and assistance. As so many of us in the organization have been touched personally in some way, either a family member, loved one or close friend active in the armed forces, we felt it would be a privilege to help in any way possible. We also have individuals in our organization who have served, so it became more personal to us. While everyone in the organization is very passionate about all of our programs, this one afforded us the opportunity to give back to our servicemen and women directly. I don't think anyone in the organization ever loses sight of the fact that what we do is ultimately about "the patient and their family" and in this instance, we felt exactly the same way, except these "patients and families" have been through so much already, it was our hope to now be able to help and serve their needs.

Q: Your organization has worked with more than 800 hospitals, what was unique to the military equation that required your ability to solve complex problems?
A: With our experience in working with civilian hospitals over a long period of time, we had a good knowledge of the guidelines, internal and external structures, requirements, and reimbursement initiatives that drive civilian healthcare needs. Prior to the implementation of the MTF accreditation program, we had no frame of reference. It required us to learn a new language and to begin to understand what makes MTFs different but also to find the areas of commonality. While MTFs do abide by all published guidelines and regulations, they are not bound to the same reimbursement incentive structures or data submission requirements as Medicare-certified facilities. Other differences included federal policies in place, for example, one known as "force protection protocols" which ensures that military bases/posts/installations (BPIs) are secured and protected at all times. Another challenge was the frequency of personnel turn-over at all levels. While we understood that turn-over occurs in civilian hospitals, we learned that an entire MTF can turn-over in 18 months or less depending on military operational requirements around the world. This led to continuity concerns over MTFs being able to adhere to the requirements for continuous process improvement and maintaining a cross-disciplinary approach to working collaboratively with EMS, emergency medicine, cardiology, nursing, laboratory and other clinical and non-clinical MTF personnel. What we learned was that the overarching program structure known as the "Military Health System (MHS)" had very definite goals, plans and protocols for dealing with targeted initiatives. As such, we felt confident that MTFs would adopt accreditation as a mission driven program ensuring operational standardization and consistency in an environment with significant fluctuations in personnel.

Q: What is in store for the future of the MTF Chest Pain Accreditation program?
A: We have learned a great deal over the past 6 years working with various MTF and we have found MTF to be very similar to civilian hospitals in all their clinical and process related steps in the care of Acute Coronary Syndrome (ACS) / Chest Pain (CP) patients. We will provide expert guided navigation and work with any unique aspects associated with MTF and Department of Defense (DoD) requirements overall. From the beginning the organizational goal was to be supportive in wanting to assist MTFs to improve their processes as well as provide a program to showcase the good work and achievements being accomplished in the care of their ACS/CP patients.

Q: How should interested MTFs contact ACC Accreditation Services to inquire about the MTF Chest Pain Accreditation program?
A: Please e-mail us at or contact us at 1-877-271-4176 or 614-442-5950