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Continuous improvement in healthcare support on NATO operations
  1. Jacopo Frassini
  1. Interoperability Branch, NATO Centre of Excellence for Military Medicine, Budapest, Hungary
  1. Correspondence to Capt Jacopo Frassini, Interoperability Branch, NATO Centre of Excellence for Military Medicine, Budapest, Hungary; interop.doctrine2{at}


An unprecedented characteristic of modern healthcare is the progressive increase in information that is available to provide optimal services to patients. Healthcare organisations need to effectively process information, by identifying proper sources and relevance of evidence in order to outline a credible management system. The North Atlantic Treaty Organization (NATO) Military Committee advocates the provision of evidence-based practices in medical support to deployed forces. Moreover, the changing and adapting requirements to deliver up-to-date medical solutions in NATO must also be balanced against the difficult marriage between warfare and healthcare that demands a strong coordination between medical and non-medical multinational players. Continuous Improvement in Healthcare Support to Operations (CIHSO), originally shaped as part of the plan-refine-execute operational planning process to bring best standards of care to troops in a well-defined combat scenario, represents a powerful transformational opportunity to translate evolving knowledge into best military medical practices. The aim of this paper is to discuss areas of possible intervention where CIHSO can enhance quality and safety in allied healthcare systems by progressing from an operational application of clinical governance into a strategic evidence-based decision-making medical tool of the Alliance.

  • clinical governance
  • quality in health care
  • health & safety
  • protocols & guidelines
  • international health services

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  • Disclaimer No direct funds have been used to produce this manuscript, the author wrote this contribute by his own initiative within the approved activities of his duties.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.