Navy Surgeon General’s Get Real, Get Better Message

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Esteemed Shipmates,

For the Navy, the concept of High Reliability Organizations (HRO) was born in the high-risk, unforgiving environments of submarines, aircraft carriers, and diving operations.  HROs function well in a complex environment with a significantly lower rate of mishap and error than expected.  An HRO is not error-free, but demonstrates resilience and improvement by moving past errors and learning from previous failures and suboptimal performance.

As part of our primary mission to support the medical readiness of our Sailors and Marines, we are committed to being a High Reliability Organization.  In fact, the principles of HRO are not only the third of our “4Ps: but are at the very heart of the CNO’s “Get Real, Get Better” (GRGB) initiative.  We must learn from the moments when we “missed the mark”.  Only when we Get Real and are honest with our shipmates and ourselves can we make the necessary improvements to Get Better.  Here are two recent Navy Medicine examples of GRGB:

*         COVID DSCA Teams.  Based on lessons learned from early deployments during the pandemic, we used rapid-cycle feedback to revamp our medical support team models.  We saw traditional deployment packages did not meet the emerging requirements so we “embraced the red” to develop innovative force generation concepts that leveraged expertise from specialized skillsets across Navy Medicine.  The teams’ chief hallmark was their versatility and agility in providing tailored support to local acute care facilities.  Since July 2020, we have deployed teams to 28 different cities where they provided indispensable medical care to civilian hospitals.

*         PHA Backlog.  Early in the pandemic, MTFs experienced a rapid accumulation of overdue Periodic Health Assessments (PHAs) – more than 25% of the force and ultimately affected readiness.  We took a hard look at the PHA process and developed ways to streamline our systems.  We improved our ability to “virtualize” visits while also creating new guidance that increased the prioritization of PHAs and readiness assessments.  The impact of these changes, along with your hard work, were immediate and significant.  By December 2021, we reduced the backlog of overdue PHAs by more than 60,000.

Of course, there will always be challenges – and with them, opportunities for improvement.  As an HRO we are never content with the status quo, but constantly strive to improve. Get Real, Get Better gives us the tools to reach even higher levels of performance. Recently, we sent one of our Forward Deployed Preventive Units (FDPMU) to Poland. While we were able to meet the ten-day timeline for deployment, the team identified several processes that need work.  We are actively applying a “Get Real” approach and investigating how we can improve Navy Medicine’s ability to equip our medical providers for deployment.  With the lessons we have learned – and will continue to apply – we can and we will Get Better in our ability to project medical power for naval superiority.

Thank you for your continued dedication to excellence.

For more on how we can Get Real, Get Better please see link below.

With my continued respect and admiration,


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