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Military Healthcare Convention & Conference Advancing the Continuum of Care:  Keynote-TBI Spotlight, San Diego, California


December 2011

Detection and Prevention of TBI and PTSD: Key Strategy for Continuum of Care and Total Force Fitness

MC Mireles, PhD, MPH, Community Medical Foundation for Patient Safety, Bellaire, TX



Continuum of care (CC) is critical for military total readiness.  A conceptual model of CC based on existing models (DoD Total Force Fitness (TFF), Community of Competence™ (C of C), public health prevention and integrated health care is presented.  This model incorporates the eight mind and body domains of TFF, the generalized model for patient safety of C of C, and the three levels of prevention (primary, secondary, and tertiary) into an integrated health care system.  CC ideally should begin at enlistment and continue through basic training, deployment, return from deployment, and transition to civilian status—the entire life cycle of a soldier.  To demonstrate this CC, mTBI was chosen as an example.  Early detection, particularly in secondary prevention, is critical to diagnose, treat and manage mTBI cases.  Four case reports are presented, including one PTSD case and one normal case for comparison. 

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