improvements so that care in the future will result in a higher degree of quality. Quality assurance activities   reflect   what   patients   and   providers expect of each other. In past years various means of reviewing and evaluating patient care have been introduced by JCAH. In 1979 the JCAH Boards of  Commissioners  imposed  the  requirement  for hospitals  to  coordinate  quality  assurance  activities and   to   use   an   ongoing   monitoring   system   to review and evaluate the quality and appropriate- ness   of   care.   This   approach   is   effective   in identifying  important  patient-related  problems and  is  applicable  in  every  health  care  delivery situation. Many of the principles, standards, and organizational requirements of JCAH have been adopted  and  are  contained  in  NAVMED- COMINST  6320.7  (Quality  Assurance  Program Guide)  as  required  elements  for  quality  assurance programs   of   naval   hospitals,   medical   clinics, and  dental  clinics. COMMAND   PATIENT   CONTACT REPRESENTATIVE  PROGRAM Navy   health   care   professionals   have   long understood the need for good communication and rapport between the patient and the medical de- partment staff. The atmosphere in which patient care  is  given  has  a  tremendous  effect  on  the patient’s  perception  of  the  quality  of  care.  The quality  of  medical  care  rendered  to  Navy  bene- ficiaries  is  superb;  however,  too  frequently  the medical  care  is  perceived  by  the  patient  to  be  poor because  personnel  manning  critical  patient  contact points  are  not  adequately  trained  in  interpersonal relations.  Good  patient  rapport  is  an  essential element of health care delivery. Many complaints voiced  by  patients  would  not  occur  if  personnel manning critical patient contact points presented a  courteous,  positive,  and  knowledgeable  attitude, an  attitude  that  reflects  a  genuine  concern  for  the patient.  To  this  end,  the  Patient  Contact  Program was instituted. The program’s primary goal is to provide assistance by intervention in and resolu- tion  of  patient’s  complaints  or  problems.  As  a covert  to  this  goal,  the  program  strives  to  enhance the   channels   of   communications   between   the hospital and our patient population, as well as our own  internal  lines  of  communication. FAMILY   ADVOCACY   PROGRAM The purpose of the Family Advocacy Program is to identify, treat, and monitor Navy personnel engaging   in   spouse   or   child   abuse/neglect   or sexual abuse, whether physical or psychological. The   program,   a   responsibility   of   the   Navy Military Personnel Command, is guided by SEC- NAVINST 1752.3. In each geographical location, a  Family  Advocacy  Representative  (FAR),  usually a Naval hospital staff member, manages the local program.   A   basewide   committee   composed   of medical,  line,  chaplain,  and  Family  Service  Center personnel  reviews  abuse  cases  and  determines whether  each  case  is  established,  suspected,  or unfounded. Established cases are reported at the central  registry  at  the  Headquarters,  Naval Medical  Command,  where  service  statistics  are compiled  and  the  future  assignment  of  established abusers  monitored  and  controlled. ALCOHOL  AND  DRUG ABUSE  PROGRAM The Navy has established a “zero tolerance” standard for drug usage. The major emphasis is on detection and deterrence of illicit drug use. This involves  the  use  of  urinalysis,  drug  detection  dogs, and  physical  inspections  of  personnel  and property   on   military   facilities.   The   general categories   of   drugs   are   marijuana,   cocaine, amphetamines,   PCP,  LSD,  barbiturates,  and heroin.  While  treatment  is  occasionally  offered to  the  individual  drug  abuser,  the  most  likely outcome  is  appropriate  disciplinary  action  and separation  from  the  service,  especially  after  the second  offense.  Individuals  with  alcohol  abuse or alcoholism are viewed as having a disease. They are often offered treatment at a variety of settings, ranging  from  local  outpatient  care  to  a  6-week residential  program  at  one  of  the  Navy-run facilities.  However,  all  individuals,  either  with alcohol  or  drug-related  problems,  are  totally accountable  for  their  actions  and  the  consequences of  them  in  accordance  with  UCMJ  and  other relevant  federal,  state,  and  local  laws. WEIGHT  CONTROL  AND PHYSICAL FITNESS The  Navy  Weight  Control  and  Physical Fitness activities are a responsibility of the Health and   Physical   Readiness   section   of   the   Naval Military   Personnel   Command   (NMPC).   The policies  governing  this  program  are  outlined  in OPNAVINST 6110.1B. Currently physical fitness testing   is   required   for   all   personnel   on   at 15-11