Fort Sam Houston employs team effort to accomplish Army Medical Action Plan.
The United States Department of the Army The Department of the Army is one of the three service departments in the United States Department of Defense. It is headed by the Secretary of the Army, a civilian, who is responsible for the administrative (non-operational) affairs of the United States Army. implemented a five-phase Army Medical Action Plan (AMAP AMAP Arctic Monitoring and Assessment Programme
AMAP As Much As Possible
AMAP As Many As Possible
AMAP American Medical Accreditation Program
AMAP Army Medical Action Plan
AMAP Automotive and Manufacturing Advanced Practice ) this year to improve medical care, services, and transition for wounded Soldiers and their families. The Army achieved success in the first phase of the plan by establishing a list of 10 Quick Wins (See sidebar on page 92) and creating special Warrior Transition Units to care for Soldiers. Phase I was led by Brigadier General Michael Tucker, Deputy Commanding General of the North Atlantic Regional Medical Command and Walter Reed Army Medical Center Walter Reed Army Medical Center, major hospital complex in Washington, D. C., and Forest Glen, Md.; est. 1923 and named for U.S. army surgeon Walter Reed. It is composed of seven units including a general hospital and a research institute. There are several thousand beds. . Fort Sam Houston Fort Sam Houston, U.S. army base, 3,300 acres (1,335 hectares), S Tex., in San Antonio; headquarters of the Fifth Army. San Antonio, long a military center, donated land in 1870 for the site of a permanent military post that was constructed from 1876 to 1890 and is one example of many Army installations that are carrying out a successful AMAP.
"The Army Medical Action Plan at
Fort Sam Houston rocks!" That is the message delivered to the Brooke Army Medical Center Brooke Army Medical Center (BAMC) at Fort Sam Houston, San Antonio is part of the United States Army Health Services Command. It is a University of Texas Health Science Center and USUHS teaching hospital and contains the Army Burn Center. (BAMC BAMC Brooke Army Medical Center
BAMC Bleed Air Monitoring Computer
BAMC Burkhard Analysis and Methods Corporation
BAMC Barring Outgoing Phonebook Match Calls ) and Fort Sam Houston community on a marquee located at the installation entrance at the BAMC exit, off I-35.
The message by Brigadier General (Brig. Gen.) James K. Gilman, Great Plains Regional Medical Command and BAMC commanding general is a pledge that Soldiers returning from fighting the battles of war will not have to fight a bureaucracy to obtain healthcare and other services during their recovery at BAMC and their transition afterward.
During a meeting on July 6, with Brig. Gen. Gilman, Colonel (Col.) Wendy Martinson, U.S. Army Garrison (USAG USAG United States Army Garrison
USAG United States of America Gymnastics
USAG Unix Support Advisory Group ) Commander, and post Army Medical Action Plan (AMAP) planners, Fort Sam Houston's installation Commander Major General (Maj. Gen.) Russell J. Czerw explained the command's focus, stating, "Executing the Army Medical Action Plan is a team effort on Fort Sam Houston. We are working with the Installation Management Command and the Medical Command to provide installation resources and services to Warriors in Transition and their Families. We understand, and we are committed as a team with Brooke Army Medical Center, to a plan of action that provides each Soldier and Family member the care, dignity, compassion and respect they rightfully earned."
On May 15, Gen. Richard A. Cody General Richard A. Cody became the 31st Vice Chief of Staff, United States Army, on June 24, 2004.
General Cody was born in Montpelier, Vermont, on 2 August 1950. He was commissioned a second lieutenant upon graduation in 1972 from the United States Military Academy. , Army Vice Chief of Staff, approved the definition for Warrior in Transition as "An Active Component or Reserve Component Soldier who meets the qualifications of Medical Hold, Medical Holdover hold·o·ver
One that is held over from an earlier time: a political advisor who was a holdover from the Reagan era; a family tradition that is a holdover from my grandparents' childhood.
Noun 1. or Active Duty Medical Extension. It also includes Active Component Soldiers who require a Medical Evaluation Board or have complex medical needs requiring greater than 6 months of treatment. Warriors in Transition do not include Initial Entry Training, Advanced Individual Training, or One Station Unit Training Soldiers except in extraordinary circumstances. Exceptions to this definition must be approved by the local military treatment facility and unit commanders."
Gen. Cody also decided two AMAP areas of responsibility:
* Army Medical Command (MEDCOM MEDCOM Medical Command (US Army)
MEDCOM Mediterranean Regional Committee for START ) will maintain Command and Control for all Medical Hold and Medical Holdover Soldiers.
* Army Installation Management Command (IMCOM IMCOM Installation Management Command ) will maintain Command and Control for all Soldier and Family Assistance Centers except at Walter Reed Army Medical Center.
As part of its AMAP, the Army established 10 Quick Wins (See sidebar) for Phase I of five scheduled phases. The Quick Wins were defined as "any change in process or service in delivering healthcare to Warriors in Transition the Army can implement by June 15, 2007." When Phase I was complete (April 28-June 15), the Army had achieved its Phase I goals.
According to Col. (Dr.) Barry Sheridan, director of BAMC Healthcare Operations, "We have addressed the Quick Wins at BAMC. We have created a Warrior Transition Unit (WTU WTU Washington Teachers Union
WTU Washington Theological Union
WTU Warrior Transition Unit (Army)
WTU Whitetails Unlimited
WTU Weapons and Tactics Unit
WTU Ward Test Urine ) at BAMC to incorporate all the Warriors in Transition. The manning of these WTUs will be filled with Army assets. We will incorporate the triad of squad leader, case managers, and Primary Care Managers."
Sheridan also noted that monthly Town Hall meetings are conducted to identify problems and areas of needed improvement for Warriors and their families. Commanders and staff from the Medical Treatment Facility (MTF (1) (Modulation Transfer Function) A measurement of monitor sharpness. MTF compares the contrast ratio between alternating black and green lines that are one pixel thick. ), the WTU, and the Garrison attend. Escorts now meet families at the airport and bring them to the MTF to meet their Warrior.
Sheridan said that a Soldier and Family Assistance Center is being established to provide administrative and financial assistance; to aid with coordinating government entitlements, benefits, and services; and to provide information and assistance in obtaining nongovernmental benefits and services. BAMC already provides facilities in the hospital for Veterans Health Administration (VHA VHA Veterans Health Administration
VHA Variable Housing Allowance
VHA Villages Homeowners Association
VHA Voluntary Hospitals Association
VHA Virtual Home Agent
VHA Very High Altitude
VHA Vapor Hazard Area
VHA Vermont Holstein-Friesian Association ) and Veterans Benefits Administration (VBA (Visual Basic for Applications) A subset of Visual Basic that provides a common language for customizing Microsoft applications. VBA supports COM, which allows a VBA script to invoke internal functions within Excel, Word and other COM-based programs or to make use of ) liaisons.
In regard to the Army's AMAP Quick Wins, Col. David Baker, BAMC Troop Commander, noted that visitors inspecting BAMC commented that BAMC was already setting the standard. "BAMC was already picking up Soldiers at the airport and taking them to their rooms. Caseworkers were already assigned to the Wounded Warriors," he said. BAMC had accountability of the Soldiers through command formations, to get them out of bed, check profiles, and follow up on Soldiers who weren't getting out of bed, he indicated. "BAMC is at the tweaking tweaking Vox populi Fine-tuning to produce optimal results stage of AMAP, because we already set the standard. BAMC is not coming up with new things to do; we are tweaking certain things to make them better for the Wounded Warriors," he said. Some of the adjustments Baker describes include keyless entries for the burn center patients, because they cannot open the doors; automatic flushers for the toilets; establishing a Family Readiness Group for the Wounded Warriors; continuing to evaluate patients negotiating one or more wheelchairs down a sidewalk; and adding 168 employees to the staff.
"Consolidating a Soldier and Family Assistance Center into a one-stop shop One-Stop Shop
A company or a location that offers a multitude of services to a client or a customer. The idea is to provide convenient and efficient service and also to create the opportunity for the company to sell more products to clients and customers. will make it easier for the Wounded Warrior to get around. Anything that the Wounded Warrior needs will be in this unit. AMAP is a good thing for BAMC and good for the Soldiers and their families. As General Gilman says, the key to success is to never stop listening," Baker emphasized.
MEDCOM has created the MyMEB (My Medical Evaluation Board) Web site on the Army Knowledge Online Web page, allowing Warriors to go online and access the status of their MEB MEB Marine Expeditionary Brigade
MEB Medical Evaluation Board (also abbreviated as MEBD)
MEB Milli Egitim Bakanligi
MEB Muscle-Eye-Brain Disease
MEB Micro Enterprise Bank (Kosovo) . In addition, a physician dedicated to assisting Soldiers with the MEB process is being assigned for every 200 Soldiers involved in the process.
To further assist Soldiers in expediting the MEB process, MEDCOM is implementing new access to care standards for Warriors in Transition. MEDCOM has trained ombudsmen to permit the identification and resolution of problems at the earliest opportunity.
The Army leadership has directed the senior commanders on Army installations to make Warrior in Transition facilities and furnishings top priorities for repairs and improvements. Fort Sam Houston Garrison Commander Col. Martinson directed the re-opening of the BAMC ID Card office on July 10 in the basement of BAMC, specifically for Wounded Warriors and their families. The facility, which has an ID Rapid machine, will be open from 7:30 to 11 a.m. and 12:30 to 3:30 p.m., Monday through Friday. Additionally, the Okubu Barracks bar·rack 1
tr.v. bar·racked, bar·rack·ing, bar·racks
To house (soldiers, for example) in quarters.
1. A building or group of buildings used to house military personnel. has been designated specifically to house Wounded Warriors assigned to the BAMC WTU. During the past few months, thirty-six rooms on the first floor of the barracks complex have been renovated and are in full ADA Ada, city, United States
Ada (ā`ə), city (1990 pop. 15,820), seat of Pontotoc co., S central Okla.; inc. 1904. It is a large cattle market and the center of a rich oil and ranch area. compliance. Recently, $1.5 million was provided by IMCOM to the Garrison to convert an additional twenty-eight rooms to ADA-compliant quarters. IMCOM also provided $4.83 million to add water softeners and anti-scalding devices for burn patients and for the installation of TV cables. Another project being planned is the installation of elevators in the Okubu Barracks to provide expansion of Soldiers quarters to the second floor, if required.
The Garrison staff is also investigating ways to support travel to administrative and medical appointments for the WTU by obtaining two additional ADA-compliant buses with wheelchair lifts that will be operated by the WTU in coordination with the Garrison.
Additional progress was made for Warriors in Transition during the Biennial AMEDD AMEDD Army Medical Department (US Army) (Army Medical Department) Physical Evaluation Board Liaison Officer (PEBLO PEBLO Physical Evaluation Board Liaison Officer ) Training Conference, held in May, in San Antonio, Texas “San Antonio” redirects here. For other uses, see San Antonio (disambiguation).
San Antonio is the second most populous city in Texas, the third most populous metropolitan area in Texas, and is the seventh most populous city in the United States. As of the 2006 U.S. . More than 200 PEBLOs, physicians, administrators, and other stakeholders from military installations around the world attended. The theme for the conference was "Maintain an Army Strong! Through Efficient and Compassionate PDES (Product Data Exchange using STEP [STandard for the Exchange of Product Model Data]) A standard format for exchanging data between advanced CAD and CAM programs. Processing."
Brig. Gen. Reuben D. Jones, the Adjutant ADJUTANT. A military officer, attached to every battalion of a regiment. It is his duty to superintend, under his superiors, all matters relating to the ordinary routine of discipline in the regiment. General of the Army, in his role as Commander, United States Army United States Army
Major branch of the U.S. military forces, charged with preserving peace and security and defending the nation. The first regular U.S. fighting force, the Continental Army, was organized by the Continental Congress on June 14, 1775, to supplement local Physical Disability Agency (USAPDA USAPDA United States Army Physical Disability Agency ), provided the keynote address. During opening remarks, he stressed that overhauling the Physical Disability Evaluation System (PDES) is key to fixing the cumbersome, inconsistent, and confusing bureaucracy for wounded and ill Soldiers and family members. "If there is only one action taken, this is it," he said.
Maj. Gen. Gale S. Pollock, Commander, U.S. Army MEDCOM, and acting Army Surgeon General The U.S. Surgeon General is charged with the protection and advancement of health in the United States. Since the 1960s the surgeon general has become a highly visible federal public health official, speaking out against known health risks such as tobacco use, and promoting disease , spoke during the closing workgroup session. She praised the quality of care that Army medical professionals provide, while recognizing that access to care is an issue of concern.
During the conference, PEBLOs and MEB physicians received certification on the new PDES Transformation Initiatives (TI), a system designed to improve and facilitate medical processing of over 15,000 injured Soldiers in the PDES.
The conference also included dedicated training tracks and updates on medical hold and medical holdover, MEB, the Army Wounded Warrior Program (WWP WWP Wounded Warrior Project
WWP Worms World Party (game)
WWP Workers World Party
WWP World Wide Packets (Veradale, WA)
WWP WebWorks Publisher
WWP Women Writers Project ), retirement services, Social Security, and VA policies and procedures Policies and Procedures are a set of documents that describe an organization's policies for operation and the procedures necessary to fulfill the policies. They are often initiated because of some external requirement, such as environmental compliance or other governmental .
According to Maj. Gen. Pollock, the AMAP vision for Army Medicine, the Department of Veterans Affairs (VA), and other support agencies is the creation of a sustainable healthcare system open to all injured and ill Soldiers for medical treatment, vocational rehabilitation, and successful return to active duty, or transition back into civilian life with follow-up healthcare provided by the VA.
In the June 6, 2007 issue of MEDCOM Now, Pollock notes that AMEDD is providing the highest quality and most advanced medical care for Soldiers on the battlefield, and saving more lives of Soldiers wounded in combat than ever before.
Yet Army leaders and medical professionals know that some wounds lie beneath the surface and are not always visible upon first assessment. According to Pollock, brain injury and psychological stress from combat deployments are a primary healthcare concern for the Army leadership.
In the weeks ahead, the Army will launch a chain teaching program (where a subject is taught to leaders, who then teach it to soldiers, continuing the sessions down through the Army's chain of command) to ensure that all Soldiers know how to identify symptoms of post-traumatic stress disorder post-traumatic stress disorder (PTSD), mental disorder that follows an occurrence of extreme psychological stress, such as that encountered in war or resulting from violence, childhood abuse, sexual abuse, or serious accident. (PTSD PTSD posttraumatic stress disorder.
posttraumatic stress disorder
Post-traumatic stress disorder (PTSD) ) and traumatic brain injury Traumatic brain injury (TBI), traumatic injuries to the brain, also called intracranial injury, or simply head injury, occurs when a sudden trauma causes brain damage. TBI can result from a closed head injury or a penetrating head injury and is one of two subsets of acquired brain (TBI TBI 1. Thyroxine-binding index 2. Total body irradiation ). It will reach more than one million Soldiers and ensure early intervention ear·ly intervention
n. Abbr. EI
A process of assessment and therapy provided to children, especially those younger than age 6, to facilitate normal cognitive and emotional development and to prevent developmental disability or delay. . The goal is to educate all Soldiers and leaders to increase their awareness and understanding of these potentially debilitative de·bil·i·tate
tr.v. de·bil·i·tat·ed, de·bil·i·tat·ing, de·bil·i·tates
To sap the strength or energy of; enervate.
[Latin d health conditions. "As Soldiers deploy on multiple and extended tours to the combat zone, recognition, diagnosis, treatment, and prevention of PTSD and TBI are of utmost importance to our leadership, Soldiers and their Families," Pollock noted.
At BAMC, "We are standing up a special team of professionals to assist in the management of Traumatic Brain Injury," Col. (Dr.) Sheridan said.
BAMC's commitment to Soldiers and their families continues with implementation of the broad initiatives of the AMAP and its installation initiatives.
10 Quick Wins
Goals in Phase I of the Army Medical Action Plan
Approved by Army Chief of Staff General George Casey, Jr.
(The Army defined Quick Wins, included in Phase I of the AMAP, as "any change in process or service in delivering health care to Warriors in Transition the Army can implement by June 15, 2007." The Army met this deadline for achieving its Phase I goals.)
Establish Command and Control. Previously, wounded and ill Soldiers undergoing prolonged evaluation and treatment (termed Warriors in Transition) were segregated by Reserve or Active Component into separate companies that fell under different commands with varying leader to lead ratios, disparate resourcing, and often disparate billeting and support structures. The disparities favored Reserve Component Soldiers in some locations and Active Component Soldiers at others. The Army values the service of all Soldiers regardless of component. The Army Medical Command has new unified companies (Warrior Transition Units) providing leadership and support at a ratio of one squad leader to every 12 Warriors in Transition.
To place a person in the care of an institution, especially one providing care for the disabled or mentally ill.
in the Structure. Previously, the companies supporting Warriors in Transition were not formally manned. Each location was left to devise a method of manning these units by diverting personnel from other duties. In addition the baseline manning document of the medical treatment facility was not adjusted to account for increased workload with increasing numbers of Warriors in Transition. A formal manning document now exists that authorizes personnel to provide leadership, clinical oversight and coordination, and administrative and financial support at a strength based on the size of the population supported. At the heart of this structure is the triad of the squad leader, the primary care manager, and a nurse case manager to provide a synergistic level of support incorporating leadership, medical oversight, and medical coordination and management.
Prioritize Mission Support & Create Ownership. Army leadership has directed the senior commanders on Army installations to make Warrior in Transition facilities and furnishings top priorities for repairs and improvements. In addition they are to conduct monthly Town Hall meetings to identify problems and areas of needed improvement for Warriors and their Families. Commanders and staff from the medical treatment facility, Warrior Transition Unit, and Garrison must attend.
Flex Housing Policies. Policies now allow for single Soldier patient attendee support to receive military or guest house lodging in the same manner that family members of married Soldiers have been authorized. Warriors in Transition are now considered on par with key and essential personnel for military housing vacancies.
Focus on Family Support. Previously, Families arriving at Medical Treatment Facilities in support of a wounded or ill Warrior received varying levels of support. The Army recognizes the importance of supportive Families. Best Practices were institutionalized in·sti·tu·tion·al·ize
tr.v. in·sti·tu·tion·al·ized, in·sti·tu·tion·al·iz·ing, in·sti·tu·tion·al·iz·es
a. To make into, treat as, or give the character of an institution to.
b. across the Army. Escorts now meet Families at airports and bring them to the Medical Treatment Facility to meet their Warrior. Soldier and Family Assistance Centers are being established to provide administrative and financial assistance; assist with coordinating government entitlements, benefits, and services; and provide information and assistance in obtaining non-governmental benefits and services. A Soldier and Family Hero Handbook will be distributed to all Soldiers and Families as a further aid. Formal Family Support Groups are being established With the support of a full-time Family Readiness Support Assistant. The Medical Command has trained ombudsmen to permit the identification and resolution of problems at the earliest opportunity. Consolidated policy is being developed to facilitate processes that support Warriors in Transition and their Families.
Develop Training & Doctrine. Previously cadre and staff in the companies supporting wounded and ill Soldiers received no formal training and no formalized for·mal·ize
tr.v. for·mal·ized, for·mal·iz·ing, for·mal·iz·es
1. To give a definite form or shape to.
a. To make formal.
b. standard operating procedures standard operating procedure Medtalk A technique, method or therapy performed 'by the book,' using a standard protocol meeting internally or externally defined criteria; a formal, written procedure that describes how specific lab operations are to be performed. existed. The Army has developed standard operating procedures for the newly established Warrior Transition Units (WTUs), focusing on the mission of these units--to set the conditions to facilitate the Soldier's healing with the goal of returning the Warrior to duty, or to facilitate the transition to active citizenship. Orientation programs for new WTU commanders and cadre have been developed and the first formal course will be held June 25-26, 007. The Medical Command has increased its training programs in the identification and treatment of Post Traumatic Stress Disorder Post traumatic stress disorder (PTSD)
A disorder that occurs among survivors of severe environmental stress such as a tornado, an airplane crash, or military combat. Symptoms include anxiety, insomnia, flashbacks, and nightmares. with special focus on Social Work personnel, WTU nurse case managers, and psychiatric nurse practitioners. The Army leadership has established a Post Traumatic Stress Disorder and Traumatic Brain Injury awareness chain teaching program for all commanders and Soldiers.
Create Full Patient Visibility. In previous wars, commanders often found it difficult to locate Soldiers after they were evacuated from the battlefield. The Medical Command has greatly improved the ability to provide feedback to commanders through the Joint Patient Tracking Application and is now further improving the reach-back with a letter directly to the Soldier's commander with instructions on how to contact the Soldier and how to submit awards and evaluation reports for battlefield service. The Medical Command has established policy for reception of Soldier-patients arriving by commercial or private transportation. The Army recognizes that Soldiers requiring evacuation may prefer to receive their care close to supportive Family and has developed a system to allow Soldiers to designate a preferred treatment location as part of the pre-deployment process.
Facilitate the Continuum of Care and Benefits. The communication between the DOD (1) (Dial On Demand) A feature that allows a device to automatically dial a telephone number. For example, an ISDN router with dial on demand will automatically dial up the ISP when it senses IP traffic destined for the Internet. and VA continues to improve. As a pilot program, the Army Medical Command is co-locating Veterans Health Administration (VA) and Veterans Benefits Administration liaisons with the Walter Reed WTU nurse case managers to support the continuum of care and benefits, easing the transition for Warriors transitioning from the military to the VA. The Army has developed formal mechanisms to seek the Soldier's approval and electronically transmit the required medical and administrative documents between the Army and the VA to expedite the continuum of care process.
Improve the Medical Evaluation Board (MEB) Process. Previously Soldiers undergoing a MEB had to make an appointment with their nurse case manager to find out the status of their MEB. MEDCOM has created the MyMEB Web site on the Army Knowledge Online Web page, allowing Warriors to go online and access the status and progress of their MEB. In addition, a physician dedicated to assisting Soldiers with the MEB process is being assigned for every 200 Soldiers in the process. To further assist Soldiers in expediting the MEB process, the Medical Command is implementing new access to care standards for Warriors in Transition. Only Soldiers preparing to deploy will have priority over Warriors in Transition for non-emergency appointments.
Enhance Physical Evaluation Board (PEB PEB Physical Evaluation Board
PEB Presidential Emergency Board
PEB Post Exposure Bake
PEB Professional Engineers Board (Singapore)
PEB Pre-Engineered Building
PEB Personal Electronic Ballot
PEB Performance Evaluation Board ) Representation. The Army called Reserve Component lawyers and paralegals to active duty to provide additional legal advocacy for Warriors undergoing the PEB process to act as legal advocates for these Warriors in Transition.
Phil Reidinger is Director of Public Affairs of the Army Medical Department Center and School and U.S. Army Garrison at Fort Sam Houston, Texas.