Southwest Asia –
The U.S. Military’s ability to provide world-class, immediate life-saving care and transportation for Service Members across the globe is preeminent and always improving. Col. Richard Bailey, 3D Medical Command (Deployment Support) (FWD) Commander stated, “We are here to fulfill the promise given to every Soldier, Sailor, Marine and Airman that if they deploy in the service of our great nation and become injured or ill they will receive world-class medical care.”
Maintaining patient records and administrative data across multiple military hospitals, countries and Services is a complex yet critical component to care that prior to now was without standardized processes for patient administration or movement in the CENTCOM area.
Upon arriving to Camp As Sayliyah, Qatar in late fall 2018, Sgt. 1st Class Annette Brown, 3D MC(DS) (FWD) and civilian pre-algebra teacher, volunteered to lead a CENTCOM medical administration team project to develop consolidated SOP for patient administration (PAD) and patient movement. Brown said she volunteered for this project because, “There was a need to standardize procedures and doing so would be a way to improve overall patient by providing greater continuity of care.”
After nine-months of research, collaboration and old-fashioned hard work, CENTCOM now has standard procedures for everything related to patient administration from eligibility and registration to tracking, documentation and movement in theater as well as follow-on definitive care in the U.S.
Until recently every facility, from an Army Combat Support Hospitals to Navy Hospital Ship, Surgical Teams and clinics operating in the CENTCOM Area of Operation operated off independent SOPs and best practices. This new policy combines the best policies into one CENTCOM approved standard policies and procedures from all services and roles of care with direct and immediate impact to Service Member care. “Although every facility has used pre-approved, site specific patient assignment and numbering systems, they were not all speaking the same language. This policy standardizes those practices, improving continuity,” said Brown.
One of the many experts assisting Brown was Capt. Felicia Gilliland with the 528th Field Hospital, Bagdad Diplomatic Support Center. After hearing Brown put out a request for assistance for a CENTCOM PAD SOP Gilliland jumped on-board, without delay, sending Brown reference documents from throughout her career. “Because I have been PAD for almost 22 years, it was my chance to assist in changing how we can improve patient care and documentation but also have the ability to give some heavy input in how patient movement should work as well,” said Gilliland.
Brown started by analyzing SOPs from every location she could, not realizing how big a project this would become. Working with representatives from Bagram, Kabul and Kandahar medical facilities in Afghanistan, Army hospitals in Iraq and Kuwait, the Navy Role 2 facility in Iraq and Air Force Role 2 facility in Qatar, several Role 1 facilities in Kuwait, Jordan, and Qatar as well as Patient Movement entities in Afghanistan, Qatar and Kuwait, she gathered joint, on the ground perspective and expertise. In addition, Brown and her team coordinated for input from CENTCOM, USTRANSCOM, AFCENT, ARCENT, Joint Trauma System, Office of the Surgeon General Leadership and Patient Administration Systems and Biostatistics Activity. “This truly is a combined effort,” said Brown.
“This policy combines the best policies into one CENTCOM approved standard policies and procedures with direct and immediate impact to Service Member care,” said Brown, adding, “Now, every facility will know instantly where a patient was treated and what care was received for and all services and treatment facilities are speaking the same language with similar reports and data capturing procedures to ensure the care received follows the patient throughout their military career.”
“If a service member needs to travel from Afghanistan to Kuwait and then to Germany, every provider and administrator along the way will instantly have access to an accurate and complete patient care history,” said Brown.
An Army.mil article, by Michael Klieman (2019, Dec. 2), “USTRANSCOM oversees strategic theater patient movement”, (https://www.army.mil/article/230534/) describes the, 8,000-mile evacuation of a Service Member from Bagram Air Base, to Brooke Army Medical Center.
“This article sites a case that highlights how standardized procedures across the Combined Joint Operations Area helped facilitate successful movement of a critical patient to the States for definitive care,” said Brown.
Brown stressed this policy is focused on improved patient care through standardized administrative and movement procedures and accurate documentation and required a total team effort. “The procedures the 'En Route Patient Staging System team in Bagram, at Craig Joint Theater Hospital, followed were from the CENTCOM PAD and Patient Movement policy draft. From a strategic point, USTRANSCOM established priorities and procedures for this type of movement. How everyone worked together to successfully treat, document and move the patient from Bagram directly to San Antonio was a combination of our standardized procedures and ones from USTRANSCOM, Theater Patient Movement Requirements Center–Europe, the Patient Administration teams and Air Evacuation specialty crews. It truly is a combined effort,” said Brown.
This SOP also spells out processes for when NATO and Coalitions partners deploy, and require medical transportation for treatment. Gilliland worked with liaisons from Canada, Romania, and Australia who wrote their own SOP's explaining how the US can facilitate moving their Service Members. “This SOP also covers troop movement to a US Role IV facility and steps to get service members to their home country, said Gilliland, adding, “These small intricacies of PAD downrange can be the difference between life and death of a patient.”
After nine-months of extensive research collaboration and writing, the new policy is set for implementation across CENTCOM, but implementation is the first step in the process, next is training, “Our goal is to design a specific program to develop and implement training for PAD professionals deploying to contingency operations,” said Gilliland.