Technology Assessment and Requirements Analysis Team Helps Put Medical Facilities Back on Track

Jill Lauterborn

“Today is a blur for me,” said CW3 Terry Dover, fresh from temporary duty. “I walked into my office over there, and I said, ‘Where’s all my stuff? Did I get fired while I was gone?’ ” Fortunately, it was just another office move. Dover’s papers and belongings were boxed in a new office.

Dover is used to being on the go. He and colleagues on the U.S. Army Medical Materiel Agency (USAMMA) Technology Assessment and Requirements Analysis (TARA) team have experienced steady growth and inevitable changes over the past few years. Dover is the Project Manager for Clinical Technologies and the TARA Team Lead in the Integrated Clinical Systems Program Management Office.

A key component of the U.S. Army Medical Research and Materiel Command, USAMMA manages strategic-level medical logistics and provides medical equipment for Active Component, U.S. Army Reserve, and U.S. Army National Guard forces. Comprising a full-time team of 14 and drawing on a corps of expert consultants from the U.S. Army Office of the Surgeon General, the TARA team conducts thorough analyses of medical treatment facilities.

The team assesses clinical operations; workload requirements; technical operations; and equipment maintenance, use, and life cycle. The team then translates those findings into recommended process improvements and equipment replacement plans. Since 1995, the program has achieved a recognized cost savings of $231 million for the Army Medical Department in service and maintenance contracts, equipment purchases, group buys, and environmental hazard reduction.

Dover’s team charts an ambitious schedule; it is slated to assess seven Army medical centers and hospitals this year alone. By year’s end, the TARA team will have zigzagged across the country, working in Maryland, Kentucky, Texas, Georgia, Washington, Alaska, and California. In past years, the team has deployed to such far-flung locales as Korea, Kuwait, Afghanistan, Iraq, and Honduras.

COMPUTED TOMOGRAPHY
Along the way, the team has made vital changes to outdated doctrine at medical treatment facilities worldwide. Dover cites the increased use of, and reliance on, computed tomography (CT) scans as a prime example.

Comprising a full-time team of 14 and drawing on a corps of expert consultants from the U.S. Army Office of the Surgeon General, the TARA team conducts thorough analyses of medical treatment facilities.

“We changed things dramatically when we went into the Gulf War,” said Dover. “The CT became essential [toward assessing] the types of trauma we are seeing now. With a CT, you can see everything to some degree, and you can perform a CT scan in a couple of minutes to know what is broken … where things may be bleeding. That becomes critical when you go into surgery.”

The CT’s benefits extend beyond the operating room, as the scans provide important feedback to field combat units. “If we see certain head injuries on a CT, we know the armor is not doing the job,” said Dover. “Or maybe it’s doing the job but missing this part of it. So people are going to go back and say, ‘Look, we know blast injuries are doing this. We are protecting the skull, but we have all these other problems.’ ”

CT is just one tool in TARA’s growing arsenal. Dover’s overriding mission is to assemble joint teams to better understand how different forces’ facilities might operate.

“The intent is to pool [experts] from different areas, so when we walk through the doors [of any] facility, that gives us instant credibility,” Dover said. “There are some nuances in how the Army does things, how the Air Force does things, and how the Navy does things, but ultimately, how they treat patients is really the same.”

OUTLINING CAPABILITIES
A TARA assessment can also outline a facility’s capabilities, enabling incoming personnel to get up to speed quickly. During winter 2009, the team traveled to Soto Cano Air Base in Comayagua, Honduras, to evaluate the medical element at Joint Task Force-Bravo (JTF-B) before a new logistics chief arrived. What the team found was a facility in need of logistical guidance.

JTF-B is wholly dependent on generators for its power. The hot and humid climate, with rain half the year, is hard on equipment. Base personnel must send the equipment stateside for maintenance. If a crisis occurs, humanitarian or otherwise, staff must pull field equipment from the clinic.

The TARA team was able to assess the equipment and put together a replacement schedule, ensuring that critical medical equipment used in delivering health care to our deployed members is the best it can be and within safety and regulatory management controls.

In just one week, Dover and 10 team members combed through JTF-B, evaluating the facility’s nursing and operations, equipment and laboratory, diagnostic imaging, and image archive and transfer system. The resulting report included an inventory of more than 150 items, from operating tables to battery chargers, listing manufacturers, model numbers, and life expectancy for each piece of equipment. TARA also streamlined the equipment replacement process and made recommendations in other areas, from staffing to training to record-keeping, all with an eye to improving operations, safety, and quality of care.

U.S. Air Force Maj Andrea Ryan, the incoming JTF-B Logistics Chief, reported to the base four months after the assessment and praised what Dover’s team was able to achieve in its short time at the facility.

“Chief Dover has been nothing short of amazing,” said Ryan. “The TARA team was able to assess the equipment and put together a replacement schedule, ensuring that critical medical equipment used in delivering health care to our deployed members is the best it can be and within safety and regulatory management controls. [That] support for field operations is more than any medical logistics officer could ask for.”

For more information on the TARA program, visit http://www.usamma.army.mil/tara.cfm.


  • JILL LAUTERBORN is a writer for the U.S. Army Medical Research and Materiel Command. She has nearly two decades of editing and writing experience.