Life Saving Life Cycle Management

By January 17, 2017Army ALT Magazine, Logistics
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Central management of medical materiel keeps four fully stocked combat support hospitals at the ready.

by Maj. Nikki L. Davis

More than a dozen years of combat have offered many lessons learned for Army medicine. As a medical materiel life cycle manager, the U.S. Army Medical Materiel Agency (USAMMA) has learned that every equipping decision has to be both affordable—including life cycle logistics costs—and cost-effective in addressing the known capability gaps. Over-procurement of medical materiel to close a specific gap may reduce our ability to close other gaps and support today’s expeditionary Army.

One way we achieve greater and sustainable medical readiness is through centralized management of high-value, high-volume materiel. An example of this centralized management is the Medical Materiel Readiness Program (MMRP), which began in 2007 under the authority of the Office of the Surgeon General.

MMRP consists of four complete 248-bed combat support hospitals (CSHs) that comprise complex equipment that requires annual maintenance on a rotational basis and must be continually updated by the USAMMA personnel at Sierra Army Depot in Herlong, California. USAMMA biomedical maintenance engineers perform technical inspections and calibration on biomedical maintenance-significant equipment for one CSH per quarter. USAMMA funds Sierra Army Depot to perform care of supplies in storage and repairs on the nonmedical associated support items of equipment. The ability to request specific elements or an entire CSH allows the four MMRP CSHs to offset the requirement for the U.S. Army Reserve Command to maintain sixteen 248-bed CSHs and supports the U.S. Army Forces Command’s seven 164-bed companies.

Lt. Col. Anita Lesure, a Soldier with the 801st CSH and head nurse of the operating room, examines a patient's chart to decide further treatment during a MASCAL exercise simulating a helicopter crash with 32 casualties at Fort Hunter Liggett, California in May 2016. Medics gave battlefield aid and evacuated the casualties to the CSH. (U.S. Army photo by Sgt. Kimberly Browne, 350th Public Affairs Detachment)

CSH SUPPORTS CASUALTIES EXERCISES
Lt. Col. Anita Lesure, a Soldier with the 801st CSH and head nurse of the operating room, examines a patient’s chart to decide further treatment during a mass casualty (MASCAL) exercise simulating a helicopter crash with 32 casualties at Fort Hunter Liggett, California in May 2016. Medics gave battlefield aid and evacuated the casualties to the CSH. (U.S. Army photo by Sgt. Kimberly Browne, 350th Public Affairs Detachment)

UNPRECEDENTED LIFESAVING

To fully understand the MMRP, you must first envision a CSH, which is the Army’s most complex medical unit. Each CSH contains thousands of medical equipment items that are packaged and transported in hundreds of military-owned cargo containers.

CSHs have provided unmatched Role 3 combat health support with a 98 percent survivability rate—the highest in the history of American warfare. The CSH provides hospitalization and outpatient services for all categories of patients within theater. The hospital has four wards providing intensive nursing care for up to 48 patients and 10 wards providing intermediate nursing care for up to 200 patients. The CSH offers pharmacy, psychiatry, public health nursing, physical therapy, clinical laboratory, blood banking, radiology, nutrition care services, emergency treatment receiving, triage, and preparing incoming patients for surgery. Within the hospital, there are surgical capabilities that include general, orthopedic, thoracic, urological, gynecological, and oral and maxillofacial—based on six operating room tables staffed for 96 operating table hours per day. Consultation services for inpatients and outpatients include area support for units without organic medical services.

Role 3 capabilities includes resuscitation, initial wound surgery, postoperative care, and more advanced ancillary services. To maintain their success rate, CSHs need significant maintenance support, as well as regular modernization to keep them updated and fully operational. Additionally, many pieces of lifesaving medical equipment, such as computed tomography (CT) scanners, are expensive and technically sophisticated, requiring specialized equipment care and calibrations performed by certified maintainers. By centrally managing four CSHs through the MMRP, USAMMA is able to ensure medical materiel that requires a significant level of regular maintenance is fully operational at all times and capable of being deployed to support active and reserve units based on the needs of the mission.

A nurse from the 212th CSH attends to a simulated victim at a mass casualty cuts the trousers away from a simulated victim at a MASCAL in June 2016 during Exercise Anakonda 2016, a Polish-led multinational exercise of about 31,000 participants and a premier training event for U.S. Army Europe. CSHs can offer intensive nursing care for up to 48 patients and intermediate care for up to 200. (Photo by Sgt. 1st Class John Fries, 326th Mobile Public Affairs Detachment)

FULL SPECTRUM OF CARE
A nurse from the 212th CSH attends to a simulated victim at a mass casualty cuts the trousers away from a simulated victim at a MASCAL in June 2016 during Exercise Anakonda 2016, a Polish-led multinational exercise of about 31,000 participants and a premier training event for U.S. Army Europe. CSHs can offer intensive nursing care for up to 48 patients and intermediate care for up to 200. (Photo by Sgt. 1st Class John Fries, 326th Mobile Public Affairs Detachment)

Though the MMRP was first developed as part of the Army Medical Department investment strategy to support the Army force-generation model, the program now supports the sustained readiness model, underscoring the need for all Army units to be ready to deploy at all times. As mission demands grow and resources shrink, it is imperative that these four CSHs are sustained at the highest state of readiness. Anything less is not an option.

Since its development, MMRP has been called on by the Army several times. In 2009, USAMMA deployed medical assets from MMRP in support of 31st CSH deployment to Operation Enduring Freedom. During that period, MMRP provided more than 60 pieces of medical equipment valued at over $4 million to support the 31st CSH. The most recent use of MMRP was in July 2016, when USAMMA issued three dental medical equipment sets to the 28th CSH, making advanced dental care available to both U.S. and allied forces.

The goal of MMRP is to deliver efficient and sustainable medical readiness. The MMRP ensures four centrally managed CSHs are maintained at a maximum state of readiness for their entire life cycle—from when they are assembled and throughout their usage until they are modernized or divested. To reduce costs where possible, the MMRP focuses on efficiently managing maintenance, inventory, spare parts and storage. When compared with the costs of having to field and sustain all previous active companies and reserve CSHs, MMRP reaps an annual cost savings for the Army of $12.3 million in reduced care of supplies in storage and approximately $500,000 in sustainment costs.

CONCLUSION

Central management of medical materiel makes sense—both in terms of cost control and sustainable readiness. MMRP is a solution that provides greater value to today’s Army where resources are limited and readiness is not an option but rather the No. 1 priority.

For more information or questions and details about the MMRP program, contact USAMMA Centrally Managed Programs at 301-619-4462. Or, see SB 8-75-S7 Chapter 6 and Appendix C – Template for Request for Release of MMRP.

1st Lt. Chuck Venable, a resident in the 10th Combat Support Hospital, and Sgt. Ravalene Butler, aviation medical noncommissioned officer of the 140th Aviation Regiment, 40th Combat Aviation Brigade (CAB), treat a simulated patient at a tactical combat casualty care lane at Camp Buehring, Kuwait in February 2016. CSHs can treat any patient in theater and handle everything from dispensing prescriptions to performing oral surgery. (U.S. Army photo by Staff Sgt. Ian M. Kummer, 40th CAB Public Affairs)

EQUIPPED TO CARE
1st Lt. Chuck Venable, a resident in the 10th Combat Support Hospital, and Sgt. Ravalene Butler, aviation medical noncommissioned officer of the 140th Aviation Regiment, 40th Combat Aviation Brigade (CAB), treat a simulated patient at a tactical combat casualty care lane at Camp Buehring, Kuwait in February 2016. CSHs can treat any patient in theater and handle everything from dispensing prescriptions to performing oral surgery. (U.S. Army photo by Staff Sgt. Ian M. Kummer, 40th CAB Public Affairs)


MAJ. NIKKI L. DAVIS is chief of centralized contingency programs at USAMMA at Fort Detrick, Maryland. She holds a master of arts in human services from Liberty University and a bachelor of science in social work from East Carolina University. She was commissioned a Distinguished Military Graduate through the Reserve Officers’ Training Corps in December 2002 as a Medical Service Corps officer. Her military education includes the Army Medical Department Officer Basic Course; the Medical Logistics Management Course; the Army Medical Service Captains Career Course; and the Command and General Staff College. She is Level II certified in program management.

This article was originally published in the January – March 2017 issue of Army AL&T magazine.

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RELATED LINKS

U.S. Army Medical Materiel Agency