Capt.
Jessica Trueblood-Brown, RN, Beaumont community health nurse,
explains the use of the Health Risk Appraisal.
Senior
leaders become aware of health risk
Clarence
Davis III
PAO, WBAMC
The
William Beaumont Army Medical Center staff held a health fair
at the Fort Bliss Consolidated Troop Medical Clinic Jan. 4
and 5 for approximately 250 sergeants major assigned worldwide
who were attending the U.S. Army Sergeants Major Nominative
Conference.
"Sgt. Maj. of the Army Jack L.Tilley wanted a weigh-in and
health assessment of all sergeants major who were attending
the conference," said Command Sgt. Maj. Terry J. Porter, Beaumont
command sergeant major.
According
to Command Sgt. Maj. Kenneth Russell, Great Plains Regional
Medical Command, "this health assessment of the senior leaders
provides a base line for their health awareness and health
care. The timing of the health fair was excellent. The Beaumont
staff did an excellent job of coordinating the fair and providing
information on cholesterol, cardio-vascular, colorectal cancer
and overall education of your health and health risks."
"It
is a forum for educating the NCO Corps about good health habits
and the effects that destructive habits may have on readiness
of the Force," he added, saying he believes that this is the
first time that a health assessment has been made of the Army's
senior leaders in the NCO Corps. He believes that it should
be conducted at least annually. The health fair communicates
to the senior leaders that the Army is concerned about good
health habits and the effects of harmful habits such as smoking,
not wearing seat belts, poor diet, unprotected sex, etc. Most
important, it provides education and information about a healthy
life style and promotes wellness.
"It gives the soldier the opportunity to prevent illness,"
he said.
With
the present world situation, it is difficult to predict or
schedule when a soldier or a unit will be deployed. "Early
identification of health care problems and being aware of
what health care problems that may arise from the soldiers
in the unit is important because they can be attended to or
solved before they become serious," said Capt. Jessica T.
Trueblood-Brown, RN, Beaumont community health nurse. When
the patients entered the health fair, they were given a briefing
and asked to fill out a Health Risk Appraisal. This appraisal
is a personalized estimation of their risks of death and major
illness in the next 10 years. It uses age and health-related
personal habits as well as national statistics on risk factors
and diseases to calculate your current risk. Risk may be expressed
in terms of "risk age' or "health score." Ideally, your risk
age should be lower than your real age.
The
second part of the appraisal calculates your risk again as
if the risk factors are reduced as much as possible. The result
is your "target" risk age or health score. It shows potential
health benefits if you adopt a healthy life style. These programs
encourage leaders and their soldiers to be more aware of their
health and especially to be safety conscious, she said.
This
health fair is especially important because many of the Army's
command sergeants major are more than 46 years old. This health
fair provides a snapshot of their health and their health
habits. This is important because the health of our nation
depends on the leadership provided by the NCO Corps. "When
the NCO leadership is aware of good health habits, they can
pass this on to their soldiers and lead by setting the example
for habits that promote good health or minimize risk factors
that may be genetic," Porter said.
"Most of all, the health fair provided me with valuable information
that is necessary for the health of myself and my family,"
he added.
"The
health fair is great. It gives the senior leaders the incentive
to take time out from their busy schedules to take care of
their health," said Command Sgt. Maj. James A. Barkley, command
sergeant major for Soldier Biological Chemical Command. "It
makes us realize that at certain points in our lives there
are certain medical procedures that we need to have done.
"I
haven't had all of them yet, but I will get them," he said.
"Now, I can go back to my command and ensure that my soldiers
are taking care of their health and their soldiers' health."
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Dr.
Cecilia Del Moral (left), Beaumont internist, discusses a patient's
case with Jesusita Silva, LVN in the Prime Adult Medicine Clinic.
Both were recently hired under the Beaumont optimization program.
Optimization
increases availability of appointments
Capt.
Marvetta Walker, RN
Baylor Resident, WBAMC
In
1999, the Military Health System (MHS) Optimization Plan was
developed to define a "most effective model" for the military
health care system.
Concurrent
goals of the MHS Optimization Plan were to reduce the costs
of health care delivery while improving access and quality of
care. The Defense Department further developed the concept of
population health improvement as a cornerstone to the MHS Optimization
Plan. This program was to transform beneficiaries from a curative
model to a preventive model. Its focus is to shift from providing
primarily interventional services to providing illness and injury
prevention and health promotion services. The Army Medical Department
developed its Population Health Clinical Optimization (APHCO)
Plan to meet the goals of the MHS Optimization Plan.
In August 2002, after being selected as the first U.S. Army
Medical Command Primary Care Optimization (PCO) site, William
Beaumont Army Medical Center received an initial $547K to optimize
its primary care clinics. Since implementation, the facility
has received additional funding, totaling $4.3M. The Primary
Adult Medicine Clinic received $1.8M of this funding to optimize
its clinic.
Optimization
of the PAMC would require implementation of PCM (primary care
manager) teams, which is central to the PCO process. These teams
consist of a provider (physician, nurse practitioner or physician
assistant), a nurse, (registered or vocational) and a nursing
assistant. The goal is to assign each patient enrolled in the
military treatment facility (MTF) to a PCM team. The team will
be proactive in managing the patient's health and providing
preventive services.
The
PCM team concept enhances continuity of care as well as develops
partnerships between patients and their PCM team. The PAMC would
also require renovations to improve access to care and efficiency
of care. Increasing the number of examination rooms and offices
would increase the number of patients that could be seen at
one time.
Implementation of the APHCO Plan has affected the delivery of
care at the PAMC. The greatest impact has been on access to
care. In July, the PAMC only had two providers, one physician
and one nurse practitioner.
Currently,
the PAMC has eight providers, seven physicians and one nurse
practitioner. "The number of patients we see has increased dramatically.
In March, we expect the patient load to be more than 2000 patients
per month", said MAJ Jennifer Burman, MD, PAMC clinic chief.
Last
August, during the month of implementation, 943 patients were
seen at the PAMC, by November the number had increased by 55.6
percent to 1,697. Five additional examination rooms and two
offices were added to improve access. More clerks were hired
to improve efficiency at the front desk, which also improved
access to providers.
"Patients
used to have problems calling in to the clinic, either due to
a constant busy signal or no answer. There were not enough clerks
to handle the volume of calls. Now we have someone available
to answer the phones, which has improved patient access to providers",
said Burman.
Currently,
the PAMC provides services to more than 9,600 beneficiaries.
Prior to implementation of the APHCO Plan, 5,000 PAMC enrollees
were not assigned to a PCM. Currently, there are 330 enrollees
without PCMs. This month, two additional providers will join
the PAMC team; thereby eliminating the problem. Implementation
of the APHCO Plan is proving successful at the PAMC. Enrollees
are experiencing better access to and more efficient use of
the MTF.
Partnerships
are developing between patients and their PCM teams. These partnerships
focus on the most effective model for the delivery of military
health care.
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