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**Trissinas** · 12-01-2009, 02:30 AM

As construction proceeds briskly on the $2.4 billion “world-class” hospital Congress approved to replace Washington, D.C.’s Walter Reed Army Medical Center, a watchdog panel’s review of the project cites serious shortcomings in the planned facilities.

The new 354-bed Walter Reed National Medical Center is slated to open in September 2011, several months ahead of schedule, at the campus of the National Naval Medical Center in Bethesda, Md. Under base realignment and closure policy, the old hospital will be shuttered once the new medical center is in operation.

In September 2008, just a couple of months after construction began, Congress asked the Defense Health Board to conduct a review of the design plans for the new joint medical center. The board, an independent advisory group to the Pentagon, formed the BRAC Health Systems Advisory Subcommittee for that purpose. The subcommittee submitted its report on July 2.

The report found several problems that demonstrate design plans fall far short of Congress’ mandate to build a “world-class” medical center, including:

• Not enough operating rooms.

• Operating rooms too small to accommodate current and future advancements in surgical technology.

• A bed plan that does not include enough single-patient rooms — important for minimizing airborne and contact infections.

• Some nursing stations located too far from patient care areas.

• Uncertainty over whether the plan addresses technological needs such as fiber-optic cabling and wireless services.

Ken Kizer, subcommittee chairman and former Veterans Affairs Department undersecretary for health, said the project — which includes multiple military branches and agencies at local, state and federal levels — lacked a cohesive master plan and clear lines of leadership.

He said Pentagon officials overseeing the project “have to figure out who’s in charge; the authority issue has to be straightened out.”

“That and the budget and the master plan are the three paramount issues,” he said.

Part of the problem, the subcommittee found, is that BRAC money may be used only for new structures, but the plans for the new national medical center also include redesign and renovation of existing structures.

“The two processes have to come together,” Kizer said. “It’s one facility. That’s not rocket science, but it hasn’t happened.”

The subcommittee’s report, titled “Achieving World Class: An Independent Review of the Design Plans for the Walter Reed National Medical Center and the Fort Belvoir [Va.] Community Hospital,” cited lack of clarity by Congress on precisely what “world class” meant in terms of hospital design and construction. “World class” indicates the intentions of Congress, the report said, but “does not provide operational or functional details.”

In part, Walter Reed Army Medical Center is moving from its current digs because of old infrastructure — everything from faulty heating and air conditioning to rough plumbing — and because of what the new facility can offer: a 354-bed center with equipment to treat brain injuries and post-traumatic stress disorder, as well as equipment to help service members with amputations recover.

The long need for a new and improved medical center to replace the more than 100-year-old hospital got sudden attention in 2007, after media reports exposed the squalid conditions and sometimes substandard care wounded Iraq and Afghanistan vets were forced to endure there.

On Oct. 15, Deputy Defense Secretary William Lynn III wrote a letter to members of Congress stating that project design and progress for the new medical center were “sufficient.”

“While Congress has specified that the new [Walter Reed] and [Fort Belvoir Community Hospital] should be designed as world-class military medical facilities, this is not an underlying requirement of the BRAC 2005 recommendations,” Lynn wrote. “Instead, the development of these facilities as world-class medical centers … will be an ongoing process, requiring continuous improvement and benchmarking to commercial best practices.”

The subcommittee responded in a letter to Congress that it was “dismayed” that those conclusions could be made after viewing the report.

Kizer expressed concerns that the Pentagon may have misunderstood his subcommittee’s recommendations in a Nov. 13 letter to the vice president of the Defense Health Board, Wayne Lednar. The board endorsed the letter, which has been forwarded to Lynn. A Defense Department spokeswoman said Nov. 19 that Lynn had not yet received the letter, and therefore had no response.

Article: http://www.armytimes.com/news/2009/1..._reed_113009w/

Walter Reed Army Medical Center
The Walter Reed National Military Medical Center, scheduled to
open in 2011, is shown in an artist's rendering.

12-01-2009, 02:30 AM	#2
Trissinas Join Date Oct 2005 Posts 521 Senior Member	As construction proceeds briskly on the $2.4 billion “world-class” hospital Congress approved to replace Washington, D.C.’s Walter Reed Army Medical Center, a watchdog panel’s review of the project cites serious shortcomings in the planned facilities. The new 354-bed Walter Reed National Medical Center is slated to open in September 2011, several months ahead of schedule, at the campus of the National Naval Medical Center in Bethesda, Md. Under base realignment and closure policy, the old hospital will be shuttered once the new medical center is in operation. In September 2008, just a couple of months after construction began, Congress asked the Defense Health Board to conduct a review of the design plans for the new joint medical center. The board, an independent advisory group to the Pentagon, formed the BRAC Health Systems Advisory Subcommittee for that purpose. The subcommittee submitted its report on July 2. The report found several problems that demonstrate design plans fall far short of Congress’ mandate to build a “world-class” medical center, including: • Not enough operating rooms. • Operating rooms too small to accommodate current and future advancements in surgical technology. • A bed plan that does not include enough single-patient rooms — important for minimizing airborne and contact infections. • Some nursing stations located too far from patient care areas. • Uncertainty over whether the plan addresses technological needs such as fiber-optic cabling and wireless services. Ken Kizer, subcommittee chairman and former Veterans Affairs Department undersecretary for health, said the project — which includes multiple military branches and agencies at local, state and federal levels — lacked a cohesive master plan and clear lines of leadership. He said Pentagon officials overseeing the project “have to figure out who’s in charge; the authority issue has to be straightened out.” “That and the budget and the master plan are the three paramount issues,” he said. Part of the problem, the subcommittee found, is that BRAC money may be used only for new structures, but the plans for the new national medical center also include redesign and renovation of existing structures. “The two processes have to come together,” Kizer said. “It’s one facility. That’s not rocket science, but it hasn’t happened.” The subcommittee’s report, titled “Achieving World Class: An Independent Review of the Design Plans for the Walter Reed National Medical Center and the Fort Belvoir [Va.] Community Hospital,” cited lack of clarity by Congress on precisely what “world class” meant in terms of hospital design and construction. “World class” indicates the intentions of Congress, the report said, but “does not provide operational or functional details.” In part, Walter Reed Army Medical Center is moving from its current digs because of old infrastructure — everything from faulty heating and air conditioning to rough plumbing — and because of what the new facility can offer: a 354-bed center with equipment to treat brain injuries and post-traumatic stress disorder, as well as equipment to help service members with amputations recover. The long need for a new and improved medical center to replace the more than 100-year-old hospital got sudden attention in 2007, after media reports exposed the squalid conditions and sometimes substandard care wounded Iraq and Afghanistan vets were forced to endure there. On Oct. 15, Deputy Defense Secretary William Lynn III wrote a letter to members of Congress stating that project design and progress for the new medical center were “sufficient.” “While Congress has specified that the new [Walter Reed] and [Fort Belvoir Community Hospital] should be designed as world-class military medical facilities, this is not an underlying requirement of the BRAC 2005 recommendations,” Lynn wrote. “Instead, the development of these facilities as world-class medical centers … will be an ongoing process, requiring continuous improvement and benchmarking to commercial best practices.” The subcommittee responded in a letter to Congress that it was “dismayed” that those conclusions could be made after viewing the report. Kizer expressed concerns that the Pentagon may have misunderstood his subcommittee’s recommendations in a Nov. 13 letter to the vice president of the Defense Health Board, Wayne Lednar. The board endorsed the letter, which has been forwarded to Lynn. A Defense Department spokeswoman said Nov. 19 that Lynn had not yet received the letter, and therefore had no response. Article: http://www.armytimes.com/news/2009/1..._reed_113009w/ Walter Reed Army Medical Center The Walter Reed National Military Medical Center, scheduled to open in 2011, is shown in an artist's rendering.
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