[chinesemedicine]

Everyone agrees that the new Walter Reed National Military Medical Center won’t meet Congress’ definition of a “world-class facility” by its scheduled completion in September 2011.

But military officials say a finished campus will be a good starting point for working toward a world-class facility.

Or, as military planners put it: “Development of a world-class medical facility is not a destination, but rather a journey of continuous improvement.”

An independent board that was asked to review the military’s progress said that’s the wrong place to start: If the Pentagon does not immediately make needed changes, it will waste money and time and disrupt care to wounded service members when the facility is inevitably renovated later.

Lawmakers at a Dec. 2 hearing seemed to agree.

“‘World class’ is most decidedly a destination — one that Congress expects the new facility to arrive at before [it] opens its doors,” said Rep. Susan Davis, D-Calif., who chairs the House Armed Services Committee’s personnel panel.

Rep. Solomon Ortiz, D-Texas, chairman of the armed service’s committee’s readiness panel, lamented the fact that four years after the process of creating a new facility began, “we still have a disorganized medical command, a disjointed funding authority and an inconsistent construction design in support of a $2.5 billion effort.”

The new Walter Reed medical center is scheduled to open in 2011 on the campus of the National Naval Medical Center in Bethesda, Md., under base closure decisions that will shutter the old Walter Reed Army Medical Center, located six miles away in Washington, D.C.

According to the Defense Health Board’s Base Realignment and Closing Health Systems Advisory subcommittee, the military is still struggling with basic tasks, such as a master plan for the capital region’s medical facilities, continued funding for construction on the new Walter Reed project, a determination of who is in charge of the facility as well as who will provide staffing for it, and coming up with fixes for a variety of problems.

Specifically, more than a dozen operating rooms at the new Walter Reed facility do not meet modern standards for size, service members would have to share rooms, and surgeons would have to walk through public areas to reach tissue-specimen storage areas, forcing them to scrub in more than once during a procedure.

Allen Middleton, the Pentagon’s acting principal deputy assistant secretary for health affairs, explained that the process of combining the existing facility in Bethesda with a new world-class facility is complicated, in large part because a major hospital still operates at Bethesda as construction continues around it.

Building such a major facility in a comparatively short period of time in the Washington, D.C., region “is certainly one of the most difficult undertakings in the history of the Military Health System,” Middleton said.

Vice Adm. John Mateczun, head of the National Capital Region Joint Task Force Medical, said construction is 60 percent done, though most of the features that would make the new Walter Reed “world class” will not be complete until after the September 2011 deadline.

Still, Dorothy Robyn, deputy undersecretary of defense for installations and environment, said the facility “will be superior to what we have now.”

Mateczun said the military plans to “evolve operating rooms as we go,” which will leave the hospital with a shortage of operating rooms in the near term.

He proposed extending the workday so doctors could continue with a full patient load.

Mater plans also are being drafted that will guide future funding decisions, Robyn said.

The new facility’s original cost estimate of $800 million has shot to $2.4 billion due to expansion of the project and improvements.

Ken Kizer, chairman of the Defense Health Board’s National Capital Region Base Realignment and Closure Health Systems Advisory Subcommittee, said he is concerned that adjustments are not being made now even as basic construction moves ahead of schedule.

“It means that the window of opportunity to take corrective action is even less than it was several months ago when the [Defense Health Board] completed its report,” he said.

“We have had concerns about the plans for the Walter Reed National Military Medical Center at Bethesda from the beginning,” Davis said. “In hearings and meetings we have had Vice Adm. Mateczun tell us, in effect, ‘Don’t worry — everything is on track.’ We have yet to be convinced this is true. In fact, we have yet to be convinced that the department takes our concerns seriously.”


Article: http://www.militarytimes.com/news/20...gress_120309w/