FALLS CHURCH, Va. --
The 81st Medical Group at Keesler Air Force Base, Mississippi, transitioned to the Defense Health Agency on October 1, 2018, one of the first military treatment facilities to transfer to DHA management.
The U.S. Air Force Surgeon General Public Affairs Office spoke with Col. Beatrice Dolihite, the 81st MDG director and service commander to reflect on her experience as the commander of one of the first MTFs to move to DHA. Dolihite also offered some advice for other commanders and medical Airmen as their MTFs prepare for the transition.
1. What is your position/title?
I am the 81st MDG director and service commander at Keesler Air Force Base, Mississippi. These two titles mean I am dual-hatted, fulfilling roles with both the Defense Health Agency and the Air Force Medical Service.
2. What does it mean to be “dual-hatted?”
In my role as the MTF director, my primary responsibility is to facilitate and coordinate with DHA in the day-to-day operations concerning the delivery of the health care benefit.
With my service commander hat on, I have administrative control over all of the active duty personnel, our readiness tasks, and anything that would be commander-specific duties. This is also that hat that I wear when I am coordinating efforts with the wing commander.
3. The 81st MDG at Keesler Air Force Base was one of the first MTFs to transfer to DHA on October 1, 2018. How was that process initially?
The process to transition to DHA began a couple months prior to October 1, 2018, and it created a good bit of uncertainty at our facility. However, the DHA transitional intermediate organization, or tIMO, held several tabletop exercises to assist the medical group leadership team in preparing for the transition. We held drills regarding the management of funds, resources, clinical practice and many other health care operations. On October 1, we successfully transitioned to the DHA and our staff continued to provide excellent care to our patients. It ended up being a seamless transition for our patients.
4. What impact has the transition had on your medical Airmen? What support do medical Airmen have at your MTF should they have concerns or questions about the transition?
The biggest impact the transition had on our medical Airmen is the uncertainty created by the change. Change is hard and not everyone likes it, especially such a wide ranging and uncertain change. At first, our medics were understandably concerned about their career options and what will happen to the AFMS.
We have several forums for our medical Airmen to engage leadership to bring up concerns or ask questions they may have about the transition. I think by being transparent and providing constant communication about the transition, we have been able to address the concerns of our personnel and decrease much of that uncertainty they initially felt.
5. What opportunities and benefits do you anticipate seeing as the transition continues? Specifically, what impact do you anticipate on patient care? What impact will the transition have on medical Airmen and Total Air Force readiness?
As the transition continues, I see the ability to share resources across different services. The Coastal Mississippi Market should stand up in the next six months, which is the next phase of the transition for us. The goal of the market construct is to provide us the ability to operate as a system with other nearby MTFs from different services. That should give us the opportunity to share resources, patients, providers, functions, and budget across facilities to improve the delivery and coordination of health care services. The Gulfport Navy Health Branch Clinic and Keesler Medical Center are both under the Coastal Mississippi Market, and letting us share resources and provide better access to care for our patients.
We will also have the opportunity to train together and build market partnerships with health care providers in our communities to provide us with more robust readiness training opportunities.
In partnering with Gulfport Navy, we are also partnering with Naval Hospital Pensacola. We also reached out to Eglin Air Force Base, Hurlburt Field, and Tyndall Air Force Base, in addition to Pensacola and Gulfport, to help address our active-duty patients’ in-patient behavioral health needs. We have come together as a united team and we are working with our local community partners on in-patient care. The whole coast is working together to build this partnership to ensure it meets the needs of the military population, their dependents, and retirees.
One of the major impacts of this market is the increased training opportunities. Right now, we do extensive training within the walls of Keesler’s medical center and we have training affiliation agreements with several hospitals downtown. Going forward, we can now bring in the Gulfport Navy Health Branch Clinic medics as well to train when we go downtown. We set this up as a market partnership instead of just a Keesler-only training affiliation agreement, and I see great benefit in this.
I think this transition now helps us make the most of these shared opportunities for training that maybe we haven’t really tapped into in the past. On the battlefield, that is exactly what we do. We are working right next to our sister service and providing that care. The more we can train like that, the better the outcomes are going to be downrange.
6. How important was the Quadruple Aim Performance Plan (QPP) in meeting your readiness and resourcing needs since the transition?
This first year was really a about getting a good, solid QPP and learning how to use it. In doing that, it was a training period for us where we got a lot of coaching from DHA, and from our service, on what types of things really need to be on that QPP.
While it’s too early to truly see the impact on readiness and resourcing needs, it’s important for commanders to look at the historical readiness demand and try to proactively project those demands into the QPP. When we were looking at ours, we looked back several years to look at what Keesler has been tasked with in the past, what exercises have we participated in, when do we have our training days, and things like that to help us build our first QPP.
7. What was the most important message for Airmen at your MDG/base to hear during DHA Transition? What was the most effective way for you to reach Airmen and beneficiaries?
The most important message for our medics and beneficiaries to hear was that it is a transition to DHA, not a takeover by DHA. This difference was crucial, because there was an initial feeling that that DHA was coming in to take over and change everything, when this really wasn’t the case.
I communicated with my staff in multiple ways. On October 1, I held a commander’s call and highlighted the priorities for phase one of the transition. We added in key messages to our executive committee meeting and our expanded staff meetings. We messaged good news stories and successes through news articles using our base public affairs office. For example, we put out a story on how we received manning assist from DHA, highlighting the effects of the transition. We really wanted to highlight the successes that are coming out of this transition.
The key for me was frequent communication to our medical staff, which was necessary since most of the transition would have an effect on processes regarding how we deliver health care. During organizational change, over communication is one of the keys to success to ensure the staff understands what is going on, what things are changing, because they are the ones who are going to implement those changes. That’s an important takeaway for any MTF commanders – communicate at every opportunity.
8. What advice do you have for medical Airmen at other MTFs to prepare for the upcoming transition?
My advice for others as they prepare for the transition is don’t resist it. Educate yourself on the transition and focus on the processes, which will allow us to better care for our patients. Again, good communication flow (internal and external) is going to be vital to success.
9. What lessons would you pass on to other MDG commanders as their MTFs transition to DHA this October?
Change is hard and it takes time. Leading through a large organizational change like this one takes deliberate thought, planning and communication. During the transition, there will be DHA priorities, AFMS priorities, wing priorities and many others. It will be up to the commander to figure out how to balance those. It is very important to build relationships with DHA colleagues, wing leadership and other key line leaders.
Over this past year, I provided updates to my leadership and kept them abreast of the transition. Our success at Keesler is absolutely due to the support from our wing commander and the 2nd Air Force commander. I had several opportunities to brief them on what was going on and the potential impacts, so they have been extremely supportive. The key is building that relationship and communicating with them.
I would also encourage commanders never to lose sight of why we exist and what matters most - keeping our Airmen medically ready, ensuring we always have ready medics and delivering Trusted Care to all of our patients. In the midst of change, you have to remain focused on what is absolutely critical most important. Change is coming, but it is going to happen over many years, so it is important to not lose sight of the important role we play in supporting the mission … we have patients on and off the battlefield who need us.