Keesler tests for improvement to outpatient care

  • Published
  • By Steve Pivnick
  • 81st Medical Group Public Affairs
Keesler Medical Center is the test site for a process that will improve outpatient medical care throughout the Air Force.

The 81st Aerospace Medicine Squadron, with support from across the medical center, is the focal point for the Base Operational Medicine Cell, which is an improvement to the Air Force Medical Service's Patient-Centered Medical Home delivery of care model.

Lt. Col. Teresa Roberts, 81st AMDS commander, is leading the BOMC test bed. A major goal will be to focus medical providers' efforts on patient care while making administrative processes more efficient.

"We want the BOMC test site to help us take better care of patients as we streamline the administrative practices," Roberts explained. "While there are always concerns with any new process, we want this to be seamless for our patients.

"Right now, we spend a disproportionate amount of time tracking and reporting the same data in different ways to different people, instead of actually 'doing what we do' for our patients. We want to reverse that trend by training and empowering our Airmen at all levels to fix problems for our patients at the lowest possible level."

The initial BOMC team members were defined and linked with subject-matter experts from the 711th Human Performance Wing at Wright-Patterson Air Force Base, Ohio. The 81st AMDS public health area was selected as the designated work center.

"We're directing our initial efforts on the administrative-heavy processes such as pre-placement exams, periodic health assessment, pre- and post-deployment exams, termination and retirement exams, profile and case-management exams and occupational health exams," Roberts explained.

Over the next month, a team from the 711th Human Performance Wing will observe workflow and processes. This follows a preliminary visit here in June by contractors to conduct interviews and obtain feedback regarding work-flow bottlenecks and work-arounds in flight medicine. Similar reviews were conducted at several other bases to obtain samplings across the Air Force concerning flight medicine operations.

A unique aspect of the BOMC is the Airmen working on the team will have the latitude to propose changes to existing directives.

Air Force Surgeon General Lt. Gen. (Dr.) Thomas Travis has given Keesler Medical Center the go-ahead to innovate at base level to create a system that works best to care for patients in coordination with the Air Force Medical Operations Agency and Air Staff, and to propose policy changes.

Col. (Dr.) Paul Nelson, 81st Medical Group chief of aerospace medicine, said, "This is the first time in my career where we've been told by higher headquarters 'Go make things better.' Good patient care, medical standards and laws are non-negotiable, but all the self-imposed 'administrivia' is on the table."

Nelson added that this is the same daily message the medical center staff gets every day from Brig. Gen. Kory Cornum, 81st MDG commander. '

Nelson said Cornum believes, "Do the best for the patient first and deal with the paperwork afterwards.' If something works, great. If not, let's try something different."
Roberts added, "Anytime the things we propose are not in line with current Air Force Instructions, we have a process to request waivers to allow us to proceed. We are being encouraged to improve our processes. It's very empowering and exciting."

Being selected as the BOMC test site is another example of Keesler Medical Center's determination to innovate, according to Cornum.

"Our staff members have great brains," Cornum commented "We want to free them up from red tape to innovate and deliver the best patient care possible."
In the current cost-conscious culture, the focus is on the patient mission and not paperwork that doesn't directly contribute to that mission.

Roberts said, "We will be experimenting and considering the lessons learned through the entire process. It's comparable to the 'fly before you buy' concept."

All active-duty Air Force members could benefit from what is developed through the test cell. Benefits could extend to the total force as well as civilian Air Force employees enrolled in occupational health programs as the lessons learned are adopted by other areas within the AFMS.