Monday, March 12, 2012

Focus on the Maternal, Infant Nursing Department

By Dan Barber
Public Affairs Officer
Robert E. Bush Naval Hospital

The Robert E. Bush Naval Hospital first opened the doors to its remodeled Labor, Delivery, Recovery and Postpartum (LDRP) care units in the Maternal Infant Nursing Department (MIND) in the summer of 2003… at the time it was one of Navy Medicine’s “Family-Centered” health care initiatives underway. The hospital decided to call the new LDRP units “Desert Beginnings.”

Since that time, more than 4,000 babies have been born at the Desert Beginnings unit… and since 2008 the trend in the numbers of births have steadily been increasing averaging more than 500 births each year. In calendar year 2011 the hospital delivered a record 631 babies.

The LDRP rooms were designed to provide the safe delivery and medical care for the Mothers and newborns, then converting into a large comfortable room for recovery and postpartum care with enough room for family visitors. A chair in the room can be converted into a bed for Dad if he chooses to spend the night.

After the birth of the baby the hospital’s galley (Navy terminology for food services) provides a special menu where Mom’s can order room service.

And if the case arises for the need of an emergency C-Section, the operating room is always ready and seconds away, by design, from the LDRP.

In addition, the Maternal Infant Nursing Department has a professional staff on hand for teaching new Mom’s the benefit of breastfeeding the newborn.

The Robert E. Bush Naval Hospital is the only hospital in San Bernardino County and one of only 40 hospitals in the entire state of California which has been designated as a “UNICEF Baby-Friendly” hospital. When the hospital first received this designation in 2003 there were less than 40 Baby-Friendly hospitals in the United States.

“The safe delivery and care of the new Mom and baby is number one concern in the Maternal Infant Nursing Department,” said Lt. Cmdr. Joanne Costello, Department Head of the MIND.
“We understand that young women want to deliver their baby just as soon as possible. We understand that nine months can seem like an eternity while being uncomfortable, but we don’t encourage early induction of labor before 39 weeks without it being a medical necessity,” said Costello.

There have been young women coming into the LDRP and demanding that their labor be induced and when denied they leave and visit a civilian medical facility to have labor induced. This action can bring harm to the baby and Mom.

“Some early deliveries are necessary because of maternal diabetes or hypertension that could harm either the mother or child,” said Costello.

According to an article published in the San Bernardino Sun at the end of January of this year, “potential complications of early delivery range from breathing and feeding problems to blood infections for the baby. Also, inducing labor before 39 weeks may double some women’s chances of needing a C-section, when this happens Moms also face a greater chance of complications from that procedure.” Costello added, “Delivery between 39 and 41 weeks is best.”

“Medicine has improved the survivability of premature babies, but we should never take a chance in harming an infant by intentionally bringing them into the world before they are ready,” said Costello.

Thursday, February 2, 2012

Why Walking Can Help Your Heart

By Shari Lopatin
TriWest Healthcare Alliance

Regular walking can reduce your chances of heart problems by about 30 percent, according to Harvard Health Publications.

Those results came from the analysis of 18 studies between 1970 and 2007. Study participants who walked 5.5 miles each week began showing benefits to the heart. And the more they walked, the greater the benefits.

So, just how can walking help you live healthier this year?

Heart Health Benefits of Walking
While countless activities are available to try—such as cycling or yoga—walking has the lowest drop-out rate, said Health Coach Meghean Cook of TriWest Healthcare Alliance.

Regular walking will:
Lower your risk of heart disease
Improve your blood pressure and blood sugar levels
Lower your bad (LDL) cholesterol, while raising your good (HDL) cholesterol
Help maintain your weight
Lower the risk of obesity
Reduce your risk of type 2 diabetes

In addition, did you know walking fast 35 minutes a day, five days a week, will make you feel better if you’re depressed?

A Harvard Health study published in 2005 proved such activity had a significant influence on mild to moderate depression. If walking five days a week is too often, you can substitute it for 60 minutes a day, just three times a week, for the same results.

Start a Walking Club!
If you’re tired of walking alone, or need new motivation to get up and move, why not start your own walking club?

The American Heart Association will “walk” you through the steps at www.mywalkingclub.org.

If you’re not up for starting your own, you can also browse nearby clubs based on your zip code. Walking clubs aren’t only a positive way to improve your health, but help those around you. They can also develop into a great social bonding experience with new or existing friends.

Want more healthy living tips? Visit TriWest’s Healthy Living Portal at www.triwest.com/HealthyLiving.

Thursday, January 5, 2012

Joint Commission, MEDIG Seeks Information

The Joint Commission and the Navy Medical Inspector General (MEDINSGEN) will conduct an accreditation survey of Naval Hospital Twentynine Palms from 10 January 2012 to 13 January 2012.


The purpose of the survey will be to evaluate the organization's compliance with nationally established Joint Commission and United States Navy standards. The survey results will be used to determine whether, and the conditions under which accreditation should be awarded the organization.


Joint Commission standards deal with organizational quality of care issues and the safety of the environment in which care is provided. Anyone believing that he or she has pertinent and valid information about such matters may request a public information interview with the Joint Commission's field representatives at the time of survey. Information presented at the interview will be carefully evaluated for relevance to the accreditation process. Requests for a public information interview must be made in writing and should be sent to the Joint Commission no later than five working days before the survey begins. The requests must also indicate the nature of the information to be provided at the interview. Such requests should be addressed to:


Division of Accreditation Operations

Account Representative

Joint Commission One Renaissance Boulevard

Oakbrook Terrace, IL 60181


The Joint Commission will acknowledge such request in writing by telephone and will inform the organization of the request for any interview. The organization will, in turn, notify the interviewee of the date, time, and place of the meeting.

Patients and staff members may contact a Joint Commission surveyor during this survey and request a public information interview. The Joint Commission survey team will be located in Classroom 4, lower level, phone 760-830-2121. Concerns may also be brought to the attention of the Medical Inspector General (MEDINSGEN) by calling the MEDINSGEN Hotline at 1-800-637-6175, DSN 295-9019 or via e-mail at



While here they will be located in Room H104, phone 760-830-2738

This notice is posted in accordance with the Joint Commission's requirements and may not be removed before the survey is completed.

Date Posted: 05 January 2012

Tuesday, December 27, 2011

Naval Hospital Operating Room "Goes Green"

Last month, the Operating Room (OR) at Robert E. Bush Naval Hospital in Twentynine Palms, Calif., began a new environmentally friendly program in their quest for efficiency.

Typically a single surgical case generates a considerable amount of waste because most of the items used for a procedure are disposable. All items needed for a particular case are put together by a Custom Pack manufacturer such as Cardinal Health in what are referred as Custom Surgical Packs.

In order to reduce the waste from these disposable pack contents, reusable surgical items are being used to replace many of the items found in these packs. In view of this, a coordinated effort to substitute as many disposable products as possible for reusable items was initiated by Lt. Cmdr. Brian Parton in March of 2010, and finally implemented in last month.

With the help of the Materials Management Department staff, the OR implemented the use of reusable surgical gowns, towels, basins, and various drapes from SRI Surgical in combination with smaller, more efficient surgical packs from Cardinal Health. The new items that were substituted will help the command reduce surgical waste generation by approximately 13,000 pounds per year at no additional cost.

The process was not as easy as first envisioned. Since Naval Hospital Twentynine Palms is the first Department of Defense (DoD) facility in the country to fully implement the use of hybrid packs, there were several hurdles to overcome. SRI did not have a Distribution and Pricing Agreement (DAPA) in place, so they utilized their partnership with Cardinal Health to add reusable items to Cardinal's DAPA. In addition, the typical three year contract obligation that SRI utilizes was modified in order to satisfy the requirements of the DoD.

After finalizing the custom pack modifications, determining the delivery and pickup schedule, updating the Defense Medical Logistics Standard Support (DMLSS) supply ordering system, and training staff on proper care and use, the new "Green" items were finally used in surgery. The Army and Air Force are also looking into implementing this program at some of their facilities. Their conversions should be smoother thanks to lessons learned between Twentynine Palms, SRI, and Cardinal Health.

Ensign Jenna Dimaggio of the Maternal Infant Nursing Department is currently exploring the potential use of SRI's reusable items in for their patients as well. Single pull items are also being implemented to minimize the use of disposable gowns and accessories when items that exceed the pack contents are required.

Other initiatives that have been implemented in the Operating Room over the past year include the installation of LED surgical lights in all OR Rooms that reduce energy demand by 40 percent, a new instrument washer that is expected to reduce water consumption by 100,000 gallons per year, the utilization of reprocessed devices from Stryker (Ascent) expected to generate savings in excess of $30,000 dollars, and filterless instrument sterilization containers that reduce waste generation and provide increased infection control measures.

By embracing ideas new ideas, researching innovations, and implementing various process improvement initiatives, the Operating Room staff has exemplified environmental awareness and best business practices within the workplace. They have found ways to reuse surgical items, reduce unnecessary waste, and upgrade equipment, all with the purpose to be more environmentally conscious and to contain costs within Navy Medicine, while still providing the best possible care for patients.

Thursday, October 27, 2011

West Nile Virus Carrying Mosquito Found on Combat Center

Just because this is the Mojave Desert with little apparent water about, doesn’t mean that there are no mosquitoes flying around.

In the past years there have been cases of West Nile virus reported in the lower desert of the Coachella Valley. Just recently a mosquito was found on the Combat Center. “This type of mosquito is known to carry the West Nile virus,” said Lieutenant Shelley Griffith, Public Health Officer at the Robert E. Bush Naval Hospital.

According to the Center for Disease Control (CDC), “People over the age of 50 and people who have ever received a solid organ transplant are more likely to develop serious symptoms of West Nile virus.” However, the CDC points out that a small number of people (about 1 in 150) who get infected with West Nile virus can develop a severe disease called West Nile encephalitis or West Nile meningitis.

Symptoms include headache, high fever, stiff neck, mental confusion, muscle weakness, tremors, convulsions, coma and paralysis. These symptoms may last for several weeks and neurological effects may be permanent. Contact your Primary Care Provider if you develop any of these symptoms. “Most people who get West Nile virus don’t feel sick, but it can lead to a serious illness,” said Griffith. “It is important that you contact your health care provider if you develop any symptoms,” she added.

“You can protect yourself and your family from West Nile virus infected Mosquitoes by removing any standing water,” Griffith said. “Mosquito larva can survive anywhere water may be pooled, such as un-kept swimming pools at vacant properties, old tires or from around the leaking sprinkler system in your yard,” she added. “Prevention is the best way to keep from getting sick.” Griffith said.

The Preventive Medicine Department at Robert E. Bush Naval Hospital will be surveying the Combat Center looking mosquitoes when they are most prevalent. This will include identifying and testing of any mosquitoes that are found. If you have any questions please contact LT Shelley A Griffith at 760-830-2474 or by email at shelley.griffith@med.navy.mil

Tuesday, August 23, 2011

New TriWest Mobile Website, App

Health Info on the Go with New TriWest Mobile Website, App
Delivering Mobile Support to Military Members, Families

PHOENIX (August 23, 2011) — You’re 2,000 miles from home, just about to board a flight. You need to see if your doctor referral was processed and all you have is your smartphone.

Tap… Tap… Scroll… Tap… Got it!

TriWest Healthcare Alliance has launched its mobile website and a mobile application, allowing TRICARE West Region beneficiaries to easily tap and scroll their way to their healthcare information, right from their smartphones and mobile devices.

TriWest manages the Department of Defense’s TRICARE health program for 2.9 million military families in the western United States.

Healthcare Info Goes Wherever You Go
Military families face distinct challenges in their daily lives, routinely managing family moves, household duties and the prospects of a loved one’s deployment.

Providing direct, mobile access to their healthcare information is one way TriWest hopes to reduce some of the burden on military members and families.

“We’re excited to unveil this technology to our customers, because it brings a whole new level of convenience to their busy lives,” said TriWest President and CEO David J. McIntyre, Jr. “Military families can now manage their health care right from their phone, while they’re traveling or at home with the kids—whenever they want or need to use it.”

Mobile Site
TriWest’s mobile website (m.TriWest.com) allows any beneficiary with a secure TriWest.com account to use their phone to:
Receive real-time status of healthcare authorizations and referrals
Check claims
Pay fees or premiums

Mobile App
TriWest’s mobile app provides added features to smartphone and iPad® users, including:
Compare TRICARE coverage plans
Change plans based on life events, such as birth or adoption
Create an address book for doctors
View guidelines for getting care

The app can be downloaded for iPhone®/iPad and Android™ devices.

Learn more about TriWest mobile capabilities, including text alerts, at TriWest.com/GoMobile.

About TriWest
TriWest Healthcare Alliance partners with the Department of Defense to do "Whatever It Takes" to support the healthcare needs of 2.9 million members of America's military family. A Phoenix-based corporation, TriWest provides access to cost-effective, high-quality health care in the 21-state TRICARE West Region. Follow us on Twitter and Facebook or visit www.triwest.com for more information.

Thursday, July 7, 2011

New model of health care delivery and communications improve patient satisfaction

By Dan Barber, Robert E. Bush Naval Hospital
Public Affairs Officer
Robert E. Bush Naval Hospital

The Robert E. Bush Naval Hospital offers “Medical Home Port” to enrolled patients.

The Medical Home Port model will allow patients enrolled at Robert E. Bush Naval Hospital, to see the same team of providers each time they call or come in for medical appointments. The ultimate goal is to see your personal Primary Care Manager (PCM) as often as possible. However, if they are not available, another provider on the same team will see you.

In addition to providers, the team of healthcare professionals will also be made up of nurses, clerks, and hospital corpsmen that are dedicated to providing their patients with the best possible care. Patients will be able to get to know the rest of the staff as well as they know their provider. According to a recent article in the Los Angeles Times newspaper, Four physician groups… the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians and the American Osteopathic Assn. , believe this method of patient care, known as patient-centered medical homes will provide patients with more access to primary care and allow longer appointments.

Medical Home Ports add continuity of care for patients even when the active duty provider deploys. The combination of both civilian and military team members cultivates stability for the teams and patients when military members are transferred or deployed.

The hospital’s Facilities Management Department is in the process of arranging the clinics spaces so team members will all be co-located.

In addition to assigning patients to one of three teams here, Naval Hospital Twentynine Palms has established ‘Naval Hospital 29 Online’ which is powered as a secure messaging program by Relay Health™ contracted through Navy Medicine. Naval Hospital 29 Online is a secure computer based program which provides a more convenient method of communications with the healthcare teams, allowing patients to securely communicate, via e-mail. Naval Hospital 29 Online allows patients to request their lab results; request a medication refill; access health care information and allows them to create their own health care record to help manage their own care, all from the comfort of home. A feature of this new communications concept that should prove very popular, patients will be able to request appointments through the Naval Hospital 29 Online link on the hospital’s web site. The hospital’s Information Management team has been working on this project to make it easy for everyone to use in a secure forum to protect patient to provider communications.

According to the Executive Officer of the hospital, Capt. Cynthia Gantt, “We hope that ideally by using this method of health care delivery and communications we will increase patient satisfaction with the services they receive here at the hospital, and at the same time increase the efficiency of our clinics to allow providers or other team members to have more time with each patient which should lead to healthier and happier patients.”