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

NavyMEDIGHotline@med.navy.mil

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

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.

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

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.

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.”

Summer Is Here -- Protect Yourself From The Sun

By Martha Hunt, MA CAMF
Health Promotion and Wellness
Robert E. Bush Naval Hospital

Warning: exposure to the sun's ultraviolet (UV) rays can damage your skin! At 93 million miles away we sometimes don’t realize how dangerous the sun can be as far as skin damage that can lead to cancer and damage to our eyes that can lead to cataracts.

Each year, approximately one million skin cancers are detected in the US. Reducing your exposure to the sun’s ultraviolet (UV) rays can decrease your risk of skin cancer.

Want to know how you can protect your skin and eyes while still having fun outdoors?

Here are some tips to help protect you and your family from the damaging rays of the sun.

Avoiding the sun during the midday hours provides the best defense against skin cancer. However, if you can’t avoid the midday sun, remember that choosing shade, hats, sunscreen, etc can protect your skin.

Use sunscreen everywhere - not just to the pool or beach. Use a sunscreen with a sun protection factor (SPF) of at least 15, generously apply it 30 minutes before going outdoors and reapply it frequently throughout the day, especially after swimming or exercise. A couple of general tips: avoid sunscreen sprays, pumps and powders because the chemicals in them can be inhaled, and choose products that use the minerals zinc or titanium as their active ingredient because they're the most stable.

Don’t be mislead by the very high SPF numbers found on some sun screens as it can give you a false sense of safety in the sun and causing you to reapply less frequently or stay in the sun for longer periods.

Never put sun screen on babies under six months old as it can be absorbed through their skin!

The best way to protect your baby is to keep them out of the sun completely by keeping them in the shade, wearing hats and baby size sun glasses to protect their delicate eyes.

Read the label before using any sunscreen to be sure there are no toxic chemicals in them such as PABA, retinyl palmitate or oxybenzone as these chemicals have been found to be hazardous. Oxybenzone is an endocrine disrupter (a chemical that can upset the hormone balance in your body) and retinyl palmitate is a form of topical vitamin A that some animal studies suggest may be linked to an increased risk of skin cancer. PABA has also been linked to increasing your risk of skin cancer.

The research group “Environmental Working Group” has compiled a sun screen safety guide that explains which sunscreens have toxic chemicals in them and which sun screens perform the best. That report can be found at http://breakingnews.ewg.org/2011sunscreen/.

Here are more tips to help prevent skin cancer. Seek Shade! Whenever possible, avoid the midday sun when UV rays are the strongest and do the most damage. When you’re outdoors, look for trees, beach umbrellas or tents as good sources of shade.

Use Your Head and wear a Hat! Up to 80 percent of skin cancers occur on the head and neck, so wearing a wide-brimmed hat is a great way to shade your face, ears, scalp, and neck from the sun’s rays. A hat with a four-inch brim provides the most protection. If you choose a baseball cap, also use a sun-screen with an SPF of at least 15 to protect your exposed ears and neck.

Cover up with clothing! A shirt, beach cover-up, or pants with a tight weave are all good choices for cover. A typical T-shirt usually has an SPF that is much lower than the recommended SPF 15 so you will still need sun screen and shade when possible.

Wear sunglasses! Don’t forget to protect your eyes from harmful UV rays. Sunglasses protect the tender skin around your eyes and reduce the risk of developing cataracts. Look for sunglasses that block both UVA and UVB rays. Also, try wrap-around lenses, which keep UV rays from sneaking in at the sides.

Remember that the damage you do to your skin and eyes as a young person never goes away. That tan or sun burn you got as a young person is directly linked to your risk of skin cancer as you get old. Protect yourself now and save yourself the pain of skin cancer later in life.

June is Men's Health Month

By Martha Hunt, MA CAMF
Health Promotion and Wellness
Robert E. Bush Naval Hospital

“Recognizing and preventing men’s health problems is not just a man’s issue. Because of its impact on wives, mothers, daughters, and sisters, men’s health is truly a family issue.”

Congressman Bill Richardson (Congressional Record, H3905-H3906, May 24, 1994). This statement and resulting legislation led to the beginning of Men’s Health Awareness. There is a silent crisis in men’s health due to a lack of awareness, poor health education, and culturally induced behavior patterns in men’s work and personal lives.

As a result, men are not seeking and getting the preventive health care that they need.

As a consequence of this, men are living approximately five years less than women. Improving men's health is not limited to the doctor's office or hospital - it starts at home with men taking steps to live safer and healthier lives.

In fact, the leading causes of death for men in the United States are – in order - diseases of the heart, cancer, accidents (unintentional injuries), chronic lower respiratory diseases, cerebrovascular diseases, diabetes mellitus, intentional self-harm (suicide), influenza and pneumonia, kidney diseases, and Alzheimer’s disease.

Learn your family health history. Are there any new conditions or diseases that have occurred in your close blood relatives since your last visit to your primary care provider? If so, let your doctor or nurse know. Family history might influence your risk of developing heart disease, stroke, diabetes, or cancer.

Know and understand your numbers. You may know your favorite team's stats, but what about your own health numbers? Keep track of your numbers for blood pressure, blood sugar, cholesterol, and body mass index (BMI). These numbers can provide a glimpse of your health status and risk for certain diseases and conditions, including heart disease, diabetes, obesity, and more.

Work safely. An estimated 11,500 workers have a nonfatal work-related injury or illness every day in the US and as a result, more than half require a job transfer, work restrictions, or time away from their jobs. Get check-ups. Just because you may feel fine, that doesn't mean you don't need your annual check-ups! Unfortunately, there are certain diseases and conditions that are silent and may not have symptoms.

See your doctor or nurse for regular check-ups, and go more often if needed.

Get Vaccinated. Some adults assume that the vaccines they received as children will protect them for the rest of their lives. Immunity can begin to fade over time and as we age, we become more susceptible to serious disease caused by common infections (e.g., flu, pneumococcus). Far too many adults become ill, are disabled, and die each year from diseases that could easily have been prevented by vaccines.

Pay attention to signs and symptoms such as any discharge, excessive thirst, rash or sore on the skin, problems with urination or shortness of breath as these are only a few of the symptoms that males should pay attention to and see a doctor about if they occur. It could be a symptom for a sexually transmitted disease, diabetes, heart disease, cancer, or other conditions or diseases. If you have symptoms, be sure to see your doctor right away.

Get enough sleep. Lack of sleep is associated with a number of chronic diseases and conditions, such as diabetes, cardiovascular disease, obesity, and depression. Moreover, insufficient sleep is responsible for motor vehicle and machinery-related accidents, causing injury and disability each year. Drowsy driving can be as dangerous - and preventable - as driving while intoxicated. Adults should get 7-9 hours of sleep per night according to the National Sleep Foundation.

Gear up properly. When playing active sports or riding a motorcycle or bike, make sure you and your family wear protective gear, such as helmets, eye protection, wrist guards, and knee and elbow pads. Also, wear seat belts as a driver and a passenger each and every time you are in a vehicle.

Eat what counts. Eat a variety of fruits and vegetables every day. Limit foods and drinks high in calories, sugar, salt, fat, and alcohol and choose healthy snacks.

Get physical activity. Be active for at least two and a half hours a week. Include activities that raise your breathing and heart rates and that strengthen your muscles. You don’t have to do it all at once. Spread your activity out during the week, and break it into smaller chunks of time during the day.

Be tobacco-free. Avoid all forms of tobacco and secondhand smoke. Inhaling other people’s smoke causes health problems similar to those of smokers. There is NO safe form of tobacco. Tobacco use is the leading detractor of combat fitness. Call Health Promotion and Wellness at 760-830-2814 if you are interested in quitting tobacco.

For more information on men’s health go to Men’s check list for health http://www.ahrq.gov/ppip/healthymen.htm or Get dad to the doc http://www.dadtothedoc.org/.