55th Medical Group: The Transformers
Featured Spotlights
Written by Eric Slack   
Tuesday, 01 September 2009
55th Medical Group: The Transformers
Despite the challenges of military healthcare in a time of war, this US Air Force medical group has been able to transform its main facility without dismantling services or hurting quality.


Premier Business Partners:

J&J Maintenance
The civilian healthcare world isn’t the only set of providers dealing with reform. Just ask the members of the US Air Force’s 55th Medical Group, where a transformation of its main facility from a hospital to a clinic is proving successful.

The 55th is stationed at Offutt Air Force Base in Omaha, Neb., serving about 50,000 beneficiaries, which includes active military personnel, their dependents, and military retirees. The base’s main medical facility is the Ehrling Bergquist Clinic, which offers everything from outpatient OB/Gyn, orthopedics, podiatry, and general surgery to outpatient pediatrics, family medicine, internal medicine, dermatology, and radiology. It is a 240,000-square-foot clinic that was recently scaled back from a hospital.

Additionally, the 55th Medical Group’s facilities consist of a 25,000-square-foot flight medicine building, a satellite pharmacy, and a medical training building with an aerospace physiological training facility where pilots undergo altitude chamber testing.

Improving operations
The plan to complete the transition of Ehrling Bergquist Hospital into Ehrling Bergquist Clinic has been on the table for some time, but funding for physical improvements came only recently, after the incentive package pushed for by the Obama administration. Previously, its north tower was used as an inpatient ward, but it currently houses outpatient mental health. Funding will allow for everything in the tower to be moved out and renovated.

“One of the driving factors behind redesigning clinics that were once hospitals was to have the first floor be accessible to services for patients and move administrative staff out of these areas,” said Col. Linda Eaton, commander.

Eaton’s office, support staff, and several other command personnel offices will be moved from the first to the third floor. Renovations will also take place in the general surgery, orthopedics, and dermatology clinics. Antiterrorism protection improvements will be part of the renovation, replacing windows and changing the traffic flow in front of the building so vehicles can’t get as close as they can now.

Although most of the care the group provides will be the same, Eaton said it will be using space better. Rather than jamming all its functions into a hospital setting instead of an appropriate clinic setting, the redesigned building will make for a more friendly design. Another rationale for the redesign was the opportunity to offer some clinical space to the Department of Veterans Affairs. Construction is scheduled to begin in the spring of 2010 and be completed by the fall of 2011.

One aspect of the 55th Medical Group’s operations that won’t change after the renovations is its status as a medical training location. In conjunction with the University of Nebraska Medical Center, Ehrling Bergquist Clinic is home to a three-year family medicine residency program. The program is a combined civilian-military program with an emphasis on rural training. The country’s second-largest family medicine residency, roughly 15% of active duty Air Force family practitioners train in this program. The clinic also runs a yearlong dental residency program and has several other training affiliation agreements with providers in downtown Omaha.

“The fact that we integrate with local providers is mutually beneficial for our beneficiaries and the local population,” Eaton said.

Ensuring access
With American troops currently overseas in harm’s way, the 55th has to deal with the inevitable deployment of some providers and support staff. To make up for the shortfall, it receives funding to hire contracted staff for the duration of deployment and in some cases can hire additional civilian providers to see patients the deployed provider would have seen.

“We are fairly lucky in Omaha as it is a robust medical community,” Eaton said. “Deployments do sometimes sacrifice continuity of care for those patients who like to see the same doctor.”

Eaton said the group is fortunate to have a fairly healthy patient population, so issues around continuity of care are not extensive. However, the group’s provider staff and case managers are vigilant about recognizing the patients that need some level of continuity. With the flexibility provided by having some permanent government service civilian providers on staff, patients that express a concern can be enrolled with those providers to maintain continuity.

In situations where the 55th is unable to handle a patient internally, it refers him/her to local providers that accept TriCare, the Department of Defense’s healthcare program.

To support the family practice residency program, the group’s capabilities include some surgical resources as well as some specialties normally not associated with smaller clinics, such as general surgery and orthopedic surgery. Although these providers see patients at the 55th Medical Group, they have agreements with local hospitals to do surgeries at their facilities.

Going forward, the 55th Medical Group’s challenges may be different than for private sector providers, but certainly not unheard of. Eaton said the group has been trying to fill a contract internal medicine position there for a while. The Air Force Medical Service central contracting service is trying to help the group fill that void. The clinic renovation project and reshuffling of the group’s resources will be a large priority in the next two years, but the construction of the private Bellevue Medical Center about two miles from the clinic will allow the 55th to perform some services in the medical center while also supporting the residency program.

One thing that isn’t in question is the quality of care the group provides. In June, it was inspected by both the Accreditation Association for Ambulatory Health Care (AAAHC) and the military’s Health Services Inspection (HSI) team. The group and its facilities passed with flying colors. AAAHC gave the group full accreditation while the HSI gave it the highest possible rating: outstanding. Although Eaton has only been with the unit for a year and will likely have been reassigned before the clinic renovations are complete, she is pleased with the group’s current performance and is optimistic about its future.

“We were only the fourth unit to get an outstanding rating of 42 Air Force facilities inspected in 2008 and so far in 2009,” she said, “Our quality of care is always very good, and my belief is we equally rival or exceed the quality of care in the civilian community.”
 
< Prev   Next >