The Excellence Health Care and Quality Patient Care at EMFK Kuwait Naval Hospital - Term Paper Example

Introduction Providing health care in different regions of the world is followed with different stipulations and expectations. These regulations also differ with the direction and organization which is offered. When examining health care and quality patient care at the EMFK Kuwait Naval Hospital, it can be seen that specific regulations and policies are followed, all which create a different outlook and sets of responses for those who are in need in the region. The advantages of this hospital come from the organization that is used as well as the regulations which are being followed. This has occurred despite the placement in Kuwait and the conditions which are a part of the hospital. This research paper will examine the different applications to health care in this region as well as how it is continuing to expand and overcome specific challenges within the community. Details of the EMFK The EMFK unit is located in Kuwait City, Kuwait and is funded by CENTECOM, a division which is under the United States Defenses. The individuals which are served under this hospital unit include service members of the army that have been shifted to Kuwait under the United States army and which are a part of Camp Arijfan. Soldiers, sailors, airmen and marines that are under the Operation Iraqi Freedom and Operation Enduring Freedom have access to the facilities when in need of health care (Mahowald, 2010). The services that are offered extend to The US Air Force, US Navy, US Marine Corps and US Coast Guard. It is also known that soldiers from the UK, Australia, Romania and Poland are deployed at this camp. There are thousands of soldiers who move into the military camp while returning to or from Iraq that are in need of assistance. The fluctuation with the demographics of the facility then continues to change, depending on the commands or missions that are associated with the different time frames (Global Security, 2010). The military agency for the hospital unit is one of the divisions that are a part of Camp Arjifan. The administration of the army for the hospital is required to look over and manage the different components that are a part of the military. This begins with ensuring that ethics and legalities are up to standard and are used in relation to the main army expectations. The relationship to the army makes the administrative personnel bound to specific laws and regulations, all which define the ethical standards that are a part of the administration. There is also the need for the administration to focus on the other noncombat roles in terms of care, treatment that is being done and the health that is required for individuals. Physicians, assistants, nurses and medics that are in the agency are required to follow the same ethical policies as well as offer specific types of care and treatment to soldiers that are coming through the facility. These administrator roles are then able to comply with standards in the terms of United States health care as well as specialized ethics and legalities that comply with the various army divisions (Bloche, Marks, 2005). The administrative duties also include overlooking the different problems with the soldiers as well as the level of health care that is used in terms of labeling different individuals who come for the care. Those who come into the army are required to receive a specific amount of care. This is diagnosed by various degrees as well as types of sicknesses through the physicians, nurses and assistants that are helping those who are ill. The administrative duties are required to overlook this to ensure that it complies with ethics and standards of both health care institutes and the army. The specific diagnosis ranges from disability that can lead to discharges to temporary injuries. There are also specifications in terms of mental health, minor injuries and physical checkups that are required when moving into different operations. The administrator is required to have knowledge on what these charges mean as well as what the needs are for those who are using the medical facilities (Bell et al, 2008). The EMFK roles of the administrator require overlooking the hospital and ensuring that the correct duties are performed in terms of health care, legalities and ethics. The health care administrator is also the commanding officer of the camp, which creates more refined roles and responsibilities. The Commanding Officer / administrator manages 11 personnel in the medical unit and is responsible for different types of duties underneath this. This includes consultation processing, civilian / contractor patient eligibility procedures, patient admission and discharge procedures, British military patient admission, translator services, inpatient medical records, release of PHI procedure, serious incident reporting, urgent patient MEDVAC procedures, patient movement requests, MEDEVAC escorts, decent affairs procedures and patient care attendants. Each of these duties has to comply with both the need to comply with the standards of the army as well as health care procedures that ensure the safety of the patients on the facility (Iverson, 2010). The scopes of responsibilities that are a part of the administrator at EMFK include several layers of defining the needs of patients. The consultation processing includes overlooking the initial check – in of different patients as well as the records that are a part of the soldier’s record. If there is consultation with nurses, doctors or physicians, then the administrator is required to process the information. The diagnosis and the different treatments which are given by the doctors are also required to be overlooked by the administrator, specifically for the assurance that the correct communication is received. The main component is to work as a liaison between patients and doctors while regulating the ethics, legal responsibilities and health care expectations of those that are caring for the patients. This relates to the scope of work with the civilian / contractor patient eligibility procedures. The administrator is responsible for overlooking whether the patient should be receiving a specific type of care as well as whether this is ethical and is in line with the legalities of the EMFK. More important, there is the need to offer the correct diagnosis through the patients and to make sure they are eligible for specific treatments. For instance, if a specific surgery or a set of medications is offered, the administrator has to overlook this and to clear the treatment. This is to ensure that the procedures don’t create more difficulties with the patients or the doctors that are working underneath the administrator (Lee, Lansbury, Sullivan, 2005). The next scope that is a part o the administrator duties is a part of the admission and discharge procedures. Medical evaluation boards are typically used for patients who are requiring assistance within the hospital, specifically if there are mental health problems or being administered to the hospital with minor injuries or illness. The admission and discharge procedures are based first on the concept of being fit for duty. It is expected that those who go to the facility will remain as a part of the operations that are being carried out in Iraq. When checking into the hospital, it is required that the army members are not fit to perform the expected role that they have with the operation. After receiving a specific amount of help in the hospital, the members have to undergo a similar evaluation to ensure that they can continue to carry out with their performance in the military. The requirements for admission is one that is not only limited to the health conditions of those that receive assistance in the ward. There are also specific requirements for those that can use the facilities from different countries. The ward is open to the UK, Australia, Romania and Poland. Checking credentials of the soldiers, ensuring that there aren’t any security breaches in the ward and creating a different level of admission for those who are from other countries is essential in maintaining the standards not only of the US army, but also that of other countries. This means that any patient that is cleared to go into or out of the hospital is required to be checked by the administrator in terms of both physical condition and demographic background that relates to the army (Kennedy, Zillmer, 2006). The description of duties by the administrator is furthered into the different components which are required when a patient is admitted into the hospital. The first is through the translator services. If an individual from another country is admitted into the hospital, it is required that translator services are used, specifically because of the physical damages and ailments that would change the overall diagnosis from different health practitioners. This is followed by monitoring and overviews of the inpatient medical records. This occurs not only at times of admission, but also when there is an expected release from those that are in the hospital. This begins when a patient is admitted into the hospital and continues with the release for surgery or medications for the illness or injury. The medical records have to be overviewed by the administrator to ensure that there isn’t an incorrect procedure which is performed and to monitor the current admissions that are in the hospital. This ensures that the care of the patient and the interactions that are taken are clearly communicated and are used for the correct diagnosis (Kaboli et al, 2006). This is followed by the communication being on record through the PHI procedure. This is a disclosure agreement that states that the patient agrees with the procedures done and authorizes and releases all information for medical records and for the care within the facility. The procedure is based on records that are typically guarded but which need release for medical attention. This also includes non – disclosure and privacy as a part of the main contract (Wager, Lee, 2005). The next responsibilities of the administrator are based on the conditions of the patient. The consent for admission and release, as well as monitoring of those who are in the hospital is only for those who have minor injuries or illnesses. If there is a serious incident, then the procedure changes with admission and release. The serious incident reporting becomes the duty of the administrator which gives immediate consent to offer assistance to those that come in for medical assistance. The reports include acknowledgement of the illness or injury as well as how this was approached for recovery. The work also includes responsibilities through the urgent patient MEDVAC procedures. The focus of this is to provide assistance to those that are at the facility and which need urgent care. If the care can’t be offered at the hospital, then the duties of the administrator are to contact the hotels that are around the world to send in requests for assistance. The same procedure may also be used with patient movement requests, which is dependent on the severity of the problem. To finalize this transaction, there are MEDEVAC escorts, which ensure that the soldiers receive the correct help in the facility that they are brought to. The last area where the administration is responsible is through the patient care attendant. It is required that there is always one care attendant on duty for all the patients. This care attendant is bound to the hospital, specifically to accept patients into the hospital or to care for those who may need extra assistance outside of operating hours. The care facility is able to contact others that can be bound to the hospital for a given amount of time as well, specifically if extra assistance is needed within the health care facility. The administrator is responsible for ensuring that the care attendants are always available while contacting others who can care for the selected hospital during different time frames (Iverson, 2010). Local, State and Federal Guidelines The main local, state and federal guidelines that are a part of the EMFK and which the administrator has to follow are under the jurisdiction of the U.S. Army. This is followed by specific guidelines that are a part of being in an Arsenic location because of the relation to Iraq and soldiers that are using the facilities in war time operations. The jurisdiction from the U.S. Army is following guidelines that state when soldiers should enter Iraq or Afghanistan with the navy and army. The budget that is currently allocated for these guidelines is based on Operation New Dawn. All orders that are given under this operation come directly from the white house to move individuals to and from the facilities and to incorporate different procedures to continue with the army moves (Iverson, 2010). The Operation New Dawn is one which is creating responsibilities by the new defined missions of those in the army. This has ended the formal combat that is a part of the Iraqi mission and is focused on rebuilding the main structures in Iraq. This is being done with advising security forces that are in the nation while leading the civilians to new reconstruction efforts within the region. There are currently 50,000 troops that are under this jurisdiction, all which are designed to advise and assist. Because there are basic requirements for a diplomatic mission, the guideline for the administrator that is a part of the mission consists of different restrictions. This includes monitoring the different diplomats and soldiers that come into the region while ensuring that those who are admitted and released from the hospital can take part in the reconstruction and security efforts. If there are tensions which arise in Iraq, then the changes from the white house come to alter the way in which the security and admissions are handled with the hospital (Hodge, 2010). The specific orders, changes and guidelines of the responsibilities then continue to alter according to the needs of the current operation and the way in which this is changing the roles of the soldiers and their connection to the army camp. Public and Community Health Issues The public and community health issues begin with the inability to monitor the soldiers that are using the EMKF hospital facilities. There are not only soldiers who are in the facilities, but also contractors that are required to be on base and which may use the facility. These efforts typically aren’t supported because of the low number of staff that is a part of the ward. This leaves many with injuries and illness to have difficulties in receiving the proper care, even though they are a part of the operations in Iraq. The result is that several of those who desire to receive health care are told to go to Kuwait City to receive the assistance of local physicians. Different medications, assistance and levels of knowledge may then become a detriment to those that can’t be helped in the ward and which need medical attention (Iverson, 2010). Another problem that is a part of the facility is from soldiers who are defined by the U.S. army as retired. Many will bring their families to the facility because of convenience, cost and the expected help which can be received. However, there isn’t a way to admit these individuals into the hospital through the current system and there isn’t a way to track the individuals who want to receive the care. This leads to several restrictions of the hospital that are usually offered through the general care of the U.S. Army. The restrictions then become based on only helping those who are active in the current operations and in military combat, specifically because of the number of soldiers that are required for the current changes in environment (Iverson, 2010). To try to compensate with the problems of limiting the facilities to active duty service members, the camp has built a HOST nation clinic. This is provided to members and contractors that have been wounded and which need to be transported. The main focus of this clinic is to provide a branch to the main camp facility to ensure that the injuries or diseases of the soldiers aren’t spread and stop from preventing further injuries or complexities with the diseases which they have. While this is used to ensure that members and those that are contracted through the military receive assistance, this limits the type of care that is available and creates some conflict in being able to provide the correct assistance to those in need. The complexity which arises is then based on the lack of staff that could be used in the facility to provide more care to the soldiers and others who are connected to the military and in need (Iverson, 2010). Strategic Plan of EMFK The strategic plan that is offered by the EMFK is based on the direction that is proposed by the army to provide care. Currently, this is to offer the basic are for soldiers who are in the combat zone and which are suffering from illness, injury or disease. The strategic plan follows the guidelines of being admitted into the hospital and receiving continuous care as well as deciphering when a soldier should be released for active duty. The strategic plan; however, can alter according to the expectations of the US army and what is expected for those that are in the specific combat zone. The only aim and objective which the army can follow is to continue with providing aid and care to the troops while ensuring that there are extra ways to care for those in need. The 11 staff and those who are on duty are required to provide general assistance. If there is a mass casualty, then 45 beds are available to ensure that every soldier is cared for. The connection to the HOST care center also provides more options in the case extra care is needed. If applications were to be given for those that were in the facility, it would need to consist of a long term health care plan that were used with the facility. Most health care institutions are focused on strategic plans that are able to provide continuous care to residents that use the medical facility for a longer period of time. Current plans are focused on upgrading technology, providing enhanced options for the administration of the facility and the ability to create better diagnosis procedures for patients that have different complications with illness or injury. There is also the need to create and integrate the organizational structure into the facility for better responses to patients that are in the community (Ginter, Swayne, Duncan, 2002). The implementation of a strategic plan outside of the orders from the U.S. Army would make it difficult for the agency to carry out the plans that are required. Since the operation is expected to end in December of 2011, the need to add into the organizational structure or to change the strategy would not allow for the proper changes to be made later. More important, those that are in the facility are expected to change with the alterations in the operations as well as what occurs within the war time zone. This makes it difficult to build a strategic plan for a longer period of time and to respond with different concepts that are a part of the army. The strategic plan which is given is one which is implemented through other branches of the army, such as the expected admissions and release forms, definitions of what is required for full health by the soldiers and the database records that are attached to the army. Each of these keeps the main organizational structure and needs with the army in tact and help to maintain what is currently a part of the operations within the general army. Conclusion The different components that are attached to the health care facilities of EMFK provide a specific structure and level of help for those that are in the army. The requirement of the administrator that is carrying out the duties is following specific procedures and practices that are required by the U.S. Army. These are being implemented with different expectations from the Army as well as the basic set-up that is a part of the facility. The regulations, policies and the requirements of the administrator implement the different levels of care that are a part of the army and assist with the soldiers that are required to receive a specific type of health care from the facility. The structure and the way in which this has been divided is then able to create a different alternative for assisting the soldiers that are in the current Iraqi operation. Learning Experiences The project that was completed carried several learning experiences that I can implement with my own experiences. The main strength that I found after interviewing the Commanding Officer and examining the different practices was based on the concept of structure. The health facility was based on a very specific set of regulations and structures, most which were followed through by the administrator duties. This is what provided continuous health care and which allowed each of those that were receiving care to gain more assistance. It is noted that the health care facility is able to release over 80% of the soldiers back into active duty. From my research, I believe that this is because the structure which is followed is able to provide more quality care and offers better options for the main operations that are a part of the health care facility. The other strength that is a part of the facility is based on the way in which the duties are given to the administrator. While there are several integrated duties in terms of admission, patient care and release, this also helps with the overall operations of the hospital. If these weren’t given to the administrator, there may be complexities with the way in which the system works. The duty of the administrator can be defined as the main communicator for those that come into the facility. Having one person who works with all communication provides more consistency for the health care and offers more opportunities for better results with the care that is received. At the same time, there is an open area for the physicians and nurses, specifically with diagnosis and care that is required. The soldiers which are required to receive care then have better treatment, specifically because of the care and monitoring of communication that takes place from the administrator. Another interesting part of this particular project was noting the information which was not revealed by the facility through the main duties and expectations. The Commanding Officer stated that there was no strategic plan for the facility. It was also noted that all orders and expectations came as command from the U.S. Army, without explanations about how this might change what is occurring within the facility. The flexibility which is required of the administrator as well as the physicians and nurses then is required to have a higher level of importance. While the job descriptions and duties don’t change, the operations and missions of soldiers may alter. The hospital facilities are then required to change, specifically because of the needs which may occur in terms of illness and injury. The only association there was with these changes was with the noticed care facilities that the Commanding Officer pointed out, which consisted of 45 beds for massive attacks which may have occurred. This shows that the flexibility and the need to change because of the war time situation was one of the most important parts of running the facility. Another important difference that was unique to this specific care facility was from the specification of who could be cared for. The administrator noted that this was a problem with the facility, specifically because retired officers and those that were contractors to the government needed to have access to the same facilities and the care couldn’t be provided for. The strategy which had been built out of this was from offering the HOST care facility. However, the weakness was from the inability to offer care outside of soldiers that were in active duty. Most health care facilities are more open than this one, specifically because of the designation that it has. This major difference is important to point out because of the extra measures which had to be taken to ensure that others outside of active duty receive some type of care for an illness or ailment. Another important part of this was noticing the lack of administrative support and health care supporters that were a pat of the main facility. This became important because it is what caused the main limitations with the ward and the health care facilities received. The Commanding Officer was the only one which was in charge of 11 people and it was noted that there weren’t as many others which were able to provide the correct level of assistance for 50,000 soldiers that were on active duty. If a mass outbreak with illness or injury occurred, then the limitations could become a hindrance to the soldiers. More important, the duties of the Commanding Officer would become limited by the amount of communication that could be received. I noted that there wasn’t a back-up plan that was used in case this occurred. The reliance on the instructions from other U.S. army officials then became the main strategy, as opposed to having physical reliance and communication which could easily be put into effect with the health care facilities. The lack of back-up was also a concern because of the concept of only keeping one active soldier on duty during the off hours. This policy is one which can create difficulties in case of outbreaks or changes in the needs of patients as well as dangers which could arise. Questions on some of these policies, specifically which related to the expectations for personnel became the main issue with this facility. While there were these specific limitations with the health care facilities, it is also known that the management by the administrator and the divided roles by those that are caring for others in this building. While the limitations are there, the monitoring and organization has allowed for a specific level of support that has stopped chaos and outbreaks from occurring. The strength of this facility then comes from the understanding of communication, duties and expectations for caring for specific soldiers that are in the army. The approach which has been taken is one which can create more benefits for understanding the strategies and organization of a health care facility while monitoring how this works to an organization’s benefit so every individual can receive the proper health care. References Bell, Nicole, Carolyn Schwartz, Thomas Harford, Ilyssa Hollander. (2008). “The Changing Profile of Disability in the U.S Army: 1981-2005.” Disability and Health Journal 1 (1), 14-24. Bloche, Gregg, Jonathan Marks. (2005). ‘When Doctors go to War.” North England Journal of Medicine (352), 3-6. Ginter, Peter, Linda Swayne, Walter Duncan. (2002). Strategic Management of Health Care Organizations. UK: Blackwell Publishers. Global Security. (2010). Camp Arifjan. Retrieved from: http://www.globalsecurity.org/military/facility/camp-arifjan.htm. Hodge, Nathan. (2010). “As Combat Mission Ends, a New U.S. Operation Begins.” The Wall Street Journal (September). Iverson, Phillip. (2010). Interview of EMFK Kuwait Facilities. Kaboli, Peter, Angela Hoth, Brad McClimon, Jeffrey Schnipper. (2006). “Clinical Pharmacists and Inpatient Medical Care.” Archives of Integral Medicine 166 (9), 955-964. Kennedy, Carrie, Eric Zillmer. (2006). Military Psychology: Clinical and Operational Applications. New York: Gulliford Publications. Lee, Teresa, Gwenda Lansbury, Gerard Sullivan. (2005). “Health Care Interpreters: A Physiotherapy Perspective.” Australian Journal of Physiotherapy (51), 161-164. Mahowald, Amy. (2010). “New Medical Facilities Improves Care for U.S. Forces in Kuwait.” U.S. Army Corps of Engineers. Wager, KA, FW Lee. (2005). Managing Health Care Information Systems: A Practical Approach for Health Care Executives. New York: Jossey – Bass. Read More