US Army Health Facilities Asse ... Disaster Relief Humanitarian Assistance Peacekeeping/Mil Spt. Peace Enforcement Low Intensity Conflict War US Army Health Facility Planning Agency

US Army Health Facilities

Assessments

Colonel Guy Kiyokawa

Asst. Chief of Staff, Facilities / Director, Facilities

HQ, US Army Medical Command / Office of the Surgeon General

UNCLASSIFIED

December 2010

Medical Facilities Life Cycle Management

UNCLASSIFIEDCOL Guy Kiyokawa / MCFA /(703) 681-8221(DSN761) / [email protected] Slide 2

PRESENTATION OUTLINE

PURPOSE: To provide an overview of US Army health facility assessment

processes and application to military assistance in foreign countries.

• US Army Medical Command (MEDCOM) • Facility Life Cycle Management • Deployable Health Facilities Expertise • Decision Making Process • Developing Facility Solutions Supporting a Health

Care System

• Case Studies • Ivory Coast • US Army Kwajalein Atoll, Republic of the

Marshall Islands

Medical Facilities Life Cycle Management

UNCLASSIFIEDCOL Guy Kiyokawa / MCFA /(703) 681-8221(DSN761) / [email protected] Slide 3 of 36

Medical Facilities Life Cycle Management

UNCLASSIFIEDCOL Guy Kiyokawa / MCFA /(703) 681-8221(DSN761) / [email protected] Slide 4

Planning

Owner’s Rep for Design Owner’s Rep for

Construction

Sustainment

Programming

Medical Facilities Life Cycle Management

Commissioning

31 years

Medical Facilities Life Cycle Management

UNCLASSIFIEDCOL Guy Kiyokawa / MCFA /(703) 681-8221(DSN761) / [email protected]

SMRC- HS

Mission

Provide deployable health

facilities expertise worldwide to

support the AMEDD’s healthcare

mission

• Assessments and assistance – Engineering, architectural, equipment &

healthcare infrastructure consulting

– Design, construction, & management

oversight

– Infrastructure development in maturing

theatre

– Support to reestablish civilian medical

infrastructure

– Liaison with engineer units and staffs

• Multi-disciplinary solutions/teams – Architects

– Engineers

– Nurses

– Biomedical Equipment Specialist

– Environmental Science Officers

– Facility Managers

– Logisticians

Readiness:

First Team: configured to support

and ready to deploy (C-1).

Second Team: Sourcing (personnel)

required from MSCs/RMCs (C-3).

Special Medical Response Contingent - Health Systems

Slide 5

Nation Building

Disaster Relief

Humanitarian Assistance

Peacekeeping/Mil Spt.

Peace Enforcement

Low Intensity Conflict

War

US Army Health Facility Planning Agency

Operational Support to Army / DoD Missions

GeorgiaGeorgia19921992

CroatiaCroatia19941994 Virgin IslandsVirgin Islands19951995

FloridaFlorida19941994

HaitiHaiti19941994

KuwaitKuwait 19951995

19951995

EritreaEritrea 19961996

KazakhstanKazakhstan 19951995

EgyptEgypt 19971997

CambodiaCambodia19971997

HondurasHonduras19981998

El SalvadorEl Salvador19981998

NicaraguaNicaragua19981998

ParaguayParaguay19981998

BosniaBosnia19981998

LebanonLebanon19981998

Guinea-BissauGuinea-Bissau19981998

Ivory CoastIvory Coast19981998

RussiaRussia19991999

QatarQatar 19991999

MacedoniaMacedonia1999199920002000

KosovoKosovo199919992000200020012001

KenyaKenya 20002000

20012001

NepalNepal20012001

JapanJapan20002000

TrinidadTrinidad20002000

KwajaleinKwajalein20002000

Dover AFBDover AFB20012001

20002000

North CarolinaNorth Carolina19961996

19921992

20022002

UzbekistanUzbekistan 20022002

War

Nation Building

Peace Enforcement

Peacekeeping

Humanitarian Assistance

Disaster Relief

Low Intensity Conflict

IraqIraq 20032003

AfghanistanAfghanistan 20032003

20042004

20042004

20042004

20042004

20042004

20042004 2005200520032003 20062006

20052005 20062006

20052005 20062006

GeorgiaGeorgia19921992

CroatiaCroatia19941994 Virgin IslandsVirgin Islands19951995

FloridaFlorida19941994

HaitiHaiti19941994

KuwaitKuwait 19951995

19951995

EritreaEritrea 19961996

KazakhstanKazakhstan 19951995

EgyptEgypt 19971997

CambodiaCambodia19971997

HondurasHonduras19981998

El SalvadorEl Salvador19981998

NicaraguaNicaragua19981998

ParaguayParaguay19981998

BosniaBosnia19981998

LebanonLebanon19981998

Guinea-BissauGuinea-Bissau19981998

Ivory CoastIvory Coast19981998

RussiaRussia19991999

QatarQatar 19991999

MacedoniaMacedonia1999199920002000

KosovoKosovo199919992000200020012001

KenyaKenya 20002000

20012001

NepalNepal20012001

JapanJapan20002000

TrinidadTrinidad20002000

KwajaleinKwajalein20002000

Dover AFBDover AFB20012001

20002000

North CarolinaNorth Carolina19961996

19921992

20022002

UzbekistanUzbekistan 20022002

War

Nation Building

Peace Enforcement

Peacekeeping

Humanitarian Assistance

Disaster Relief

Low Intensity Conflict

War

Nation Building

Peace Enforcement

Peacekeeping

Humanitarian Assistance

Disaster Relief

Low Intensity Conflict

IraqIraq 20032003

AfghanistanAfghanistan 20032003

20042004

20042004

20042004

20042004

20042004

20042004 2005200520032003 20062006

20052005 20062006

20052005 20062006

Slide 6

Medical Facilities Life Cycle Management

UNCLASSIFIEDCOL Guy Kiyokawa / MCFA /(703) 681-8221(DSN761) / [email protected] Slide 7

Facility Project

Scope and Cost

Data Collection

Mission

Market Assessment

Business Plan

Population (RAPS)

Workload (MEPRS/CHCS)

Staffing (TDA)

Capital Investment

Proposal (CIP)

Prioritization/

Submission

Constraints & Opportunities

Existing Program Capacities

Photographs

Site and Accessibility Info

Infrastructure Assessment

Architectural

Engineering Systems

Equipment

AT/FP

Facilities

Data

Space Utilization

Capacity Analysis

Architectural CADD Drawings

Site Drawings

List of Current Projects

Historical Background

Cost Option Studies

Provider Requirements

Volume Thresholds

Optimization

Functional Alignment

Planning

Scenarios

Enrollment (MCFAS)

Utilization (M2)

Capacity Analysis

Space Program

Functional Options

Health Care

Requirements Analysis

Site/Facility/

Capacity Analysis

Mission

Business Plan

Bio-Safety Levels

Research Population

Animal Population

Research Focus

Equipment-driven Space

Researcher Requirements

Phasing

Optimization

Functional Alignment

Animal Models

Utilization

Throughputs

Protocol Durations

Capacity Analysis

Space Program

Functional Options

Research

Market Analysis

Space

Requirements

Forecast

Site

Assessment

Demand

Analysis

Planning

Scenarios

Army Medical Construction Planning Process

*See back-up slides for Health Care

Requirements Analysis process

resulting in staffing leading to space

leading to cost.

Medical Facilities Life Cycle Management

UNCLASSIFIEDCOL Guy Kiyokawa / MCFA /(703) 681-8221(DSN761) / [email protected]

Decision Making Process

• Define the problem • Gather the facts and state assumptions

– Physical plant assessment, understanding the health care

system, health care requirements analysis

• Develop evaluation criteria necessary to solve the problem • Develop various courses of action (status quo is always a

course of action)

• Eliminate courses of action due to inability to execute • Weight criteria for evaluating courses of action • Decision matrix analyzing various courses of action. Each

course of action must address every criteria.

• Make recommendation based on the analysis

Slide 8

Medical Facilities Life Cycle Management

UNCLASSIFIEDCOL Guy Kiyokawa / MCFA /(703) 681-8221(DSN761) / [email protected]

Facility Solutions Supporting a Health Care System

• Political situation affecting ability to provide health care • Health care system

– Is it affiliated with a larger facility or University? Is it a NGO or PVO organization?

– Who funds the facility? Payment system?

• Scope of Services – What type of medical services are provided by this organization? Primary care, sub-

specialty care, OR, ICU, med-surg wards, CMS, procedures

– Ancillary: lab, radiology, pharmacy, imm