US Army Health Facilities Asse ... Disaster Relief Humanitarian Assistance Peacekeeping/Mil Spt. Peace

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  • 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) / guy.kiyokawa@us.army.mil 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) / guy.kiyokawa@us.army.mil Slide 3 of 36

  • Medical Facilities Life Cycle Management

    UNCLASSIFIEDCOL Guy Kiyokawa / MCFA /(703) 681-8221(DSN761) / guy.kiyokawa@us.army.mil 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) / guy.kiyokawa@us.army.mil

    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) / guy.kiyokawa@us.army.mil 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) / guy.kiyokawa@us.army.mil

    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) / guy.kiyokawa@us.army.mil

    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