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
