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Expeditionary Medicine Administration Chapter 2

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1 Expeditionary Medicine Administration Chapter 2
HM2 Alcazar

2 Reports Reports are a required aspect of HM work, the reports are found in NAVMED P-117 Management of the reports, forms is covered in the BUMEDINST Forms and Reports Management Program

3 Kinds of reports Report to the OOD- Reported by the SMDR (Senior Medical Department Rep) Who is usually an Medical/ Dental officer or an IDC. Items reported are sever injuries, items that might affect the health if the crew, damaged/ lost equipment. Names of Pts in serious conditions are reported to the CO and OOD, along with information needed to notify the next of kin. A Memorandum for Record- IAW the SECNAVINST Department of the Navy Correspondence Manual. Notates information that would be of legal/ historical importance, EX serious injury/death of a pt. Pt refusing treatment or are non compliant.

4 Kinds of logs Sick call Log- is maintained IN SAMS on the ship, contains the date, time, name, rate, division, and complaint and treatment. This report is made daily to the CO Training log- Documented in SAMS, include date, time, how long it lasted, who the training was given to, and the # of attendees broken down. Potable Water- daily residual Chlorine/Bromine levels and weekly bacteriological testing documentation maintained IAW NAVMED P5010 chapter 6. Recorded in SAMS Environmental Management Mode

5 SAMS/MRRS SAMS- Shipboard Non-Tactical Automatic Data Process(SNAP) Automated Medical System- Admin tool that tracks Medical/Dental Readiness, also tracts supply, Prev Med inspections, medical training, report/receive Radiation Data MRRS- Medical Readiness Reporting system Admin tool used to track readiness of every AD or Reserve sailor or marine. Internet based. SAMS and MRRS are able to share data between each other by the Central Data Repository (CDR) and Defense Enrollment Eligibility Reporting System (DEERS)

6 Navy Maintenance and Material Management System 3M
Used to record, report and evaluate maintenance requirements. To plan schedule and control planned maintenance. OPNAVINST Ships Maintenance and materials management systems, is the guidance for the program, this tells how to use the PMS planned maintenance system. The Work Center PMS manual is maintained in the work space neat the weekly PMS schedule. This schedule tells the periodicity and what’s required for the checks. This is a minimum standard to keep equipment operational.

7 Directive Issuance System- OPNAVINST 5215.17
Permanent Directive- used to establish policy, delegate authority and assign mission function or task Temporary Directive- usually issued as a notice, to announce changes, such as promotion/education opportunities and change of commands. Notice- lasts no longer than a year Change Transmittals- used to issue changes to instructions and notices, Each describes the nature of the change and how to complete it. Filed in front of the instruction with the most recent on top Correspondence – Standard Navy letter instructions found in SECNAVINST Department of the Navy Correspondence Manual

8 Filing Instructions are filed in numerical sequence according to the Standard Subject Identification Code (SSIC) If they are classified then they are stored separately, and placed in a safe IAW SECNAV M Department of the Navy Information security Program If a correspondence does not have an SSIC from the originator then upon receipt it will be assigned one Records Management Program SECNAVINST Tells how to retain records and dispose of those that are expired

9 SECNAVINST 5210.11 Standard Subject Identification Code
A method of identifying the subject for all Navy/Marine letters, messages, forms, directives. Divided into primary, secondary and tertiary groups 1000- Military Personnel Telecommunication Operations & Readiness Logistics 5000-Gen Admin& management Medicine/ Dentistry Financial mang Ordnance material Ships Design & material Gen. Material Facilities/ Activities Ashore Civilian Personnel Aeronautical/ Astronautical Material Coast Guard missions

10 Operational medical& Dental Readiness
Individual Medical Readiness (IMR) has six Elements Individual Medical Equipment Immunizations Readiness Laboratory Studies Deployment limiting Conditions- Limited Duty, Physical Evaluation Board, Medical Evaluation Board Periodic Health Assessment (PHA)-used to correct IMR deficiencies Dental Readiness- Class 3&4 non deployable SECNAVINST Periodic health Assessment for Individual Medical Readiness Outline the regulations

11 Medical/ Dental support to the Fleet Marine Force
FMF Consists of Marine Logistics Group (MLG) marine divisions, brigades and Aircraft wings. BAS- direct support to company and platoon HMs, consists of 65Hms and 2 medical officers depending on the size. Dental detachments are attached to provide care for 1-3 level dental care. Combat personnel- medical and initial first aid, evacuation Support personnel- surgical/ medical aid to those who need it and are unable to evacuated. Medical Battalion- attached to MLG. Missions are Combat collection, Emergency Treatment, Temporary hospitalization, Specialized surgery, and Evacuation

12 Fleet Hospital Transportable, provide support during intense combat/ long term low intensity Expeditionary Medical Facilities – 500 beds Fleet hosp. used in operation longer than 60 days with moderately sophisticated, the chain of command is similar to a MTF Command Staff, 5 directorate, Nursing services, Medical services, Surgical services, Ancillary, and Admin services

13 Naval Mobile Construction Battalion
Work with the Seabees, there are 8 NMBC home ported in Gulfport MS and Port Hueneme CA.

14 Healthcare Administration Programs Chapter 3
HM2 Alcazar

15 DEERS Eligibility instruction NAVMEDCOMINST 6320.3
Enrollment in to DEERS happens by completing Privilege Identification Card application- DD1172and the Uniform Services Identification card DEERS verification conducted using CHCS is outlined in OPNAVINST Defense Enrollment Eligibility Reporting System If a person shows up without an ID card but are in DEERS treatment will be issues and individual will be billed 30 after if an ID card has not been shown. Resources Management handbook NAVMED P-5020 Exceptions to eligibility Secretary of the Navy Designees Foreign Military Personnel

16 Ineligibility Not enrolled in DEERS, member separated from the military, family member child is married, spouse is divorce, not entitled to the benefits of the former spouse 9 Eligibility over rides DD the person has a copy or original DEERS enrollment form Family members recently becoming eligible for treatment ie baby, adoption New ID card- previous 120 days Ineligible due to ID card expiration- if Deers say its no good as long as the person has a card that was issues up to 120 days prior Entering active duty status for 30 days or more- need a copy of orders Newborns- 61st day they need to be on the members pg2 and enrolled in to tricare prime Emergency care Sponsers duty station is outside the US or has an APO/FPO address. Survivors- the deceased sponsor remains in DEERS to allow care for the family members as survivors.

17 Tricare An enhancement of Civilian Health and Medical Program of the Uniform Services (CHAMPUS) it is the health coverage for MTF/DTF. It shares in cost for civilian services. DENTAL- AD for 30 days or longer are eligible for dental care, Tricare dental plan to dependents as long as 12 months left on AD Dental exams, restoration of lost tooth, treatment of periodontal conditions, surgical procedgers, and replacement of missing teeth.

18 Dental Priority CAT 1A- AD members CAT 1B- members of the Reserve and National Guard CAT 2- family members of active duty, and family of a dead member CAT 3- members of the Senior Reserve Officer Training Camp CAT4- Retired members and their family CAT 5- Civilian Employees of Federal gov. Cat 6- Everyone else.

19 Quality Assurance Program BUMEDINST 6010.13
Uses various sources to evaluate the degree of excellence and to make improvements as needed for health care. Joint Commissions and Medical Inspector General value Quality assurance, and the program derives form OPNAVINST Health care Quality Insurance Policies for Operating Forces. BUMEDINST series Navy’s Health Care Relations Program, provides the guidelines for setting up the program in thee parts Internal External and Patient Relations. Survey which help with the commands yearly QA check should be displayed at the front desk.

20 PT Relations & PT contact point programs
Patient Relations Program- help resolve Pt complaints IAW BUMEDINST , by enhancing communication between the Hospital and PT. Patient Contact Point- subset of the relations program, ensure a way of resolving issues before the PT has left. The point of contact will have there picture visible at the front desk/ reception area. Next to the picture the PT bill of rights will be displayed.

21 Family Advocacy Program
SECNAVINST and BUMEDINST It is designed to identify and monitor spouse/child abuse/neglect and sexual abuse in military families. Managed by the Family Advocacy Rep

22 Drug and Alcohol Abuse Prevention and Control Program
OPNAVINST Drug abuse “Zero Tolerance” Alcohol use “Responsible use” DAPAS are the commands primary Advisers to all ETOH and Drug matter. They are responsible for screenings, prevention education, monitor aftercare, and preparing required reports

23 Physical Readiness program
OPNAVINST Testing required for all on a semi-annual basis. Medical staff are responsible for: Providing assistance to BUPERS Conducting lifestyle, fitness and obesity research Reviewing health status/ and waivers Help make a exercise prescription.

24 Legal Implications to medical care
Informed Consent- requires the provider to provide the to with information they will need to know to make an knowledgeable choice. Who can consent-parents/ guardian for a child Spouse for and incompetent spouse. Laws of the state where the hospital is controls the rules of “Substitute Consent” Consent is valid as long there are no material changes between the date of consent and the date of a procedure. Implied/ written Consent

25 Incident Report Falls under Title 10 U.S.C 1102, Confidentiality of medical Quality Assurance records. Incidents as submitted via a QCR to notify the events of an incident to the Risk Manager, Co and others who may be involved. QCR are not allowed to be provided to people to assist in legal action. The Risk management Program BUMEDINST

26 Release of Information
Freedom of Information Act- reasonable request for information will be responded to with in 20 days of receipt of request does not include PII Prviacy Act of the individual is allowed to: Know what records are retianed on them, prvent a record that is on them to be used for other purposes with out their consent, have a copy made, make sue the information retained is correct.

27 Health Information portability and Accountability Act (HIPPA)
Started in protects health information, and compliance with the military started 14APR2003, DODINST With this act MTF are allowed to release information to the Pt and the Secretary of the Department of health and human services Information released for treatment, payment and helath care opperations.

28 Medical conditions and law enforcemtn
Posse Comitatis Act 1956 Makes it illegal for the military to enforce or assist in a federal/ state civil laws, there are exemptions. No Pt under treatment will be released until medically sound to do so. Non-AD Pt- when released from medical care the Hosp. has no control, authorities maybe notified of a discharge from care AD Pt- the Co is allowed to turn Pt over with the proper paperwork. If local authorities desire the pt a warrant is needed and will have to consult the JAG before the release of the Pt.

29 Pt Prisoners Enemy POW/ Detained Personnel- are eligible to all care
Non Federal Prisoners- only emergency care Military Prisoners- all care Rape/Sexual assault-NCIS will investigate, it is medicals job to provide care IAW NAVMEDCOMINST management for Alleged or Suspected Sexual Assault and Rape Case

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