1. Medical Surveillance Exam Completion Report Instructions
With Visual Examples
October 2014

2. General Information
The Medical Surveillance Exam Completion Report spreadsheet will take about 10 to 15 seconds to open.
Not all of the medical surveillance exams listed in the Completion Report spreadsheet are applicable to every command. Most commands may have less than 10 applicable exams. Industrial commands (maintenance depots, shipyards, etc.) will have a greater number of exams applicable to their personnel.
Military and Federal civilian personnel should be included in the data input.
Do not alter the spreadsheet format. Do not move, reorganize, or delete rows or columns.
Be careful to not accidentally delete the formulas contained in columns D and E in the green “Master” worksheet tab.
The “PASTE SPECIAL” function must always be used (instead of the usual “Paste” function) when entering direct report subordinate command inputs to build a Consolidated Completion Report
See the “Building a Consolidated Medical Surveillance Exam Completion Report” section for more info on the “PASTE SPECIAL” function)
The Completion Report spreadsheet will automatically calculate the following:
Total number of command personnel requiring medical surveillance or certification exams
Total number of command personnel within exam periodicity
Medical surveillance exam completion rate (compliance) for each individual program
Overall medical surveillance completion rate for all subordinate commands (in the ISIC consolidated report)
Overall completion rate for each program category (chemical hazards, physical hazards, mixed exposures, certification exams)

3. Gathering the Data
Commands may use whatever electronic or manual method they currently use for medical surveillance program management to obtain the data needed to fill out the Medical Surveillance Exam Completion Report spreadsheet
Examples of some tracking systems or methods include:
ESAMS- Enterprise Safety Applications Management System
SAMS- SNAP Automated Medical System
MRRS: Medical Readiness Reporting System
OSHSYS: Occupational Safety and Health System
MES: Medical Events Scheduling
Excel spreadsheets
Access databases

4. Medical Surveillance Programs
Selection of personnel for medical surveillance programs is based primarily on the results of the Industrial Hygiene (IH) survey and is driven by exposures to chemical and/or physical hazards. This is "hazard-based" medical surveillance
Specialty exams are intended to ensure that persons working in positions with assigned medical standards are healthy enough to perform their assigned duties and tasks
The requirements for Specialty exams can come from a variety of different sources such as civilian position descriptions, Navy rate or specialty requirements (such as aviation or diver), OSHA regulations, etc., and the medical examiner is asked to determine whether or not a worker is medically capable of performing the duties of the job
Specialty Examinations are generally not discussed within the command Industrial Hygiene survey
See Chapter 7 of the “Medical Matrix” (NMCPHC-TM 6260) or contact your supporting Medical Department Representative (MDR) or Occupational Health clinic for more information

5. Download a Blank Completion Report
Download the Medical Surveillance Exam Completion Report at the following link:
Save the file using the format “Command Name_Medical Surveillance Completion Report”
Ex. USS Neversail_Medical Surveillance Completion Report

6. Entering Medical Surveillance Exam Completion Data

7. Go to the yellow “Command 1” tab and populate columns D and E for each program applicable to your command personnel.
Note: Not all of the 125 exams listed in the spreadsheet are applicable to every command. Most commands have just a few (less than 10) which are applicable to them.
Review your command Industrial Hygiene (IH) survey for exposure-based programs (chemical stressors, physical stressors, mixed exposures) applicable to your command personnel
Specialty exam requirements: see Chapter 7 of the “Medical Matrix” (NMCPHC-TM OM 6260) or your supporting Medical Department Representative (MDR) or Occupational Health clinic for more information.
You may gather your data from any electronic or manual method which your command uses to manage the medical surveillance program. Common systems and methods include:
ESAMS- Enterprise Safety Applications Management System
SAMS- SNAP Automated Medical System
MRRS- Medical Readiness Reporting System
OSHSYS- Occupational Safety and Health System
MES- Medical Events Scheduling
Excel spreadsheet
Access database
Etc.
- The completion rate for each individual program automatically calculates
The overall completion rate for your command automatically calculates at the bottom of the page (rows 132 and 133)
Work on improving programs with low completion rates. Prioritize those which are colored in blue since they are regulatory in nature.

8. Rename the “Command 1” worksheet tab to reflect your command’s name
the entire spreadsheet report to your administrative Immediate Superior in Command (ISIC) medical surveillance completion report POC so that they can build a Consolidated Completion Report.

9. Building a Consolidated Medical Surveillance Exam Completion Report
(for ISICs)
Each administrative Immediate Superior in Command (ISIC) must build a Consolidated Completion Report using the Completion Report inputs from their direct report subordinate commands. The roll-up process allows higher Echelons to provide required program implementation oversight and to advise their direct subordinate commands program improvement.
Instructions on how to create a Consolidated Medical Surveillance Exam Completion Report are contained in the following pages of this presentation.
Each ISIC must in turn roll their Consolidated Completion Reports up through their next higher administrative chain of command ISIC. The roll-up process repeats until Consolidated Reports are at the Echelon 2 level by 28 FEB 2015.
Echelon 2 POCs must their Consolidated Reports to the Naval Safety Center POC at by 15 APR 2015.

10. Building a Consolidated Medical Surveillance Exam Completion Report
Suppose you are an Echelon 3 (ex. COMNAVPACTYCOM) medical surveillance POC and need to create a consolidated report using Completion Reports from 3 direct report subordinate commands, “USS Neversail”, “Type Wing X”, and “Maintenance Center”.
1. You should save a blank version of the Medical Surveillance Exam Completion Report to use as the consolidated Completion Report. Use your command name in the file name.
Example: “COMNAVPACTYCOM- Medical Surveillance Completion Report.xls”
2. Enter your COMNAVPACTYCOM staff’s medical surveillance completion data (if applicable) into the yellow “Command 1” worksheet.

11. Copy each direct report subordinate command’s (in this example, it’s the USS NEVERSAIL) Completion Report data from the their spreadsheet’s “Master” worksheet (green tab) and prepare to copy into your Consolidated Report spreadsheet.
Steps:
Highlight Columns D and E (rows 3 to 128) in your subordinate command’s “Master” worksheet (green tab).
Right click on the mouse and click “Copy”.

12. Go to your Consolidated Report “Command 2” worksheet
Highlight Columns D and E (rows 3 to 130). These are the same exact rows you highlighted in the above step.
Right click the mouse and choose “PASTE SPECIAL”. The choose the “Values” option.
Repeat this step for each direct report subordinate command Completion Report you have received. Each subordinate command input should go into a separate worksheet tab.
For example, the next direct report subordinate command input would go into the “Command 3” tab. The next would go into the “Command 4” tab, etc.
So, if you had inputs from 15 Echelon 4s, then you would fill tab 1 with your COMNAVPACTYCOM staff completion data (again, if applicable) and the rest of the tabs with the “Master” worksheet data from each Echelon 4 (each Echelon 4 data entered into its own tab).
REMEMBER TO ALWAYS USE THE “PASTE SPECIAL” AND “VALUES” OPTION.
Rename each tab to reflect the command who’s input you entered into it.

13. Go to your Consolidated Report “Master” worksheet (green tab) to make sure that all direct report subordinate inputs have calculated automatically.
The “Master” worksheet will compile all of the data, including your own “COMNAVPACTYCOM” data along with the data from your direct report subordinate commands and their subordinate commands.
your entire Consolidated Report spreadsheet to your next higher administrative ISIC medical surveillance completion report POC.
The next higher Echelon POC will repeat the entire process described in this “Building a Consolidated Medical Surveillance Completion Report” section.
Timelines
- Medical Surveillance Completion Reports must be completed by 31 DEC 2014.
Echelon 3 Consolidated Completion Reports must be forwarded to Echelon 2s NLT 28 FEB 2015.
Echelon 2 Consolidated Completion Reports must be forwarded to the Naval Safety Center POC NLT 15 APRIL 2015.

14. Medical Surveillance Toolbox
Resources
Naval Safety Center maintains various tools to help commands properly complete the Medical Surveillance Exam Completion Report and help manage an effective medical surveillance program
Be sure to check out our new Safety and Supervisor’s Guide to Medical Surveillance!
Naval Safety Center
Medical Surveillance Toolbox
The Medical Surveillance Toolbox can be accessed using the link above or by going to: