Iraq Theater Hospital
Among all of the military treatment facilities in Iraq, the Iraqi Theater Hospital at Balad is perhaps at the small part of the funnel—providing care and the portal to higher levels of care —an interview with Colonel (Dr.) Patrick Storms.
In September 2004, the Air Force assumed responsibility for the Iraqi theater hospital, which is a Level I trauma center with more than 650 ER patients and 1,500 surgical procedures conducted each month.
The 332nd Expeditionary Medical Group, Balad Air Base, Iraq, is responsible for the hospital. The group is comprised of three squadrons with approximately 380 Air Force and Army active-duty, Guard, Reserve, Navy and Marine Corps personnel assigned during each Air Expeditionary Force rotation. The group’s responsibilities include operating the Air Force Theater Hospital, a clinic, and the Contingency Aeromedical Staging Facility, which prepares patients for aeromedical evacuation out of theater.
Military Medical Technology magazine wanted a first hand look at what goes through there on a routine basis and what the staff there does to ensure the absolutely best care possible. We asked Colonel (Dr.) Patrick Storms to share with us some of what they face everyday.
Q: What are the two biggest challenges that your hospital faces on a routine basis?
Storms: Throughput is one of our biggest challenges. We staff 58 beds in a combat zone that could potentially inundate us with patients at any time. As such, we must constantly work to stabilize and transfer patients, making bed space available for new casualties as they arrive. Movement of U.S. servicemembers is a smooth and well-oiled process, and our U.S. patients rarely spend more than a day here before moving to the next echelon of care. Our Iraqi patients present a more substantial challenge, as their health care system is not yet capable of handling the severely injured patients that arrive here for care. Iraqi hospitals are making steady progress, however, and we are very hopeful for a bright future for them.
Our second biggest challenge blends in to the first. We must engage with our Iraqi counterparts to enhance their ability to care for severely injured Iraqi patients. Our Army partners share our resolve in this arena and are involved in all aspects of this endeavor, from provincial reconstruction teams, to strategic planning. We are energetically prepared to assist in any possible fashion. A strong and capable Iraqi health care system would be a powerful stabilizing force in this country.
Q: How effective are your telemedicine capabilities and are there any limitations on its use?
Storms: Given the depth and diversity of our medical staff, and the tight focus of our mission, telemedicine is not routinely required for mission success. We do, however, utilize technology to exchange information across the echelons of care.
We receive electronic records from referring facilities, record our findings electronically in a centralized data system, and forward images and medical records all the way back to the U.S. Patients arrive at each echelon of care with a complete electronic record of their treatment from the point of injury, through each stop along the way.
Q: How digital is your facility [versus film and paper]?
Storms: Our patients encounter records and radiographs—plain film, CT, sono—are all electronic. Patient immunizations are tracked via a computer database, and our file plan is fully electronic. We use some paper forms within the facility, but information leaving us is almost all electronic.
Q: What kind of staff rotations in and out of theater do you face and are there any issues with the staffing levels for any particular professions?
Storms: The Air Force generally utilizes a four-month rotation schedule, though some high demand/low density specialties may utilize longer rotations. Staffing levels have never been a concern. Availability of certain specialties can become problematic at home-base locations, but we’ve been wonderfully supported by manpower and readiness shops throughout the Air Force. The training and support our airmen receive at home station prepares them for the fast-paced operation we experience here.
The skill mix we draw to theater hospital operations is dissimilar to that used in most of our home-base units. We are, first and foremost, a trauma hospital. As such, we draw critical care providers, surgeons and inpatient staff from a shrinking supply in the inventory at-large. Intensive training makes up for any experience gap we might encounter, and support from the Guard/Reserve component has greatly enhanced our talent pool.
Q: Any growth plans in terms of number of staff or physical additions?
Storms: We moved into our current facility in July 2007 and are quite pleased. We opened our outpatient clinic in August 2008. The oldest facility in our campus was built in 2005, so we have been blessed with a new and capable infrastructure. There are no current plans to add any physical addition in the foreseeable future.
Our staffing model has been stable some time, with no anticipated changes in the immediate future. We are hopeful that the sustained reduction in monthly casualties observed over the past 18 months could result in staffing reductions at some point. ♦