Two of the Defense Department's top health officials visited Naval Hospital Bremerton in Washington state for a firsthand look at the staff's efforts to stop the spread of COVID-19.
Thomas McCaffery, assistant secretary of defense for health affairs, and Army Lt. Gen. (Dr.) Ronald J. Place, Defense Health Agency director, visited the hospital July 16.
Both said they came to observe the commitment by Navy Medicine in helping to stop the spread of COVID-19, protect the health of warfighters — past and present — and their families, and provide a ready medical force ensuring a medically ready force.
"We're here to hear your questions, concerns and comments on our Military Health System," McCaffery said. "Before COVID-19, we were in the midst of the biggest change of our health system in 30 years. Due to COVID, we put that on pause."
He noted that trying to bring change to existing military health systems — actually four separate systems — is not a new proposal. "There's been at least 12 times since World War II where there has been efforts to change our system," he said. "All focused on the best way to organize and manage for the mission, have a ready medical force and a medically ready force. The mission is still the same, and having a more integrated system is the way to do it."
Place added what's most important to military health is not headquarters, but rather where that military health is delivered.
"What we learn from visiting military treatment facilities helps give a sense of where the focus needs to be. How do we continue to improve our systems, in the clinic, suite and ward?" he said. "That's what's important. Optimization is our goal. From your position here at the deck-plates, if it doesn't make sense, we need to know."
The visit itinerary included several efforts implemented in early April at the hospital based on criteria set by the Centers for Disease Control and Prevention, such as expanded drive-thru COVID-19 screening, triage and testing. They viewed the COVID-19 Asymptomatic Testing Clinic, which opened July 6 and was established to test asymptomatic service members sent from their respective command, pre-operative surgical patients and those deemed to require testing for administrative purposes. The military health leaders also visited the hospital's laboratory department, with emphasis on how the COVID-19 tests and other lab tests are managed, prepared and controlled.
With the continual overlapping emphasis on the pandemic outbreak, NHB's efforts — along with response plans, lessons learned and lessons sustained — was explained by Navy Cmdr. (Dr.) Robert Uniszkiewicz, the command's COVID-19 czar and COVID-19 working group head.
"We knew first off that we needed to work directly with our partners," he said. "We established multidisciplinary collaborative efforts across civilian health officers, tri-service public health experts and emergency managers with Navy Region Northwest, Joint Base Lewis-McChord and Madigan Army Medical Center, Kitsap Public Health District and Naval Medical Forces Pacific.
"We shared lessons learned, policies, procedures and products," he continued. "We combined various guidelines and policies into a clear public health strategy for the Pacific Northwest and were able to bridge communication and unified messages [among] medical community and operational commanders. Those lines of communication were extremely important."
Uniszkiewicz added that NHB's COVID-19 response was a total team collaborative effort, including a virtual health transition for primary care and mental health patients, adding changes to the main pharmacy such as curbside medication delivery for high-risk patients; and applying sustained health protection measures such as single points of entry for staff and patients, mandatory cloth face covering and maximizing telehealth and services.
"Quoting Terry Lerma, our emergency preparedness manager, 'Don't let a good crisis go to waste,' we were flexible to leverage a number of changes, many of which are just not taught," Uniszkiewicz said. "Our working group is made up of multidisciplinary, cross-functional, collaborative subject matter experts. Our public health emergency officers were constantly engaged in fleet communications. Command Navy Region Northwest, Naval Base Kitsap and Puget Sound Naval Shipyard provided outstanding operational support. We had consistent communication with civilian counterparts with Kitsap County Public Health and Washington State Hospital Association. Our SharePoint site for fleet and commanding officer access has been a 'best practice.' Utilizing public affairs in a variety of ways to communicate internal and externally has also been very effective."