(FORT DETRICK, Maryland) Leaders emphasized teamwork during a forum Dec. 12, to discuss the Army's ongoing conversion of combat support hospitals to hospital centers.

The U.S. Army Medical Materiel Agency, which has been charged with synchronizing the medical materiel equipping strategy, organized the event to bring together key stakeholders to work together to address concerns related to the conversion.

In July 2014, the Vice Chief of Staff of the United States Army approved the force design update. Subsequently, in June 2017 the Army began converting its large and logistically challenging 248-bed CSHs to make them more modular and scalable. The new HC structure consists of a command and control headquarters detachment, one or two smaller 32-bed field hospitals, as well as augmentation detachments that provide additional medical, surgical and laboratory capabilities.

While change is necessary in order to bring battlefield health care delivery into alignment with combatant commander requirements, many units have expressed challenges with the new structure and conversion process.

"This is a paradigm shift. We are going to have to work together – share 'lessons learned,' solutions and resources – in order to move forward successfully," said Lt. Col. Brian Haug, Project Manager, Role of Care 3 Program Management Office at USAMMA, which is a subordinate organization of the U.S. Army Medical Research and Materiel Command.

The forum brought leaders from converted units together with units scheduled to convert throughout the next two years. Commanders shared lessons learned as well as suggestions for a more seamless conversion.

"My advice is to start early. If you are within six months of your effective date and you aren't working with USAMMA to get your unit ready for conversion, you are way behind," said Maj. Jamie Southerland, 531st Hospital Center, who talked about his unit's lessons learned with setting up new unit identification codes as part of the conversion process.

Property Book Officers are key players in the conversion process. Prior to accepting any equipment from USAMMA, the PBOs need to establish unique codes called Department of Defense Activity Address Codes, commonly known in the Army as DoDAACs, to the newly converted unit. If DoDAACs are not properly assigned, the unit supply officer will be unable to requisition, receive, and issue equipment to the newly converted unit. In the event that the unit receives a piece of equipment that is not currently reflected on their Modified Table of Equipment, USAMMA's Force Sustainment Directorate Deputy Director Greg Gehler advised the unit to contact USAMMA to resolve the property book discrepancy.

"If required, we will give you a letter of authorization so you can retain those items until your MTOE is updated," said Gehler.

The Army's Capabilities Development and Integration Directorate representatives, as well as leadership from the Army Office of the Surgeon General, also answered questions, many of which centered on staffing and concept design decisions.

"There is confusion about why certain individual capabilities mutually support both the Headquarters and Headquarters Detachment, Hospital Center and the Field Hospital. There are not enough personnel authorizations in the Army Medical Department to provide duplication of personnel such as a Command Sergeant Major, Human Resources Specialists (42As), nurses, and other support personnel. The capabilities in the HHD, Hospital Center and the Field Hospital are interdependent. This limitation also affects equipment, especially vehicles compounded by the Army-wide reductions during the Tactical Wheeled Vehicle studies. The hospital modular design will cause duplication if more than one type of Standard Requirements Code is co-located," CDID leaders explained. "The concessions during the [Force Design Update] process led to a number of compromises with personnel and equipment."

The forum also provided an opportunity for units to ask product managers specific questions regarding newly fielded systems, such as TEMPER air-supported tents. Commanders have expressed issues with the tent's flooring and air compressors. The U.S. Army Medical Materiel Development Activity informed the attendees that the new insulated flooring system is scheduled for testing and evaluation in March 2019. In addition, USAMMDA added air compressors as a common table of allowance (CTA 50-970) to support set-up and tear-down operations of the tents. For tent-related inquires, units are encouraged to reference the tent training tool at https://partners.usammda.army.mil/index.cfm/training/tas

Units also described set-up challenges while trying to reconfigure the water/waste water systems and power distribution to support the new design. To better assist in the hospital's site layout design, the Program Executive Office Combat Support and Combat Service Support provided an overview of a computer modeling tool called AutoDISE. This tool is predominately used by Engineer Warrant Officers (MOS 120As), which are authorized in every field hospital. Chief Warrant Officer 5 Jerome Bussey from the Army Center of Excellence in Fort Leonard Wood, Missouri, encouraged commanders to utilize this organic asset as they have extensive expertise with the AutoDISE tool and can assist in developing a power layout design.

As the forum came to a close, organizers thanked the participating units for providing candid feedback and asked that they continue to share lessons learned with the Center for Army Lessons Learned and Army Medical Department Center and School's Lessons Learned Division.

"Survivability depends on our ability now to envision future needs and equip our forces appropriately," USAMMA Commander Col. Timothy Walsh. "Let's remember why we are here. We are here because of the Warfighter and our commitment to provide life-saving care on the battlefield."