Joint Services Audiology Support Agreements
Col Ben Sierra, USAF
Wilford Hall Medical Center, Lackland AFB, TX
Personnel cuts continue to impact the Medical Services (Army, Navy and AF) stressing the need for creative solutions. More and more, the Services are resorting to support agreements. A year ago, the Army and AF Audiology Consultants discussed options on how WHMC could support the audiology mission at BAMC. This presentation will outline the process and discuss the challenges setting up that agreement that successfully culminated in establishing a MOA between Brooke Army Medical Center (BAMC) and Wilford Hall Medical Center (WHMC). In addition, specific recommendations will be presented that can be used as a roadmap by the audience. In April of 2001, WHMC and BAMC finalized a MOA allowing both facilities to attain a win-win situation. I hope to have a live interaction where additional ideas for joint support projects can be discussed.
Background On Audiology Support MOA Between WHMC & BAMC
Issue:
As of 1 October 2000, Brooke Army Medical Center (BAMC) Audiology ceased to have Military Audiology Services. This event poised the Audiology Service at WHMC to capture this additional patient caseload provided Wilford Hall Medical Center (WHMC) providers could use BAMC Audiology facilities/equipment and get 100% of the workload credit. Since CHCS policy doesn’t allow to record a patient visit at one facility as being done in another a formal agreement between the two facilities was needed to let WHMC get workload credit for Audiology patients seen at BAMC.
Background:
In early July 2000 I the Army Audiology Consultant asked the AF Audiology Consultant to evaluate the possibility of providing audiology support at BAMC. If not seen at BAMC, the patients will have been seen at WHMC or referred to the private sector. The role of both Consultants (Army and AF) was critical in justifying the support agreement. Reasons to support this initiative were numerous
- MOA allows WHMC to get workload credit for patients seen at BAMC and in fact establishes a WHMC Audiology Satellite Service
- Establishes WHMC/BAMC Audiology as the leading DoD Audiology Service hub
- Increase of patient visits for WHMC with no administrative support tail or facility fixed costs
- Eases space crunch at WHMC Audiology and Speech Clinic
- Improves access to care for North San Antonio and Randolph AFB patient population
- Results in increased customer satisfaction
- BAMC patients would be seen at BAMC–retirees service loyalty is high
- Convenient short drive for AF active duty from Randolph AFB
- Access to a literally new facility and audiology equipment with no investment or maintenance costs on AF part
- A modest investment will garner a larger resource market share and market penetration
- Greater Potential to capture/recapture patient care that otherwise will go to the private sector
- Positive impact on potential Bid Price Adjustment
- Maintain/increase currency and competency of AF providers by exposing them to different population demographics
- Facilitates continuity of care for patients enrolled at BAMC where their physician care and administrative support is provided
- Supports joint Otolaryngology Resident Training Program between WHMC and BAMC Opened additional avenue of dialogue and cooperation between WHMC and BAMC
Mapping a Winning Strategy
The most critical component is to plan and articulate a “win–win” strategy both for all parties involved and to get “buy–in” from key decision-makers on both sides. In order to achieve this, key information must be gathered beforehand and a lot of groundwork must be accomplished prior to starting the formal coordination process. It is critical that all concerns are addressed along the Chains of Command and validation of benefits must be done as many times as needed. One must be ready to brief at a moment’s notice and above all never assume that your are clearly understood. In addition, one must be prepare to alleviate any inter–service concerns as well as being prepared to defused any potential challenges that might derail your efforts.
Bottomline
- do your homework ahead of time
- have valid and reliable data
- coordinate ahead of time
- if you run into any “road blocks” personally address them
- “follow–up, follow–up, follow–up”
Outcome: MOA established in April 00 to address above. AF audiologist currently supporting both AF and Army mission at BAMC.
Basis of Tinnitus Retraining Therapy
1Lt H. Dean Hudson, USAF
Lackland AFB, TX
This presentation will begin with definitions for tinnitus and hyperacusis. It will next discuss neurophysiological/psychologicaI principles to include: auditory-limbic connection, neural plasticity and habituation. In conclusion, it will examine theoretical models.
BabyTracker–Newborn Hearing Screening Software
Capt Bridget McMullen, USAF
Elmendorf AFB, AK
This presentation will begin with a brief overview of the universal hearing screening. It will describe the basic philosophy, testing procedures and referral criteria. Next will be a discussion on tracking results, for example: Why do we need to track results; What do we do with these data; and How do we track results? It will conclude with an overview and description of the Baby Tracker Software program.
The Sound of Honor–Noise Report on the M-1 Garand Ceremonial Rifle
Maj Joseph Narrigan, USAF, Bolling AFB, DC
Capt Stephen Steele, USAF, Lackland AFB, TX
The United States Honor Guard has a long and proud history of providing military ceremonial support. Most of the men and women who are detailed to the Honor Guard are junior enlisted and come from a wide variety of Air Force (AF) specialties. I estimate that approximately 60 to 70% of Honor Guard members do not have occupational exposure to hazardous noise, other than the exposure to the M-1. Very few, if any, Honor Guard units are included in the AF’s Hearing Conservation Program or use hearing protective devices when firing the ceremonial rifle. This presentation will describe the type and degree of noise exposure to the M-1 Garand ceremonial rifle, and encourage the inclusion of the base Honor Guard in the HCP.
Dental Services to be Added to the Hearing Conservation Program
1Lt David Pedersen, USAF
Keesler AFB, MS
This presentation will begin with a brief history dating back to the 1950’s documenting hearing loss from dental drills. It will also look at current dental research regarding hearing loss and address some of the issues that need to be resolved. It will examine several case studies and discuss the Dentist’s position and the impact on the mission. It will suggest ways to implement a hearing conservation program based on research, legal issues and physical exam findings.
Base Health Promotion Programs and Hearing Conservation
Lt Col Carolyn Bennett, USAF
Hill AFB, UT
This presentation will begin with a brief introduction into the purpose of Health Promotion Centers and Health Promotion key areas. It will describe the strategies for promoting life style changes. Focus will be on Healthy People 2010, garnering top level support, determining needs and interests, behavioral change strategies, and planning and scheduling activities.