Army transforms wounded warrior care

Service focuses on ‘triad of care\' for soldiers

By Jason Miller
Executive Editor
FederalNewsRadio

Nearly 18 months after the Army’s problems at Walter Reed Hospital surfaced, the medical care and oversight of soldiers has made a 180 degree turn.

Brig. Gen. Gary Cheeks, the Army’s assistant surgeon general and director of warrior care and transition, says there has been a complete transformation of how the Army cares for more than 11,000 wounded soldiers.

“It is a completely different approach to what we had before,” says Cheeks Wednesday at the AFCEA Bethesda, Md., chapter’s Health IT day in Bethesda, Md.

“It is a hard working program that tries to be adaptable and versatile, and works with soldiers to move them forward.”

In the past, the Army too often left outpatient care and the management of it largely to the solider.

Now the Army uses a “triad of care” to manage the soldier’s recovery at 36 Warrior Care Transition Centers around the world. These centers are located near Army bases so the wounded soldiers can remain near family and their units.

The triad includes a nurse case manager to help orchestrate the care and manage medications, and a physician who will oversee the care and provide continuity between specialty types of care. The third piece is the squad leader who provides oversight to all parts of the soldier’s rehabilitation.

“This triad is probably the most critical and important part of what we are doing,” Cheeks says.

“It provides for the solider that individual squad leader that will make sure that soldier is holding up their part of the bargain, it provides the counseling and daily leadership and interface with the family to make sure we keep the solider on track.”

The Army also changed the criteria to make sure the soldiers who needed help the most were getting it from the program.

“We are screening people based on the severity and complexity of their wound and the care needed,” he says.

Cheeks says the soldiers give the Army about an 80 percent approval rating. While this is up from 58 percent at back in February 2007 — when the Walter Reed news broke — the Army is far from satisfied.

“We really want to be above 80 percent and look at the areas that are not doing as well,” he says.

“Soldiers tell us they are happy with leadership, nurse case management and facilities. Were we are lacking is pain management.”

The other area the Army needs improvement in is in how they provide services to the soldiers’ families.

Cheeks says both of these can be improved through better communication. The families need to know what services are available, and the soldiers need to know why certain rules apply around pain management.

Cheeks says the Army has five program areas they want to improve on:

  • Managing the soldiers who receive care better and make sure those who need it the most are receiving it.
  • Updating the administration processes and physical disability evaluation system.
  • Increasing access to mental health care.
  • Measuring their overall performance.
  • Managing soldier and family expectations.

Cheeks says the physical disability evaluation system needs to be updated—it’s more than 50 years old—but the Army needs Congress’ help to develop a new system.

Cheeks says the Defense Department has received good support from the Armed Services Committee, and is hopeful something can be done in the next year or so.

The Army also is focusing on keeping wounded soldiers in the service after they heal.

Cheeks says historically about 65 percent of injured soldiers remain in the Army, but in the last few years, that percentage is much lower—around 40 percent.

“It costs the Army $1.5 million to recruit, train and retain a sergeant and a few hundred thousand dollars to get them healed,” Cheeks says.

He says 30 days after a solider is assigned to a Warrior Care Transition Center they will get them assigned to one of three paths:

  • Stay with the Army in their current assignment
  • Stay in the Army but learn to do a different task
  • Transition from the Army to be a civilian.

“We found plans existed for soldiers to plan their future, but they were disparate,” Cheeks says. “We will bring it all together to make it easier.”


On the Web:

Staying Power: Army program reinvents wounded care (U.S. Army)

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