U.S. Army Capt. Ashely Sarlo, a critical care nurse attached to the 240th forward resuscitative surgical detachment, and Spc. Connie Sariraksa, a licensed practical nurse attached to the 7454th medical operational readiness unit, simulate experimental postoperative critical care at Camp Grayling, Mich. on Aug. 12, 2023, during Northern Strike 2023(NS23).
Exercise NS23 is a premiere reserve component training even that integrates both U.S. and partner nation readiness training to build interoperability and strengthen partnerships in an all-domain environment. (U.S. Air National Guard photo by Staff Sgt. Jacob Cessna)
U.S. Army Capt. Ashely Sarlo, a critical care nurse attached to the 240th forward resuscitative surgical detachment, and Spc. Connie Sariraksa, a licensed practical nurse attached to the 7454th medical operational readiness unit, simulate experimental postoperative critical care at Camp Grayling, Mich. on Aug. 12, 2023, during Northern Strike 2023(NS23).
Exercise NS23 is a premiere reserve component training even that integrates both U.S. and partner nation readiness training to build interoperability and strengthen partnerships in an all-domain environment. (U.S. Air National Guard photo by Staff Sgt. Jacob Cessna) (Photo Credit: U.S. Army)
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Innovation lies at the heart of the Army's pursuit of an advanced Health System for 2030. The Northern Strike (NS) Prolonged Care Augmentation Detachment (PCAD) experiment showcases the Army's commitment to continuous enhancement in collaboration with the Michigan Army National Guard (Army NG, MI) (Role 2), Army Reserve Medical Command, Regional Training Sites Medical, Joint Operation Medicine Information System, United States Army Medical Center of Excellence, and several other entities within the Army Health System (AHS) by embracing a persistent experimentation approach.

This article delves into the various stages and objectives of the experiment, highlighting the significance of Doctrine, Organization, Training, Materiel, Leadership and Education, Personnel, Facilities, and Policy (DOTMLPF-P) analysis in shaping the future of Army healthcare.

The Functional Solutions Analysis sets the stage for innovation by conducting a comprehensive DOTMLPF-P analysis. This analysis determines whether a non-materiel or materiel approach is needed to bridge capability gaps identified in the Functional Needs Analysis. By covering the entire life cycle, including sustainment, Environment, Safety, and Occupational Health, and all Human Systems Integration domains, DOTMLPF-P analysis enables informed decision-making. It guides the path toward a more advanced Health System.

The PCAD experiment exemplifies the Army's commitment to collaboration and integration with partner units. Lt. Col. Margaret Kucia, Lt. Col. LaTonya Williams, and Dr. Edward Michaud, from MED CDID, fostered an environment of collective learning and sharing. Their engagement with the command-and-control center for the NS Team and the 1171st  Medical Company Area Support (MCAS) elevated decision-making and resource coordination, strengthening the experiment's outcomes. Streamlining communication channels ensured seamless integration within the operational structure, maximizing efficiency and effectiveness.

The PCAD team's orientation to Operational Health Information Technology (OHIT) showcased their commitment to staying at the forefront of technological advancements. Trauma Advanced Care (TAC), Battlefield Assisted Trauma Distributed Observation Kit, and Health Assessment Light Operations (HALO) were integrated into their practices. As observer analysts underwent standardization training on data cards, Dr. Laura Scott's expertise enhanced the team's ability to leverage the latest technological advancements for a successful PCAD experiment.

Maj. Gen. John Epperly's presence at the PCAD experimentation area showcased the Army's recognition of the dedication and efforts of the personnel involved. He acknowledged the importance of experimentation, OHIT, and the role of PCAD squad participants. By expressing gratitude to the PCAD squad for their commitment to supporting innovation and presenting coins to Sgt. Nicholas Vazquez and Spc. Katiuska Garcia-Barboza from the 1171st MCAS, Army NG, MI, for their contributions, Epperly underscored the significance of each individual's efforts in shaping the future of Army healthcare.

During the execution phase on Day 8, the PCAD team provided care for seriously ill post-operative patients, utilizing TAC and HALO to guide decision-making. With a focus on high-fidelity patient scenarios, the team's ability to perform within a 72-hour timeline was thoroughly assessed by observer analysts. The seamless integration of medical equipment sets and relocation to enhance integration with patient hold and other medical company capabilities streamlined operations.

The NS PCAD experiment demonstrates the Army's unwavering commitment to innovation and continuous improvement. Anchored by DOTMLPF-P analysis, the experiment exemplifies the holistic approach to the Army's healthcare transformation. Through collaboration, streamlined communication, technological advancements, and recognition of dedicated personnel, the Army paves the way for an advanced Health System. By persistently experimenting and integrating DOTMLPF-P, the Army ensures seamless readiness on the future battlefield, making substantial strides toward delivering a responsive, effective, and cutting-edge AHS for the years to come.

Col. Bill Soliz, 10th Army Physician Assistant (PA) consultant to the Surgeon General, stated, "Embracing the future of battlefield medicine, the integration of Prolonged Care Augmentation Detachments, led by trained Physician Assistants, stands as a testament to our commitment to superior care in prolonged field scenarios. By partnering with civilian training institutions, we ensure that our PAs bring a synthesis of military precision and the best civilian medical innovations. As The Surgeon General's consultant, I can unequivocally state that this fusion enhances our medical readiness and solidifies our position at the forefront of combat medical care. Our PA-led teams embody the adage: 'In Knowledge, There's Strength; In Unity, Victory. Our Future is Bright!'"

Soliz emphasizes the significance of integrating PCADs, particularly those led by skilled PAs. By leveraging the expertise and resources of civilian training institutions, the Army ensures that its PAs combine military precision with the latest advancements in civilian medical practices. This approach enhances medical readiness and solidifies the Army's position as a leader in combat medical care. The unified knowledge and collaboration of PA-led teams contribute to their success in delivering superior care on the battlefield.