By 31st Combat Support HospitalSeptember 29, 2010
In August, the 31st Combat Support Hospital (CSH) at Camp Dwyer, Afghanistan, became the first Army facility in Southwest Asia to utilize the Defense Medical Logistics Standard Support (DMLSS) system. DMLSS is an automated medical logistics (MEDLOG) system used to support inventory management and property accountability in medical treatment facilities.
The DMLSS fielding team, comprised of representatives from Medical Communications for Combat Casualty Care (MC4) and the 6th Medical Logistics Management Center (MLMC), Fort Detrick, Md., helped the 31st CSH improve business processes, shelving old methods built upon paper forms and confusion.
Today, the hospital has better visibility and management of its medical supplies. They process thousands of transactions electronically, and the data entered into DMLSS gives commanders around the world better visibility of their supply chain.
The hospital's commanders and MEDLOG staff welcomed the change. Some anticipated that a complete overhaul of business practices would put some time back in their pockets. They were right.
When the DMLSS fielding team arrived at Camp Dwyer, the unit's logistics section needed assistance. SFC Enoc Santos, medical supply specialist with the 6th MLMC and member of the DMLSS fielding team, describes the "before DMLSS" picture.
"Every morning, medical personnel throughout the hospital and remote locations hand-carried orders on paper forms to the medical supply section," SFC Santos said. "Clinicians filled the orders by walking the aisles like they were at a neighborhood grocery store. They pulled the items ordered, and additional supplies just in case. If a ward ran low on supplies, someone walked to the medical supply section to restock."
The steady stream of clinicians through the medical supply section made stock management difficult. The interruptions caused delays in reordering supplies. Additionally, MEDLOG personnel regularly walked the isles to update the levels of on-hand provisions.
To help the unit's MEDLOG staff, the MC4 team conducted a wall-to-wall inventory. The results further proved the need for a digital management system. The remote treatment facility had enough medical supplies on hand that it could fulfill orders for dozens of treatment facilities throughout Afghanistan.
Fortunately, the installation of DMLSS eased that burden. Once installed, orders poured in electronically throughout the hospital, eliminating the paper trail. After a week, the unit digitally processed more than 1,500 transactions, compared to approximately 900 averaged before the upgrade. They did not miss an order.
Using the new proactive business model, customers at remote locations received supplies directly, rather than the CSH receiving the orders and then routing the supplies forward. In turn, this helped to reduce the amount of supplies stored by the CSH. SPC Daniel Guzman, medical supply technician for the 31st CSH, witnessed a faster turnaround on supply.
"Hospital personnel are more reliant upon the tools at hand and trust the application to help maintain appropriate supply balances," SPC Guzman said. "They now have instant visibility of the items they need and the items on the shelf. We have a better idea of the supplies ordered on a daily basis and now maintain a better inventory. In turn, we're able to fulfill the orders faster."
With DMLSS empowering hospital wards to manage their own stock, users such as SFC Jean Hue, intensive care ward technician for the 31st CSH, can now focus more time on patient care instead of browsing supply isles.
"Sitting at my desk, I know what items are in stock and what must be ordered from outside supply warehouses," SFC Hue said. "Previously, I would make multiple trips to the supply section for an order status. Today, using DMLSS, I know if I'll have an item within one hour or if I need to wait a couple days for it to be shipped in. For those items on backorder, I can electronically look around the hospital to see if I can borrow supplies until my order arrives."
Commanders responsible for supply management and oversight have also gained an advantage. Data entered into DMLSS feeds into the Joint Medical Asset Repository (JMAR). It serves as the roll-up reporting tool for medical supply management, similar to how the Joint Medical Workstation (JMeWS) helps with medical care surveillance.
"The use of DMLSS helps senior leadership to better manage the global MEDLOG efforts," SFC Santos said. "Since commanders have visibility of the entire supply chain, they can take action to rectify a variety of issues, ranging from transportation problems to moving critical supplies to another part of theater."
Since implementation of the MEDLOG system, SFC Santos says hospital personnel play a huge role to properly train new users.
"The resident knowledge reduces the reliance upon deployed technical support personnel for support and training," SFC Santos said. "The unit is also better positioned to fine-tune their MEDLOG business processes. It's great to see the unit take ownership of their system."
This article first appeared in The Gateway.