LANDSTUHL REGIONAL MEDICAL CENTER, Germany --The Livorno Army Health Clinic, Italy, is only the second U.S. Army Medical Command facility to receive the prestigious Army Star Strong recognition for exemplary occupational health and safety management practices following a stringent evaluation by MEDCOM officials Oct. 22-24.

The comprehensive on-site inspection concluded a three-phase, 243-item checklist review that began in January 2011 and culminated with the award of the Army Star Strong status by a team of MEDCOM and civilian safety experts from the Department of Defense's Voluntary Protection Program Center of Excellence.

"To the clinic, this is extremely important," said Maj. James D. Phillips, commander of the Livorno clinic. "It validates what we have been doing to keep ourselves safe and the fact that we are helping to blaze a trail to a safer working environment in the MEDCOM."

"To the community," he continued, "I think that this is important because, at a time when so much is closing down or has (reduced) services, this shows the community that their health clinic is striving to reach for a higher level of performance."

The VPP was created in 1982 by the Occupational Safety and Health Administration to recognize and partner with worksites that implement systems to manage worker safety and health that go beyond basic compliance with OSHA standards. In June 2012, the Surgeon General of the Army Lt. Gen. Patricia D. Horoho made the program a requirement for MEDCOM facilities to transform from the compliance-based Army Occupational Safety and Health program to a performance-based management system.

"The Europe Regional Medical Command leadership volunteered to participate in the OSHA VPP two years before it became mandatory," said Carol Fontanese, ERMC Safety Manager, explaining that the Star Strong process usually takes 36 to 42 months to complete. The Illesheim Army Health Clinic, Germany, was the first MEDCOM unit to receive the award this past June after only 17 months, and Livorno achieved it in 22 months.

"Because of the ERMC leadership commitment to safety, we are now leading the way in MEDCOM," added Fontanese. "(As a result) beneficiaries will experience a culture where hazards are quickly identified and corrected, making it a much safer and healthier place to receive their medical care."

The different phases of the VPP to achieve Star Strong status include assessments focused on management, leadership and employee involvement, worksite analysis, hazard prevention and control, and safety and health training. During last week's final stage of the evaluation at Livorno to assess the staff's understanding and knowledge of the program, all employees were interviewed, to include military, local nationals, DoD civilians and contractors.

"It's not just a safety manager responsibility anymore -- it really involves everybody," said Harry Raith, Landstuhl Regional Medical Center Safety Manager who accompanied the MEDCOM assessment team at Livorno. "This program establishes a culture where everybody sees it as their responsibility to take action where safety is concerned."

"It's a mindset," agreed PFC Gregory Swindell, a radiology technician at Livorno. "Too often you'll see an organization playing host during a command team visit, where (they) will implement or exercise certain ideologies and practices that the command team wants to see.

"Then, as soon as the command team leaves, everything returns to the way it was before they arrived," he continued. "That's the wrong answer. As a team, while preparing for this assessment, we simply continued to do the same things we had previously been doing because our culture of safety was already established. We already possessed a common mindset that prioritized safety as our mission."

Raith noted that the Livorno staff was also recognized with an ERMC-level award recently for not having a DUI/DWI in the last five years, as well as not having had an accident during the last three fiscal years.

"We make sure the overall program elements are in place, set overall policy and standards and provide some training," said Raith of Livorno and the eight other outlying military treatment facilities that fall under LRMC, "but really, it's the accomplishments of the men and women of the Livorno Clinic."

Under the LRMC footprint, the Baumholder and Kleber clinics, Vicenza Health Center and Landstuhl Medical Transient Detachment have all completed the first phase and are awaiting the inspection team's visit for validation of phase two. In the meantime, the clinics at Wiesbaden and Stuttgart will receive their stage one assessments before the end of the year, and LRMC is slated for its initial assessment in January.