ROLE 1 - 3 Improvements

Discussion in 'Professionally Qualified, RAMC and QARANC' started by ViciousCircle, Apr 4, 2006.

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  1. I am in the process of writing a paper on ways and means to improve our current role 1, 2 & 3 medical installations, this includes our rearward passage of casualties/patients and the forward passage of critical medical equipments including blood and gasses. Now I have twenty years experience in primarily role 1 and 2 so I have my own views on changes that could improve these area's.

    But while scratching my ARRSE the other day thinking what other ways improvements could be made I thought of you (Venty, D-L, FF, Wasme, GP3 Bunny) the all seeing all powerful ARRSERS, this site is a font of all knowledge, with AMS representatives from across all of the CEG's. Some of you have seen the wheel re-invented on numerous occassions.

    Now, improvements dont neccessarily need to be completely new concepts but could be tried and tested practices that for one reason or another have been changed. So please feel free to add your ideas.

    If I may be so bold as to say if you have a change for the better please elaborate as to why it is better than current practice.

    Thanks in anticipation.
  2. Get at IT system that can track all of these assets, so you know where everything is and use it to identify where its needed.

    Something like this from e-health Insider DMS - Ready for take off

    p.s. have a look at the jobs section, some DMS experience can gain £600 contractor pay per day
  3. Percy_Pigeon

    Percy_Pigeon War Hero Book Reviewer

    Having had the dubious pleasure to sit on the generic GJ/4 chain on a recent operational tour.

    I can recommend the following:

    Connect all the elements together Div making decisions and not consulting it all.

    Remember the role of the facility and not try and recreate Holby City

    Connect all aspects of the hospital stores and drugs and allow the clinical and G4 chains to liaise.

    G4 training for medical planners so they don’t expect things to magically appear or have thing explained slowly and loudly by a Cpl in the RLC Med sup Sqn.

    Better G4 training generally, if you are aware of the massive problems in this area you will understand this point, I include in this accountability.

    Expectation management having liaised with some of the senior medical staff they were unclear of there role and how to staff changes correctly and the way things happen within the DLO (ie. slowly). I believe it is due to there employment when not on ops and unrealistic expectations on Ops. This has not helped with the reorganisation of the Medical supply chain whist 2 Ops are running.

    This is by no means a dig Medically and doctrinally I found them spot on and had a minor(ish) operation during my tour. But there is more to it that pure med.

    I hope this helps please PM if you want me to expand I have many notes at work as my introduction to |med was pure baptism of fire.

    But my overriding point is that there requires further or closer liaison with the GJ4 elements both supply and ES (Med Equip serviceability reporting and ECI).
  4. Ooooooh, where the hell do I start :roll:

    1) What about a module review from the recent Op capability study?? All modules, because some of the ones that concern my CEG are so antiquated its embaressing

    2) More liason between DCAs, so we in the support CEGs know what the fecking Doctor/Consultant/Specialist wants and not be totally surprised when he/she/it asks for serum rhubarb on tour :roll:

    3) For DLO to make itself workable and to try to help its customers instead of ignoring them :evil:

    4) For the AMS to come up with a concept for surgical care forward of Role 3 and to see it through to completion, not decide to ditch it and tell no-one but leave it open to speculation and rumour

    5) How's about a degree of flexibility to change the module contents easily and often, the reason? the commercial market moves and changes rapidly, new techniques and analysers are evolving rapidly and constantly. To provide the best care, we need this flexibility.

    There, that'll do for the moment from me. I'll add more when I think of it........probably tonight when I'm down Emmas drunk :twisted:
  5. I agree with the comments regarding overhaul of the modules; I can recall trying to push this up the chain 6 years ago with little effect. CMTs need to have more clinical training to perform their war role - things like urinary catheterisation and passing of nasogastric tubes are essential skills for anybody dealing with major trauma - I know the MO and (some) Med Sect RGNs will have this skill, but what about mass casualties? Have to say that I have found the system generally good in the past. Maybe there is an argument for provision of O2 concentrators to complement cylinder O2, or would this just be another item of expensive and intimidating kit for a lot of people? I agree that people need to remember where they are and that the niceties may not always be available, but CG demands that the soldiers are provided with a level of care on Ops commensurate with that which they would receive in the NHS. Cons Surgeons need to be aware that their particular penchants may not be catered for by the modules - in which case they need to be staffing something themselves, but they are busy people - is it likely to happen - I would be hesitant to comment.
    Medical planning and reconnaissance is accorded a suitably high priority, but does it reach the guys at section level, this would enable anticipation of the ordering of resupply promptly, however order to promptly and your facility will be swamped with a load of kit that they might struggle to fit into the trailers and vehs should there be a short notice move. At R1 CSMs etc need to know that the BFA is not a platform for the movement of the Coy HQs excess baggage, and that is is a no-no to use BFAs for transport of ammunition etc - yes, I have had both these arguments before!
  6. Thanx for the above points and hopefully there will be more incoming in the future.

    Captainchaos I agree with your points I also think that CSM's need to be aware that they need to place more emphasis on their personal role in triaging and evacuating the sick and wounded during the contact phase.

    D-L, I know what you are saying is true with regards to the med modules but although a review is neccessary I feel that an ongoing review system is required so that when a user of a particular module finds something has been improved or is no longer needed or simply isnt in the module then a simple form should be completed and returned to a certain address for consultation. Currently the method of adding a piece of kit to a module is so drawn out and expensive that if you or I requested a piece of kit, by the time it came in it would already be out of date.

    Also the Cbt Sp Hosp will replace the Critical Care Station that never really lived.
  7. See my PM V-C but the idea of on-going review of the modules with an easy system of replacement would be heaven sent......however if we ever get one is another idea totally
  8. Typical, How come subject matter experts are not aware this ???? :!:
  9. Aware of what, my 20 odd years of experience ?
  10. Put your handbags away ladies :wink:
  11. Dont worry D-L, my handbag never even saw the light of day a bit like Venty's wallet or FF's serious side ? :roll:

    or even Wasme's Red Book :lol:
  12. Are there any Med Regt troops out there who can confirm that the Critical Care Station is in fact dead ? and that the CS Med Sqns' are running with the old Dressing Station concept ?

    until the new plan is unveiled 8O
  13. Percy_Pigeon

    Percy_Pigeon War Hero Book Reviewer

    As the control and transportation is now a Supply chain function I can see the point in doing a paper without the assistance of the Supply Chain policy people or the relevant Med Log department be it PJHQ or LAND.

    Has I am constantly bombarded with medical questions from my S01 I can assure you that this matter is being looked into from start to finish..

    However I feel the problems in the green end are skills and ethos based and over the next year or 2 be resolved. But the following problems stand out.

    • Poor maintenance and control of modules
    • Hospitals trying to operate beyond the designated role

    Every 01 I sanctioned was in this category.

    • People in the first line QM’s that want to be there, if this means that the Q function is handed over to the RLC, then so be it.
    • The rewriting of JSP 340 to actually say something.
    • To jump all over staff that cut corners with CD’s and instil military displine in the clinical staff. It’s just to pally for me on Op’s I know it’s due to the way you work when not on Ops.
    • An understanding of the wider non medical regulation JSP 336 Vol 10 & 12in this we had top pull 3 changes to regulation because of insufficient knowledge in this area

    I must add that this is NOT a dig on the Medical services I have the up most respect for there skills and I have my leg in tact because of them.
  14. At the risk of becoming too specific, here is my two pence worth.

    The X-ray module at the moment is bulky, with processors, chemicals (and their own inherent hazzards) dark rooms and banks of light boxes et al....

    What we need is somthing LIKE this, a digital imaging system that will display images as they are taken. They can be downloaded to a laptop and sent anywhere on a field LAN.
    Though I would not buy shimadzu if I could help it {legal disclaimer. the author is expressing an opinion and not trying to suggest that this manufacturer is a big pile of pants, at all :wink: }

    This would obviate the need for processors and chemicals (indeed all of the above).

    The module would be smaller and lighter, and perhaps the best bit, it would take minutes to set up rather than hours and a damm sight more manoverable.

    I would also endorse DL's points, there needs to be a way to swap items in and out of modules quickly dependant on changing technology in the medical sector. At the present time equipment procurement is a nightmare.
  15. :idea:

    I see a theme here, maybe an increase to the Eqpt Sponsor team at AMD with a hot line = Tel/Fax/email for direct interface with the procurement chaps ? individual completes form with lets say the following info:

    Module concerned:

    Item to be replaced/removed Info:

    Item Name:
    Reason for replacement/Removal:

    New item details:
    NSN: (if applicable, maybe from a different module)
    Item Name:
    Reason for Procurement:

    This could then be processed through the individuals G4 chain with the additional paperwork being attached as required by WO1 Eqpt Sponsor at AMD then faxed/emailed or verbally passed to AMD, take a week max to gather and return info to AMD.

    It doesnt mean you/I/we get the item but this would then give AMD the steer on the issue and allow research into the viability of the request ie expense etc.

    would mean an increase to the said AMD team but dare I say at the expense of an improved capability in whichever area and better overall treatment to the troops on the ground it may be a way forward for constant ongoing evaluation of modules instead of 5 - 10 yearly reviews, which dare I say are labour intensive and frustrating for all concerned.

    Your views :?: