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ROLE 1 - 3 Improvements

#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
 

Percy_Pigeon

War Hero
Book Reviewer
#3
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
ViciousCircle said:
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.
Typical, How come subject matter experts are not aware this ???? :!:
 
#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
 

Percy_Pigeon

War Hero
Book Reviewer
#13
Northern-Monkey said:
ViciousCircle said:
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.
Typical, How come subject matter experts are not aware this ???? :!:
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:

NSN:
Manufacturer:
Item Name:
Reason for replacement/Removal:



New item details:
NSN: (if applicable, maybe from a different module)
Manufacturer:
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 :?:
 
#16
Another point from me as a way to improve the AMS would be someone with a better understanding of the internet ? 8O no not someone to study ARRSE or to download funnies for the DG ? No sadly one of our failings in the AMS is the time it takes to pass info to the people that need to know it.

An example would be that recently I spent a day on the phone speaking to a number of people trying to find out info on the future plans for the CMT(V) (a family member is in that CEG) and I got nothing from anyone ! I placed one post on ARRSE and got all the answers I needed.

Now call me a bluff old traditionalist but if the more senior officers/Warrant Officers of the AMS understood the enormity of the audiance that use the internet maybe they would consider placing more info on the internet sooner ?

This has been an AMS problem for many years the slowness of our passage of info, another classic example would be the death of the Critical Care Station, there were still troops on the ground that werent even aware of the CCS even though they had been moved into a CCS Sqn, the ET written to reflect CCS's and the DS had been killed off ? Now they are being told the CCS is no more and their response is ?

What is a CCS :?:

WE NEED TO BE SHARPER.

The recent release of MATT's excellent delivery and I would suspect that most that matter know all about them and are in a position to brief upwards or downwards.


OUCH ! OUCH ! OUCH !

Sorry fell off my soapbox

:oops: :wink: :oops: :wink: :oops: :wink: :oops: :wink: :oops: :wink: :oops: :wink:
 
#17
ViciousCircle said:
:
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 :?:
Would the ideal solution be to let the CEG's have direct control of the module rather than providing suggestions to the procurement team?
 
#18
Percy_Pigeon said:
• Poor maintenance and control of modules
yesa, that happens but the modules are too bulky and not easy to store, for example the A&E module has soo many drugs required and extra 2 reefers would be needed :roll:

PP said:
• Hospitals trying to operate beyond the designated role
That is thanks to our revered leaders of the AMS, namely the Clinicians. They are notorious for asking for "other tests" to be added and before you know it, your trying to do the same as a DGH back in the UK :roll:

PP said:
• The rewriting of JSP 340 to actually say something.
And one that actually is easy to use and has extant NSNs would be a start

PP said:
• 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.
Military ethos is there my friend but in a hospital, we are all working in close proximity and when patients are involved you cannot be yielding the big military stick. After all, the best way to recuperation is in a relaxed atmosphere, not one where discipline is rigidly enforced and AGAIs thrown around like your in a Guards Btn. We are all professionals in this environment and act as such, sorry if it isn't brace up and stand up when an officer walks in.......well OK the CO gets it buts that about it! Also you seen how many Lt-Cols and Cols we have :roll:
 
#19
T x 3 Wrote:

Would the ideal solution be to let the CEG's have direct control of the module rather than providing suggestions to the procurement team?
Either way the CEG's would receive the form from the individual then process it through AMD (with supporting paperwork) for finacial approval and procurement !

6 of 1 and half dozen of tother

CEG;s having direct control wouldnt work as they dont have the shopping power that AMD has ?
 
#20
ViciousCircle said:
CEG;s having direct control wouldnt work as they dont have the shopping power that AMD has ?
We tend to know the Reps quite well, and you'd be surprised how good we are at getting the buggers to lower their prices :wink:

Also the module revisions take too bloody long to come into effect, this needs to be speeded up!

What about getting Doctors to wind their necks in and stop asking for stupid tests? Mentioned previously, but I thought its a damn good whinge :twisted:

And getting ridiculously expensive analysers requested for one consultants whim, only for it to sit in its box and not be used 8O
 

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