COVID-19: Opportunity to Re-Imagine Our Response to a National Medical Crisis

Remick, Kyle N.; Carr, Brendan G.; Elster, Eric A.

doi:10.1016/j.jamcollsurg.2021.01.013

Cited by 4 publications

(5 citation statements)

References 6 publications

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“…Numerous authors, particularly after major disasters, have repeatedly raised concerns that the NDMS does not have the capacities and capabilities to respond to a catastrophic disaster or a large-scale conflict. Recommendations for increasing NDMS definitive care capabilities and capacities focus on either strengthening civilian-military coordination, [17][18][19][25][26][27][28][29] civilian-federal coordination, 13,15,16,22,27,29,30 or regional health care response coordinating bodies. 17,23,27,31,32 Given the critical nature of the NDMS for US security, it was surprising to find so few publications focused on the system in general and, more specifically, on its definitive care component.…”

Section: Discussionmentioning

confidence: 99%

The National Disaster Medical System and military combat readiness: A scoping review

Lee

Allard

Adeniji

et al. 2022

J Trauma Acute Care Surg

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A scoping review was conducted to describe the history of the National Disaster Medical System (NDMS) in the context of US military medical preparedness for a large-scale overseas military conflict. National Disaster Medical System civilian hospitals would serve as backups to military treatment facilities if both US Department of Defense and US Department of Veterans Affairs hospitals reached capacity during such a conflict. Systematic searches were used to identify published works discussing the NDMS in the scientific and gray literature. Results were limited to publicly available unclassified English language works from 1978 to January 2022; no other restrictions were placed on the types of published works. Full-text reviews were conducted on identified works (except student papers and dissertations) to determine the extent to which they addressed NDMS definitive care. Data charting was performed on a final set of papers to assess how these works addressed NDMS definitive care. The search identified 54 works published between 1984 and 2022. More than half of the publications were simple descriptions of the NDMS (n = 30 [56%]), and most were published in academic or professional journals (n = 38 [70%]). Only nine constituted original research. There were recurrent criticisms of and recommendations for improving the definitive care component of the NDMS. The lack of published literature on NDMS definitive care supports the assertion that the present-day NDMS may lack the capacity and military-civilian interoperability necessary to manage the casualties resulting from a large-scale overseas military conflict.

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Section: Discussionmentioning

confidence: 99%

The National Disaster Medical System and military combat readiness: A scoping review

Lee

Allard

Adeniji

et al. 2022

J Trauma Acute Care Surg

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“…While the recent NDAAs emphasized trauma care, the importance of all types of critical care was also recognized, as data show that nearly 50% of patients medically evacuated from combat theaters are for non-traumatic medical illnesses 18 . Further, the ongoing COVID-19 pandemic has demonstrated the need for MCPs to be prepared for a comprehensive medical response and has brought a renewed focus on the intersection of the US health care system and national security 19 . Clearly, to meet the future needs of the military and the nation, MCPs will need to address further military and civilian medical integration and to expand to the full spectrum of preparedness and disaster medicine.…”

Section: Discussionmentioning

confidence: 99%

“…18 Further, the ongoing COVID-19 pandemic has demonstrated the need for MCPs to be prepared for a comprehensive medical response and has brought a renewed focus on the intersection of the US health care system and national security. 19 Clearly, to meet the future needs of the military and the nation, MCPs will need to address further military and civilian medical integration and to expand to the full spectrum of preparedness and disaster medicine.…”

Section: Discussionmentioning

confidence: 99%

The Las Vegas military-civilian partnership: An origin story and call to action

Kilburn

Streit

Degoes

et al. 2022

J Trauma Acute Care Surg

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Military-civilian partnerships (MCPs) in urban American trauma centers have existed for more than 60 years to assist in the development and maintenance of wartime skills of military medical professionals. In the last 5 years, MCPs have gained congressional support, and their number and variety have grown substantially. The historical impact of these flagship trauma MCPs is well documented, with bidirectional benefit in the advancement of trauma care during the wars in Iraq and Afghanistan both deployed and stateside, and the future aim of MCPs lies primarily in mitigating the "peacetime effect." The majority of data regarding MCPs; however, focus on trauma care and are biased toward surgeons specifically. The Las Vegas (LV) MCP began in 2002 with the similar goal of sustaining Air Force (AF) expeditionary medical skills by embedding AF medics from nearby Nellis Air Force Base (AFB) into University Medical Center of Southern Nevada (UMC), the only Level 1 Trauma Center in Nevada. Over nearly 20 years, the LV-MCP has evolved into an innovative market-based collaboration composed of numerous relationships and programs that are designed to develop and sustain critical skills for military medical personnel in all aspects of expeditionary medicine. This includes AF medical personnel providing care to federal beneficiaries as well as civilian patients in a variety of medical settings. The partnership's central coordinating authority, the Office of Military Medicine-Las Vegas (OMM-LV), brings together military and civilian organizations with distinct and intersecting missions to support the greater LV population and the DoD mission of readiness. The LV-MCP is presented here as a model for the future of MCPs within the integrated local and national trauma and medical systems.

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“…this response offers an opportunity to consider how our nation can use its resources most effectively to respond to future crises. 12 This study identified 19 consensus recommendations for care transitions between military and civilian health care assets during a medical crisis. These recommendations may be useful to optimize care transitions during any future episodes of military support to civilian health care.…”

Section: Daily Operationsmentioning

confidence: 99%

Military Response to Medical Crises—Consensus Recommendations for Military–Civilian Transitions of Care

Goolsby

Schuler

Tilley

et al. 2022

Disaster med. public health prep.

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Objective: The threat that New York faced in 2020, as the COVID-19 pandemic unfolded, prompted an unprecedented response. The US military deployed active-duty medical professionals and equipment to NYC in a first of its kind response to a “medical” domestic disaster. Transitions of care for patients surfaced as a key challenge. Uniformed Services University and the Icahn School of Medicine at Mount Sinai hosted a consensus conference of civilian and military healthcare professionals to identify care transition best practices for future military-civilian responses. Methods: We performed individual interviews followed by a modified Delphi technique during a two-day virtual conference. Patient transitions of care emerged as a key theme from pre-conference interviews. Twelve participants attended the two-day virtual conference and generated best practice recommendations from an iterative process. Results: Participants identified 19 recommendations in 10 “sub-themes” related to patient transitions of care: needs assessment and capability analysis; unified command; equipment; patient handoffs; role of in-person facilitation; dynamic updates; patient selection; patient tracking; daily operations; and resource typing. Conclusions: The COVID-19 pandemic resulted in an unprecedented military response. This study created 19 consensus recommendations for care transitions between military and civilian healthcare assets that may be useful in future military-civilian medical engagements.

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COVID-19: Opportunity to Re-Imagine Our Response to a National Medical Crisis

Cited by 4 publications

References 6 publications

The National Disaster Medical System and military combat readiness: A scoping review

The National Disaster Medical System and military combat readiness: A scoping review

The Las Vegas military-civilian partnership: An origin story and call to action

Military Response to Medical Crises—Consensus Recommendations for Military–Civilian Transitions of Care

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