A Worldwide Publication Telling the Army Medicine Story ARMY MEDICINE MERCURY CONTENTS DEPARTMENTS

Volume 42, No. 1 A worldwide publication telling the Army Medicine Story ARMY MEDICINE MERCURY CONTENTS DEPARTMENTS FEATURE 2 | ARMYMEDICINE.MIL ARMY MEDICINE MERCURY US ARMY MEDICAL COMMAND ARMY MEDICINE PRIORITIES Commander COMBAT CASUALTY CARE Lt. Gen. Patricia D. Horoho Army Medicine personnel, services, and doctrine that save Service members’ and DOD Civilians’ lives and maintain their health in all operational environments. Director of Communications Col. Jerome L. Buller READINESS AND HEALTH OF THE FORCE Chief, MEDCOM Public Army Medicine personnel and services that maintain, restore, and improve the Affairs Officer deployability, resiliency, and performance of Service members. Jaime Cavazos Editor READY & DEPLOYABLE MEDICAL FORCE Dr. Valecia L. Dunbar, D.M. AMEDD personnel who are professionally developed and resilient, and with their units, are responsive in providing the highest level of healthcare in all operational environments. Graphic Designers Jennifer Donnelly Rebecca Westfall HEALTH OF FAMILIES AND RETIREES Army Medicine personnel and services that optimize the health and resiliency of Families and Retirees. The MERCURY is an authorized publication for members of the U.S. Army Medical Department, published under the authority CONNECT WITH ARMY MEDICINE of AR 360-1. Contents are not necessarily official views of, or endorsed by, the U.S. CLICK ON A LINK BELOW AND JOIN THE CONVERSATION Government, Department of Defense, Department of the Army, or this command. The MERCURY is published FACEBOOK monthly by the Directorate of Communications, U.S. Army FLICKR Medical Command, 2748 Worth Road Ste 11, Fort Sam Houston, TX 78234-6011. Questions, comments or submissions for the MERCURY should be directed to the editor at 210-221-6722 (DSN 471-7), or by email; TWITTER The deadline is 25 days before the month of publication. Unless otherwise indicated, all photos are U.S. Army photos. The MERCURY submission YOUTUBE and style guide can be accessed 3 | ARMYMEDICINE.MIL TSG SPEAKS! The Surgeon General Focuses on Patient Harm During TEDMED Talk By Ron Wolf, Army Medicine Public Affairs Lt. Gen. Patricia Horoho, Surgeon Reducing preventable harm is part of General of the Army, delivered a live the transformation of healthcare that will TEDMED talk on Sept. 11. Horoho reduce costs and improve access. Hospital participated in a session titled, “Don’t you safety and patient confidence in the safety dare talk about this,” that was held in the of care they are receiving is a critical part Kennedy Center in Washington, D.C. of promoting health and wellness as well, Horoho aimed to refocus national an important part of the transformation attention and provide insights on the of Army Medicine. problem of preventable harm in U.S. “We can eliminate preventable harm,” hospitals. the surgeon general said. “The problem TEDMED—TED is short for is not the errors. The problem is that we “technology, entertainment, and ignore the errors.” design”—talks are the medical and health “But in our U.S. hospitals we talk version of the internationally known about harm in hushed tones. We use and highly regarded TED conferences. metaphors; we talk about near misses, The short talks bring together the most Lt. Gen. Patricia D. Horoho unintended complications, and close calls. innovative and forward-thinking minds To err is human.” to share “ideas worth spreading” and have as a result of medical error. Horoho issued a call to action. “As been viewed online more than two billion That figure from the IOM falls far individuals, we need the confidence, the times. short, however, of the number of deaths integrity, and the courage to speak up. As Horoho compared the consequences estimated in 2013, when the Journal of leaders we need to listen to our patients, of patient harm to Pearl Harbor and Patient Safety put the number of deaths to our families, and to our staff. If we the September 11 attacks. More than each year for preventable harm at closer to decide our system isn’t working, we can 2,300 died at Pearl Harbor, and more 400,000. change it.” than 2,900 died on September 11. But Horoho made the point that we have “By addressing the errors, we can those were one-day totals, she said, every done essentially nothing about this prevent harm. We can do this, and I day more than 1,100 people die in U.S. problem. Silence on this topic by the believe the time is right,” she said. hospitals due to preventable harm—more medical community is the main cause that The enemy is our silence; our than 400,000 each year. allows preventable harm to continue, she ambivalence, our complacency, our lack of Preventable harm in our hospitals is said. confidence, Horoho said, “Silence kills.” much worse, Horoho said, than these acts of war. We expect harm from acts of war, and we can plan and prepare for it. However, we do not plan or even expect preventable harm to happen in our hospitals. As a result, harm is talked about in “metaphors,” such as “near misses, unintended complications, and close calls,” she said. Preventable harm and death associated with it has been mentioned previously in widely known reports. The Institute of Medicine (IOM) published To Err is Human: Building a Safer Health System in The Army Surgeon General Lt. Gen. Patricia Horoho tackled the difficult issue of medical harm before a live 1999 in which the IOM estimated that as audience at the John F. Kennedy Center for the Performing Arts in Washington D.C. during the TEDMED Talks on September 11. This year’s TEDMED talks were simulcast via livestreaming from San Francisco many as 98,000 deaths occurred each year and Washington D.C. to over 130 countries. 4 | ARMYMEDICINE.MIL AMEDD GLOBAL AUSA Medical Symposium Tackles “Hot Topics”: High-Reliability Organizations Can Improve Patient Safety By Ron Wolf, Army Medicine Public Affairs On September 10, the Association of an HRO is directly linked to reducing important because errors can result in the United States Army held a medical medical harm. Horoho made it clear severe consequences. symposium that discussed military that Army Medicine had a commitment Decision-making is critical for an medical needs and concepts for new to a culture of patient safety and there HRO to function well. During a crisis, approaches to care. The symposium— would be no compromise. decision making is deferred to the most held close to the Pentagon— knowledgeable person on the featured Gen. Daniel B. Allyn, team; however, there often is new Vice Chief of Staff, and Lt. more than one decision maker, Gen. Patricia Horoho, Army and each decision can impact surgeon general, as key speakers. the next. As a result, decision Although the theme for makers must communicate the day was “Strengthening effectively. the Health of Our Nation by Finally, frequent feedback Improving the Health of Our drives changes in an HRO. Army,” Allyn, the opening The continuous adjustments speaker, provided the focus for based on feedback allow staff the symposium when he said to anticipate and avoid medical that the reason the group was errors. there was to discuss the Army’s Unfortunately, Horoho said, future and prepare for Force most evidence indicates that the 2025 and beyond. number of medical errors is not The discussions that followed being reduced. In fact, medical focused on the future of Army errors seem to be increasing Medicine. Horoho discussed in hospitals across the United how technology advancements States. in Army Medicine will be a Nevertheless, she reported key part of how our healthcare that positive changes in attitudes will continue to improve. At and behaviors are becoming the heart of our pursuit of “embedded in the DNA of our Lt. Gen. Patricia Horoho addresses the audience at the Association of excellence, she said, is becoming the United States Army medical symposium on “hot topics.” The Surgeon Army.” Those improvements, a high-reliability organization General emphasized the need for Army Medicine to become the leader in she said, can be seen in our “zero harm” just as it endeavors to be a leader in promoting a healthier (HRO). nation. health, resilience, readiness, and HROs meet the standards for performance. their industry by having well-established Reasons for becoming an HRO are as Just as Army Medicine is becoming policies and systems in place that ensure complex as an HRO itself. HROs exist one of the nation’s leaders in improving consistency of practice and enable them in complex environments with multi- the healthcare of its Families, Army to reach their goals and avoid errors. faceted teams that must coordinate their Medicine can also become the nation’s Examples of industries that could not efforts to ensure patient safety. The safety leader in creating a culture of safety in function without being comprised of of a hospitalized patient depends on the medical care, she said. HROs include nuclear power and air effective communication of a number of Our soldiers, our Families, and travel. High reliability are critical to clinical and technical personnel—from our retirees will always need excellent operations for these industries—there is the surgeon to the lab tech. A well- healthcare, as does the entire nation, no room for failure—and important for coordinated team is critical for an HRO Horoho said. “We must not accept consumer trust. to ensure patient safety. anything other than zero harm.” As part of preparing Army Medicine Accountability for actions, especially for the future, the issue of becoming if an error has occurred, is especially 5 | ARMYMEDICINE.MIL AMEDD GLOBAL FEATURE Command Sgt. Major Brock: Army’s Longest Serving Enlisted Female Soldier to Retire Army Medicine’s Command Sgt.

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