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New Equipping Strategies for Combat Support Hospitals ARROYO CENTER and RAND HEALTH Center for Military Health Policy Research THE ARTS This PDF document was made available from www.rand.org as CHILD POLICY a public service of the RAND Corporation. CIVIL JUSTICE EDUCATION Jump down to document ENERGY AND ENVIRONMENT 6 HEALTH AND HEALTH CARE INTERNATIONAL AFFAIRS The RAND Corporation is a nonprofit institution that NATIONAL SECURITY POPULATION AND AGING helps improve policy and decisionmaking through PUBLIC SAFETY research and analysis. SCIENCE AND TECHNOLOGY SUBSTANCE ABUSE TERRORISM AND HOMELAND SECURITY Support RAND TRANSPORTATION AND INFRASTRUCTURE Purchase this document WORKFORCE AND WORKPLACE Browse Books & Publications Make a charitable contribution For More Information Visit RAND at www.rand.org Explore the RAND Arroyo Center RAND Health View document details Limited Electronic Distribution Rights This document and trademark(s) contained herein are protected by law as indicated in a notice appearing later in this work. This electronic representation of RAND intellectual property is provided for non-commercial use only. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. Permission is required from RAND to reproduce, or reuse in another form, any of our research documents for commercial use. For information on reprint and linking permissions, please see RAND Permissions. This product is part of the RAND Corporation monograph series. RAND monographs present major research findings that address the challenges facing the public and private sectors. All RAND monographs undergo rigorous peer review to ensure high standards for research quality and objectivity. New Equipping Strategies for Combat Support Hospitals Matthew W. Lewis, Aimee Bower, Mishaw T. Cuyler, Rick Eden, Ronald E. Harper, Kristy Gonzalez Morganti, Adam C. Resnick, Elizabeth D. Steiner, Rupa S. Valdez Prepared for the United States Army Approved for public release, distribution unlimited ARROYO CENTER and RAND HEALTH Center for Military Health Policy Research The research described in this report was sponsored by the United States Army under Contract No. W74V8H-06-C-0001. Library of Congress Cataloging-in-Publication Data New equipping strategies for combat support hospitals / Matthew W. Lewis ... [et al.]. p. cm. Includes bibliographical references. ISBN 978-0-8330-4996-4 (pbk. : alk. paper) 1. Military hospitals—United States—Equipment and supplies. 2. Military hospitals— United States—Planning. 3. Military hospitals—United States—Management. 4. United States. Army—Medical supplies. I. Lewis, Matthew W. UH473.N38 2010 355.3'45—dc22 2010019796 The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world. RAND’s publications do not necessarily reflect the opinions of its research clients and sponsors. R® is a registered trademark. © Copyright 2010 RAND Corporation Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND documents to a non-RAND Web site is prohibited. RAND documents are protected under copyright law. For information on reprint and linking permissions, please visit the RAND permissions page (http://www.rand.org/ publications/permissions.html). Published 2010 by the RAND Corporation 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138 1200 South Hayes Street, Arlington, VA 22202-5050 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213-2665 RAND URL: http://www.rand.org To order RAND documents or to obtain additional information, contact Distribution Services: Telephone: (310) 451-7002; Fax: (310) 451-6915; Email: [email protected] Preface This monograph documents findings and recommendations from the RAND Arroyo Center project “AMEDD’s [Army Medical Department’s] Equipping and Maintenance Solution to ARFORGEN [Army Force Generation].” The objective of the project was to develop and evaluate alternative strategies for equipping the Army’s Combat Sup- port Hospitals (CSHs) that would meet their equipment needs in each of the readiness pools of the ARFORGEN cycle. The study identified a new equipping and maintenance strategy that has the potential to enable the Army to reduce the cost of equipping and maintaining its CSHs at fully modernized levels, providing them with equipment that is newer and in better condition on average than what they have now. Because the proposed strategy represents radical change in several respects, the study recommends a phased imple- mentation, beginning with the fielding of new equipment set designs to several active and reserve CSHs at home station. Evaluation of the performance and effects of these sets will permit fine tuning of the proposed strategy. This research was sponsored by the Commanding General, U.S. Army Medical Command/The Surgeon General. It was conducted within RAND Arroyo Center. The research was managed jointly by RAND Arroyo Center’s Military Logistics Pro- gram, directed by Ken Girardini, and the RAND Center for Military Health Policy Research, co-directed by Sue Hosek and Terri Tanielian. RAND Arroyo Center, part of the RAND Corporation, is the United States Army’s federally funded research and development center for policy studies and analyses. The RAND Center for Mili- tary Health Policy Research is a joint endeavor of RAND Arroyo Center and RAND Health. The Project Unique Identification Code (PUIC) for the project that produced this document is MCCSG08834. iii iv New Equipping Strategies for Combat Support Hospitals For more information on RAND Arroyo Center, contact the Director of Oper- ations (telephone 310-393-0411, extension 6419; fax 310-451-6952; email Marcy_ [email protected]), or visit Arroyo’s web site at http://www.rand.org/ard/. Contents Preface . ................................................................................................ iii Figures . ................................................................................................vii Tables . ................................................................................................. ix Summary . ............................................................................................. xi Acknowledgments . ................................................................................ xvii Glossary of Acronyms . ............................................................................. xix chAPTer one Introduction . .......................................................................................... 1 Understanding CSH Equipping and Maintenance Needs . ....................................... 2 Research Objective, Tasks, and Methods . .......................................................... 5 Overview of Research Results . ....................................................................... 6 Structure of This Document . ........................................................................10 chAPTer Two cSh Personnel Perspectives on equipping and Maintaining combat Support hospitals . .............................................................................13 Surveys of CSH Personnel . ..........................................................................13 Respondents and Instrument . .....................................................................13 Survey Findings . ....................................................................................15 Focus Groups with CSH Personnel . ............................................................... 23 Participants and Questions . ...................................................................... 23 Focus Group Findings . ............................................................................ 24 Key Lessons from Surveys and Focus Groups . ....................................................29 chAPTer Three Alternative Designs for home Station equipment Sets . .....................................31 chAPTer Four Alternative equipping Strategies . ................................................................37 Estimating the Equipment Requirement for Deployed CSHs . ..................................37 v vi New Equipping Strategies for Combat Support Hospitals Sources of Deployable Hospitals . ...................................................................39 Sizing the Training Base . ............................................................................41 Summary of Alternative Equipping Strategies . ................................................... 43 chAPTer FIve Assessing the costs and risks of Alternative Strategies . .....................................45 Cost Assessment of Alternative Equipping Strategies . ........................................... 46 Equipment Replacement Cost . ................................................................... 46 Upgrade Costs and Obsolescence Management . ...............................................47 Maintenance Burden . ..............................................................................49 Risk Assessment of Alternative Equipping Strategies . ............................................52 chAPTer SIx Toward an Improved cSh equipping and Maintenance Strategy . ........................57 APPenDIx A. how cShs currently engage in Training to Achieve and Maintain Individual and collective Skills . ............................................................65
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