GUAM (Dec 18, 2017) - U.S. Naval Hospital Guam (USNH Guam) is a community hospital serving a Department of Defense (DoD) community of approximately 25,000 eligible beneficiaries. In addition to our DoD beneficiaries, we also serve the local community as the trauma facility for the southern part of the island. We are one of the few DoD Military Treatment Facilities (MTF) with an Emergency Department open to the public. USNH Guam is one of three hospitals on the island of Guam; we are the only ones who can boast that we are fully funded, fully staffed, and fully accredited.
USNH Guam developed and executed the first Navy Medicine “Minute Clinic” model at a Navy Exchange. Partnering with Naval Base Guam and Navy Exchange Guam, USNH Guam established a Mobile Field Clinic in the NEX courtyard. Leadership from all three organizations met to discuss how to better serve their beneficiaries.
“The mobile clinic is a great opportunity that brings together a service from the hospital in a convenient location. The clinic offers families an alternate option that meets their busy lifestyles,” said Naval Base Guam commanding officer, Capt. Hans Sholley.
“There is a positive impact on outreach to the community because the location of the NEX provides a centralized area, allowing families to multi-task and care for their health needs on a day-to-day basis. Not only does the mobile clinic provide a convenient location, there are other values added. The mobile clinic promotes a healthy lifestyle, and fosters a healthy community, healthy family, and healthy warfighters,” said Sholley.
“I am truly excited about the mobile clinic presence at the NEX, it is an expanded choice for people to care for health issues. The NEX is a central point for our Navy/DoD Family; the clinic provides access and convenience. The partnership between the NEX, the hospital, and the base, strengthens the relationship of being one Navy family,” said District Vice President, Navy Exchange Guam, Mr. Tom Goodman.
Of the 25,000 island beneficiaries, over 12,000 are enrolled to USNH Guam as their primary care provider. Using the Mobile Incident Command Post of Naval Base Guam and the Courtyard of Navy Exchange Guam, the Naval Hospital opened Navy Medicine’s first “Minute Clinic” model on September 23, 2017.
When asked what was the driving force behind this innovative idea, Capt. Dan Cornwell, commanding officer of USNH Guam stated that our Surgeon General, Vice Adm. Forest Faison, challenged all MTF commanders to take a hard look at “how and where” we provide care. The Surgeon General’s guidance was to ensure access and convenience was at the forefront. We could no longer rely on the same routine “hospital/clinic” based approach of delivering primary care and expect to remain competitive.
USNH Guam had always offered a weekend clinic, but it was operated out of the Naval Hospital. Cornwell and his leadership team reviewed historical data, reviewing the patient workload for Saturday clinics over a twelve month period. The numbers revealed an average patient load between eight to ten patients per Saturday; the relative low patient volume was not a healthcare issue, but rather a geographic issue. The hospital is centrally located on the island; approximately twenty minutes from Naval Base Guam and forty minutes from Anderson Air Force Base.
With the majority of the enrolled healthcare population living on base, Cornwell knew what had to be done. He began the initiative of “Bringing the Provider to the Patient” using a Mobile Field Clinic at the NEX courtyard. The idea of relocating the Saturday duty crew to the Naval Base Guam’s NEX as a central point to deliver care for minor acute ailments and common illnesses has resulted in doubling the average patient volume for a Saturday clinic.
“One of the added bonuses of relocating the Saturday clinic to the NEX is that no additional manpower is needed. It is not looked upon as one more thing the staff has to do. Everyone involved already had the ‘duty’ and was standing watch at the Naval Hospital; all we did was relocate the duty to the NEX courtyard,” said Cornwell.
The minute clinic model is staffed with mid-level providers who are physician assistants and family nurse practitioners, one clinic manager (RN) and four hospital corpsman. In addition to the medical staff, we have support staff from the hospital’s information technology, facilities, and logistics departments. We leverage today’s technology and securely log-on to the Hospital’s Electronic Health Record to review prior patient encounters, document the current visit, order ancillary services, schedule follow-up appointments, and if needed, refer to a specialty provider.
The mobile clinic has been such a big success to the community, USNH Guam recently signed a 12-month lease for its own mobile clinic to secure services throughout the year and not depend on scheduling through Naval Base for use of their mobile trailer.
The mobile clinic is not and was not intended to be a one-stop-shop, patients requiring lab work, X-ray, or medications will still need to make a trip to the hospital. However, they can make the trip at their convenience, the order is in the “system” and they may go after their visit or the next work day.
What the mobile clinic does is put the “community hospital” back in the community. Taking care of our beneficiaries is our business, but more importantly it’s our passion! A key component of keeping the “Warrior Fit to Fight Tonight” is the ability to ensure their family members have the proper access and convenience to the world’s greatest care.