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----------------------------------------------------------------The Navy Public Affairs Library (NAVPALIB)A service of the Navy Office of Information, Washington DCSend feedback/questions to navpalib@opnav-emh.navy.mil----------------------------------------------------------------Department of the Navy Policy Paper"...From the Sea" UpdateNAVY MEDICINE - "SHAPING THE CHANGE"Spring 1994The Navy - Marine Corps white paper "... From the Sea" set anew course for U. S. naval policy. It foretold a fundamentalshift away from global war and open ocean warfare to a focus onregional conflicts and joint operations conducted in littoralregions, from the sea. Today's naval forces must prepare forunique operations including humanitarian assistance, disasterrelief and peacekeeping as well as conventional wartimecontingencies. This change affects the entire Navy, includingNavy medicine."... From the Sea" served as the foundation for significantchanges in doctrine, organization, operational requirements,education, training, and acquisition involving the entire navalforce.Navy medicine is prepared for the challenges of the post-Cold War era and the special requirements of the NavalExpeditionary Forces in particular. The following health careinitiatives will shape Navy Medicine's operational role into the21st century. HEADQUARTERS ORGANIZATIONOperations envisioned in ". . . From the Sea" require ahighly responsive, flexible, and well-trained Navy MedicalDepartment. As new joint military missions occur, the Navy mustadapt and size its health care delivery system to fit theparticular contingency. To improve organizational effectiveness,three changes have been implemented at the headquarters level:- At the Pentagon, the Medical Resources, Plans, and Policydivisions on the Navy Staff have been consolidated into onedivision to more effectively interface with the Office of theSecretary of Defense, the Joint Staff, and other agencies withinthe Department of the Navy.- At the Bureau of Medicine and Surgery, the Plans Analysisand Evaluation (MED-08) code was established to coordinate theexecution of operational health care planning initiatives withthe peacetime health care delivery system.- In the fleet a Navy medical augmentation unit is beingplanned. This initiative will create a "standing" health carecell that can be activated to advise operational commanders onhealth care issues, and provide Navy input at the Unified Commandheadquarters.OPERATIONAL HEALTH SERVICE SUPPORT
 
Responding to crises requires great flexibility andinnovative approaches to providing prompt access to qualityhealth care while limiting the drain on logistics, personnel andother resources.Anticipating the requirement for a lighter, more mobilefleet hospital, Navy medicine has developed the concept for a100-bed modular, self-contained unit. The modular design featurewill provide the Joint Task Force commander with a tremendousdegree of flexibility in tailoring the hospital's size andcapability to the requirements of the mission. Two 100-bedfleet hospitals are planned; they will be assembled from theexisting fleet hospital inventory and pre-positioned on eachcoast.Navy medicine is evaluating the primary casualty receivingand treatment capabilities on board existing and futureamphibious ships, to ensure quality health service support to ouroperational Marine Corps forces ashore. Planning has begun todevelop incremental staffing packages for the hospital ships forcapacities ranging from 250 to 1,000 beds in support of bothwartime contingencies and unique peacetime tasking.With the increased likelihood of providing health care forhumanitarian assistance and disaster relief operations, NavyMedicine continues to train it's fixed medical treatment facilitystaff in the management of mass trauma. These training exercisesare designed to enhance the responsiveness of our health careteam in dealing with the wide range of medical and dentalproblems our active duty force and local civilian communities mayencounter.The relief effort following hurricanes Andrew and Hugo gaveNavy medicine the opportunity to quickly respond to emergenthealth needs and provide support to civilian providers.Additionally, humanitarian Mobile Medical Augmentation ReadinessTeam (MMART) medical equipment and supply kits have beendeveloped to provide specialized health care required in remoteor isolated locations.Navy medical research and development is focusing itsefforts on medical problems that constrain operational forcesinvolved in regional and littoral contingencies. The JointForward Laboratory significantly enhanced the effectiveness ofpreventive medicine in Somalia during Operation Restore Hope bykeeping the disease rates of our forces to an absolute minimum.The many important research areas being explored includeadvanced wound healing, cholera and malaria vaccines, and freeze-dried blood. Navy medical research is on the cutting edge.EDUCATION AND TRAININGEducation and training is an integral part of our ability tomeet all operational health service support requirements. Stronggraduate medical education programs ensure that the Navy willhave a sufficient number of needed specialists to support both
 
operational and peacetime health care missions.Using Navy trained specialists, we can keep CHAMPUS costsdown in peacetime, minimizing the risk of paying for health carebenefits with readiness funds.Navy medicine is continually re-evaluating every element ofthe health care system, especially as new expeditionary warfareconcepts evolve. Innovative training approaches, such ascomputer simulation technology, are being explored to maximizetraining opportunities.Joint operations are a key element of military missions.Navy medicine is making a concerted effort to include asufficient number of medical department officers in the JointStaff Internship and other Joint Staff training courses.Representatives from each of the Navy medical corps are beingenrolled in various Service Staff and War Colleges to gaingreater understanding of military science and help develop a morebalanced health care perspective.Navy Hospital Corpsmen play an important role in Navy healthcare support. Corpsmen are being provided with greateropportunities for clinically supervised, hands-on training inmedical treatment facilities. This develops the proficiency andpersonal confidence needed to provide the best care for sailorsand Marines in the fleet.NAVAL RESERVENaval Reservists continue to play an important role inproviding enhanced health care for Naval Expeditionary Forces.Medical and dental Reserve personnel contribute by:- Providing active duty training back-fill, which improvesaccess to care, and further reduces CHAMPUS and supplemental carecosts.- Supporting humanitarian assistance and disaster reliefoperations.The Reserves accomplish this while maintaining a readinessposture in support of mobilization requirements with the FleetMarine Force, in fixed medical and dental treatment facilities,and in fleet hospital operations.NAVAL MEDICAL DOCTRINEIn 1993 Navy medicine established the Naval Medical DoctrineCenter to develop guidelines to use medical and dental assets.The center is scheduled to become part of the Naval DoctrineCommand and to work closely with the Marine Corps CombatDevelopment Command and the Joint Doctrine Center to optimizejoint mission capabilities of Naval Expeditionary Forces. Also,the center is developing ways to effectively employ the fleethospitals and hospital ships to meet the needs of operationalcommanders.
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