The Pulse

NAVAL HOSPITAL JACKSONVILLE, FLA.

Navy Medicine
World Class Care… Anytime, Anywhere

Spring 2009

Inside ths issue
CO’s Message Women’s Heart Health Food For Your Eyes Baby News Red Cross Recruiting Teen Volunteers 2 4 5 6

TRICARE Advisors 7 in new offices Tooth Care Promotion Pet Visitation Program 8 Grapevine—Walker is NH Jacksonville Sailor of the Year NH Jacksonville Civilians of the Year NH Jacksonville Core and Branch Health Clinic Top Sailors More Top Sailors First in Service
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Disaster Preparedness 13 Training keeps New Officers in Charge at Kings Bay and Albany Clinics More NH Jax News Phone Directory 14

‘Navy Medicine’s humanitarian civil assistance (HCA) missions offer a positive vision of hope and opportunity rooted in our history and in the promise of our future. HCA missions reflect our belief in the worth, dignity, equality and value of every person in the world.’ — Surgeon General of the Navy Vice Adm. Adam M. Robinson, Jr.
Naval Hospital Jacksonville staff members joined an international civilian and government team in making a difference in the lives of thousands in Latin America during Operation Continuing Promise 2008. The photos above show Lt. Cmdr. Celeste Santana, Lt. Carmon Harmon and HN Shanisha Fitch and other Operation Continuing Promise volunteers working with home-country patients and school homechildren during the August—December cruise. For more see page 8. August—

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For more NH Jax news go to: navalhospitaljax.med.navy.mil

A MESSAGE FROM THE COMMANDING OFFICER
aval Hospital Jacksonville is focused on taking the health care we offer from “Good to Great.” This reflects a business philosophy outlined in the well-known book of that title by Jim Collins. A central theme in the book is that organizations that make Capt. Bruce Gillingham the leap from “Good to Great” steadily build on their successes to accelerate “the flywheel” of improvement. They objectively face the “brutal facts” learned from less successful outcomes and study them in detail to improve the way they operate. Lasting success is not based on the stellar achievements of a star figurehead, but on the cumulative improvements of the entire team. Great organizations empower all team members to recognize problems before they become a crisis and to speak up and be heard. This may sound familiar to those of you who are members of the aviation community. Aviation has long practiced the concepts of “crew resource management” emphasizing the importance of clear communication between all levels of the crew, starting with a pre-flight brief that emphasizes each crew members responsibilities to the common mission. These techniques are honed in a simulation environment in which aircrews simulate scenarios in which unexpected, even frightening challenges are thrown into the mix. The idea is that if the crew members effectively communicate, collaborate and coordinate their response in the drill situation, they are better prepared to respond correctly under the pressure of a real event. Navy Medicine, working with the DoD Patient Safety Program, TRICARE Management Activity and the Agency for Healthcare Research and Quality, is implementing a program based on the principles of crew resource management to better prepare medical teams to recognize and resolve crisis issues. This program, called TeamSTEPPS™, stands for Team Strategies & Tools to Enhance Performance and Patient Safety. I’m proud to report that NH Jacksonville is one of the first military treatment facilities to implement this program. Through this program health care members are, in the jargon of the aviation community, trained to hear low amplitude signals before they become high volume. In other words they spot potential problems, surface them by communicating with other members
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of the team and are prepared through training and practice to deal with them before they become a disaster. The recent successful landing of the US Airways passenger plane on New York’s Hudson River is an example of an air crew who had this down to an art. Similar “miracles” can and do happen in the medical field and TeamSTEPPS™ is a tool designed to make them happen more often. This program holds promise for improving safety for patients whether they are treated in the hospital emergency room, the operating room, in labor and delivery, or in a war zone. Patient safety and prevention of patient harm occurs at three inter-related levels or tiers: Tier I: System Approach. This tier recognizes that the majority of patient harm comes from errors in a systemic process. Improvements at this level are made after careful review of the systemic factors that contributed to the error in order to minimize the chances that they will occur again in the future. Tier II: Anticipation. This tier is predicated on the understanding that, even in the best designed systems, errors will still occur. Therefore, the strategy in this tier is to anticipate that these errors will occur and build multiple buffers into the system that will interrupt the chain of events between the error and its harming of the patient. Tier III: Prove It. This tier recognizes that human beings are fallible. Although tiers I and II minimize and anticipate errors, this tier requires that health care workers adopt a “prove it” mindset. For instance, when a nurse is verifying a medication prior to administering it to a patient, the appropriate mindset is not to assume that it is correct but to adopt an attitude that the medication is incorrect and could be harmful to the patient until he or she has proven it correct and safe. Or when the nurse is transfusing blood, it should be assumed that the blood is the wrong type, even if the paperwork has already been checked by others previously. In both instances the caregiver must prove that it is correct, not assume that it is. TeamSTEPPS™ integrates concepts from all three tiers, emphasizing the enhanced patient safety that results from collaboration, communication and coordination. Although not a panacea, it is an important step in strengthening our Continued on page 3

culture of safety as we transition from “Good to Great.” More than 30 members of the NH Jax staff have already completed TeamSTEPPS™ training and are mentoring co-workers. We’re starting with the highrisk, high-volume areas such as operating rooms (OR), labor and delivery and the Emergency Department but eventually this will touch every department and every member of our staff. TeamSTEPPS™ is truly multi-disciplinary, involving junior and senior providers, nurses, interns and residents, civilians, our enlisted and administrators – all essential members of your health care team. I was very involved in the implementation of TeamSTEPPS™ at other Military Treatment Facilities including Naval Medical Center (NMC) Portsmouth, Va. and NMC San Diego. The results were impressive. As an orthopedic surgeon, I’ve seen how the program empowers everyone, from the lowest ranking operating room technician to the nurses and surgeons, to effectively enhance patient safety. That E-2 OR tech who calls a “time out” if they spot something not quite right just before surgery, is just as much a hero as the nurse, the anesthetist or the surgeon, who catches an error in the patient chart or realizes a sponge is unaccounted for just before closing. Teamwork, effective communication and real-time problem solving are crucial elements in this program. I saw this in practice while deployed to a surgical shock trauma platoon in Iraq during Operation Iraqi Freedom. Early on, our unit, which received a high volume of severely wounded casualties from Fallujah and Ramadi, received feedback from the higher echelon treatment facilities that the patients we had resuscitated and operated on were arriving to them with lowered body temperatures. Our group brainstormed about possible solutions to this problem which was due to the air currents in the helicopters taking the patients to Baghdad. After we’d tried

several options for keeping the patients warm, including using special warming blankets to no avail, a junior hospital corpsman suggested putting the patients in body bags modified with openings for their head. As you might expect, this was initially greeted with muted enthusiasm, but after giving the idea a chance, we discovered it worked extremely well. This real time solution to a vexing and dangerous patient care challenge improved the patient’s body temperature throughout the flight and greatly improving chances for recovery. The lesson for me was that great patient safety innovations don’t just come from those with advanced healthcare degrees. Had the corpsman opted to stay quiet fearing a negative response from his seniors a great idea might have been wasted and many more patients would have been at much greater risk. Obstetrics/Gynecology Department Head Cmdr. Mark Fowler, a key leader in our TeamSTEPPS™ implementation, notes that the program is evidencebased with studies indicating a 30-50 percent decline in adverse outcomes in health care facilities that have adopted it. Although our program is still in its infancy, Fowler said he sees great promise. He predicts it will help NH Jax develop an even stronger culture of patient safety, not only benefitting patients but enhancing staff job satisfaction as well. I share his enthusiasm. The TeamSTEPPS™ philosophy will be integral to the care you receive at Naval Hospital Jacksonville. I have challenged my staff to think back to the best team they were ever involved with and to replicate that level of collaboration, coordination and communication here. High performance organizations never rest on their laurels. Implementation of the TeamSTEPPS program is yet another example that we are never satisfied with the status quo and will continually pursue cutting edge strategies to ensure the high quality healthcare you deserve.

NAVAL HOSPITAL JACKSONVILLE, FLA.
Commanding Officer CAPT BRUCE L. GILLINGHAM, MC, USN Executive Officer CAPT JENNIFER VEDRAL-BARON, NC, USN Command Master Chief CMDCM(AW/SW) CAMERON W. BRACEWELL, USN
Public Affairs Officer NEIL GUILLEBEAU Editor LOREN BARNES Marketing, Special Contributor MARSHA CHILDS Photographers HM1(SW) Michael Morgan & HN Jermaine Derrick

The Pulse is published quarterly by the Public Affairs Office, Naval Hospital Jacksonville. It is an authorized publication for members of the military and their families. Its contents do not necessarily reflect the official views of the U.S. Government, the Department of Defense or the U.S. Navy and do not imply endorsement thereof. If you have questions or suggestions regarding this publication, please email: Loren.Barnes@med.navy.mil, call (904) 542-7417 or mail your question to Public Affairs Office, 2080 Child St., Jacksonville, FL 32214-5000. Mail delivery subscription also available.

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NH Jax observes Red Dress Day
‘Heart Disease, #1 Killer of American Women’
new fad many young adults are trying. “Many smokers believe that smoking flavored tobacco through a hookah water pipe removes the nicotine, but this simple isn’t the case. They are subject to all the dangers a regular smoker faces,” he said. Another key factor that contributes to heart disease is physical inactivity. Most Americans are not physically active enough to gain any health benefits. Activities such as swimming, cycling, jogging, skiing, dancing and walking can all help you heart. The American Heart Association suggests healthy adults ages 18 to 65 should be getting at least 30 minutes of moderately intense activity five days each week or vigorous aerobic activity for a minimum of 20 minutes three days weekly. But be sure to check with your doctor before starting any exercise program, especially if you have long term medical conditions or physical conditions that affect your ability to move. Sometimes getting started is the hardest part, but fitting physical activities into your daily life is easier than you think. Start with short walks and work up to 30 minutes. To keep fit at the office, start off your day by parking farther away from the building and walking the extra distance. Include activity in your life through play and recreation. Go dancing, fly a kit or play Frisbee. Play tennis, play badminton, play anything. Just keep moving!

By Marsha Childs Naval Hospital Jacksonville observed Red Dress Day on Feb. 6 with a health fair to raise awareness about heart disease and the risks to American women. Terry Botkin, RN secures a Red Dress pin on Fran Smith , RN . (Photo by Marsha Childs) Heart disease is the nation’s leading cause of death for men and women, alEating well-balanced meals and though many women think it is a reducing or avoiding certain foods man’s disease and fail to take it can lower your risk for heart disas a serious threat. ease. A serving of lean meat February is designated as should be no larger than the size American Heart Month. It is a of your computer’s mouse. At dinnatural fit as we think of Valennertime, fill your plate with twice tine’s Day associated with imas many fruits and vegetables as ages of the heart. But the heart other foods and choose fat-free is much more than a symbol. It dairy products whenever possible. is also the vital organ that Naval Hospital Jacksonville’s pumps blood throughout our Public Health Director, Cmdr. Jobodies. Many of us tend to take seph McQuade, warns about the our heart for granted until it two major risks associated with stops working properly. heart disease. He said, “Cigarette The hospital’s Wellness Center smoke contains carbon monoxide, Department Head, Lt. Cmdr. a toxic gas that decreases the Stacey Dawson, organizer of the blood’s ability to carry oxygen.” event, believes you are what Long-term exposure at lower you eat. She said, “Sixty-five levels can lead to heart disease percent of all Americans over 20 and brain damage. are overweight or obese. That’s Smoking also prompts the liver a pretty scary statistic.” to increase the production of low Dawson explained Americans density lipoproteins (LDL) that is are getting bigger from a combirich in cholesterol. Unfortunately, nation of factors. Americans are it is the bad kind that forms plaque leading inactive lifestyles, eating and clogs the arteries resulting in bigger portion sizes, and eating cardiovascular disease. more processed foods with McQuade also warned about a fewer nutrients.
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pening your eyes to healthy eating habits
From the NH Jax Optometry Clinic March is “Save Your Vision Month.” Honoring that observance the NH Jax’s Optometry Clinic reminds you that caring for your eyes includes paying attention to nutrition. Approximately 43 million Americans suffer from age-related macular degeneration or cataracts, the two leading causes of vision loss and blindness. Based on research from multiple studies, there is a strong correlation between good nutrition and the prevention of these age-related eye diseases. By eating foods rich in seven nutrients—lutein, zeaxanthin, omega-3 fatty acids, vitamins A, C, and E, and zinc—you can help protect your eye sight and vision. “Basic and clinical research has shown that nutrients in eye-healthy foods can lower the risk of vision loss,” said Dr. Todd Lauby, department head of Optometry. “While vision loss may not occur until your senior years, I recommend specific nutrients to all my patients. I also emphasize the necessity of wearing UV-blocking sunglasses outdoors as well as smoking cessation in order to help prevent future vision loss due to certain eye diseases.” The American Optometric Association recommends eating a diet with a variety of foods loaded with key nutrients for maintaining and improving eye health. Avoid hydrogenated fats and eat a

well-balanced diet that includes the currently recommended five to nine servings of fruits and vegetables a day whenever possible. Lauby recommends consuming the nutrients above as key nutrients for eye health. Ingestion through food is preferred instead of pill form; however, in some cases, dietary supplements may be necessary. Always consult your primary care provider before taking any dietary supplements.

New babies the TeamSTEPPS™ way

Participants remain standing during the brief which is usually done in five minutes or less and only proceeds when all the key players are present. (Photo by HN Jermaine Derrick)

Communication between all members of the health care team is key to quality and patient safety. This is particularly true in obstetrics. The new evidence-based program (TeamSTEPPS™) is being implemented here to facilitate better communication between doctors, nurses, hospital corpsmen and other staff caring for the new mom and baby (See CO’s Message, page 2). A key initiative in this approach is the shift turn over brief in which unit leadership share the specifics on each patient’s case enabling the development of a mental picture of every patient as the shift begins. This ensures that everyone is on the same page with patient care expectations. Like an aircrew doing flight checks before take-off, this process decreases surprises and better prepares the staff to deal with the unexpected. The hand-off covers 4 Ps: patient, problem, plan and precautions. Also discussed are scheduled procedures, staffing issues, expected admissions and discharges, and equipment issues. This approach is promising for managing complex pregnancies and proactively identifying high-risk situations.
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Welcome aboard Noah
NH Jax’s first baby of ‘09
elebrating the New Year’s Day birth of their son Noah Rylan Jacobs, hospital Executive Officer Capt. Jennifer Vedral-Baron present Melissa and CSCS Greg Jacobs a congratulatory certificate from NH Jax on Jan. 2. Noah was the hospital’s first delivery in 2009, arriving at 9:16 a.m., Jan. 1. Chief Jacobs serves aboard the USS Vicksburg. Mom’s pregnancy was followed by Cmdr. Ruth Duda and the delivery was performed by Lt. Cmdr Jason Bosco assisted by Lt. John Saenz with follow-up care in the hospital’s OB/Gyn and Maternal Infant Unit.

Red Cross recruiting Junior Volunteers
The NH Jax Red Cross Junior Summer Volunteer Program is taking applications for 2009. If your teen is dependable, accepts responsibility and has a desire to help the community and meets the requirements, then the Junior Volunteer Summer Program is for them. High school students 15 to 18 are encouraged to apply by May 1. Enrollment is limited, so apply early. The Red Cross volunteer chairman will interview all applicants for approval. The teens will be assigned to designated hospital areas under staff supervision. The program requires a minimum of four hours per week and a maximum of 24 hours a week. Return applications to the Red Cross Office by May 1, with a copy of the applicant’s current PPD. Orientation is June 8-9, Room 205, Bldg. 2004 on the hospital campus. Call 542-7525.

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(Photos by HN Jermaine Derrick)

Free Weekly Parenting E-mail
Step by step through baby’s first year
xpecting and new parents receiving care at NH Jax now have a trusted resource to guide them through pregnancy, labor, delivery, and the first year of their baby’s life: the NH Jax weekly parenting e-mail. This free service, available on the hospital’s Internet site, Alisa Davis, RN http://navalhospitaljax.med.navy.mil, includes customized information, news, and resources - and announcements from the hospital’s parent education staff, access to hospital classes, and tour information - all delivered to your e-mail in-box. Besides providing great information to parents, it also allows staff to develop a richer, more supportive relationship with patients. When you register for the weekly parenting e-mail, you’ll receive information tailored to your week of pregnancy and then the age of your newborn. This service is powered by The Parent Review. Authorization is for the duration of your pregnancy and through the first year of infancy, and will automatically expire on your baby’s first birthday. The Weekly Parenting E-mail provides: • Weekly support, tips and advice from NH Jax • Great resources to better support you • Your baby’s developmental milestones, week by week • Research findings that impact your child’s development.
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Perinatal Class Schedule
Classes are by appointment only. Call 542-BABY to schedule. All classes except breastfeeding are in the Family Medicine conference room. Breastfeeding is in the main 2nd deck conference room. Baby Boot Camp 8 a.m. - noon— May 6, June 3 Prepared Childbirth 9 a.m. - 4 p.m.—April 18, May 16, June 13 Third Trimester Class 9-10:30 a.m.—April 27, May 18, June 22 New OB Intake—First-time Moms 8:30 - 11:30 a.m.—April 17; 24 May 18 and June 22 New OB—Experienced Moms 1:15-3 p.m.—April 16, 13, 20, 27; May 4, 11, 18; June 1, 8, 15, 22, 29 Hypnobirthing Five weekly classes, 5:30-8 p.m., Next session TBA.

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NH Jax TRICARE Office renovations enhance privacy, comfort, efficiency
By Loren Barnes

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isitors to NH Jax’s TRICARE Health Benefits Office are now being served in newly renovated spaces. The TRICARE area, located on the second floor of the facility’s main tower, has been divided into individual offices in which each health care beneficiary advisor can work with customers in a more private and comfortable setting. Previously the HBA area was crowded and divided by cubicle partitions. The renovation was completed by contracting firm IAP Hill for $85,000. It was overseen by Jim MacKinder of NH Jax Facilities. “This is yet another testimonial to our desire to make sure that we are offering the best possible experience to our patients,” Capt. Bruce Gillingham, hospital commanding officer, said. “It is another demonstration of how much we value them… to have auditory privacy.” Gillingham also lauded the HBAs courteous, efficient service. “It’s all about patient privacy,” HBA Office Supervisor Cathy Chapman said. “We can sit in our offices and give them our full attention, one-on-one. We can conduct business, make phone calls, and work cases with complete privacy and fewer distractions. That change has been well received by hospital customers. To meet with a TRICARE HBA visit their new spaces on the hospital’s second floor, room 2026 or call 542-9164.

NH Jax Commanding Officer Capt. Bruce Gillingham, and Director, TRICARE Business Operations Capt. Brenda Baker, cut a cake for guests as part of the official opening of the newly renovated TRICARE office suite. Looking on (left to right) is TRICARE Health Benefits Office Supervisor Cathy Chapman, NH Jax Executive Officer Capt. Jennifer Vedral-Baron and CMDCM(AW/SW), Cameron Bracewell. There was also an official ribbon cutting for the Feb. 9 event. (Photo by HN Jermaine Derrick)

Keys to good

rushing – Done two times a day, this removes plaque, a sticky bacterial film that's always forming in your mouth. Plaque is a direct cause of cavities, it's also a major contributor to gum disease which can lead to tooth loss in adulthood. Brushing keeps your teeth and mouth clean and bright, your breath fresh. Flossing - Along with brushing, flossing can often prevent or reverse the gum disease "gingivitis.” Fluorides - prevents cavities by strengthening and protecting the tooth enamel from acid. Fluoride can be found in toothpastes, community water supplies, over-thecounter mouth rinses, gels and solutions, drops and dietary supplements. Dental Checks - See your dentist regularly.
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dental health

"Children's teeth are meant to last a lifetime and with proper care, a balanced diet and regular dental visits, children can have a lifetime of healthy smiles." -ADA President Mark J. Feldman, D.M.D.

HM3 Andrew Herzberg shows a Sigbee Elementary School student how to brush properly. NBHC Key West Dental staff instructed children from 10 classes on proper dental hygiene on Feb. 20, marking Children’s Dental (Photo by MC2 Rachel McMarr, Health Month. Southernmost Flyer)

By Marsha Childs

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et Visitation
Making rounds, sharing
By Loren Barnes

‘Continuing Promise’

from page 1
By Loren Barnes Naval Hospital Jacksonville Individual Augmentees (IAs) were vital to Operation Continuing Promise in 2008 serving aboard the hospital ship USNS Comfort (T-AH-203) and the USS Kearsarge (LHD 3) in the Caribbean and Central and South American cruises. Three NH Jax providers served aboard the USS Kearsarge, Aug. 2 to Dec. 2, alongside more than 1,500 volunteers from an international partnership of government and nongovernmental agencies. The cruise brought Navy Surgeon General Vice Adm. Adam Robinson’s vision of “hope and opportunity” to thousands of people in Nicaragua, Colombia, the Dominican Republic, Curacao, Trinidad, Haiti and Guyana. The Kearsarge not only provided medical assistance to the people of these countries but also aided recovery efforts after Haiti’s hurricanes with Seabee engineering assets. NH Jax Public Health/Environmental Health Officer Lt. Cmdr. Celeste Santana, Physician Lt. Carmon Harmon (NBHC Jax) and Pharmacy Technician HN Shanisha Fitch were there. The mission participants saw first hand in many regions the poorest of the poor struggling to survive in appalling living conditions, with little medical care. Health issues virtually eliminated in more developed countries are still big problems there. Santana said the health care teams dealt with the entire spectrum of maladies of poor tropical countries - malaria and widespread tuberculosis, parasitic infections, malnutrition, untreated injuries and the full range of sexually transmitted diseases. Her efforts, recognized with a Navy and Marine Corps Commendation Medal, dealt with issues ranging from educating teens about hygiene, dental care and STDs to a crisis in Colombia in which cyanide entered a local water supply when a barge accident sank drums of the deadly poison into a river. Fitch, who organized and dispensed medications also helped de-worm more than 7,000 children, saw more than 300 in sick call, cross-trained on the ward and in surgery and was amazed by the people’s resilience to dire circumstances. She said there were always people they couldn’t reach Continued on page 10

There’s nothing like belly rubs, hugs and kisses to make your hospital visit less stressful. Just ask Molly! No, Molly isn’t a patient, she’s part of the NH Jax staff with a hospital ID to prove it. Four-year-old Molly and 18-month-old Teddy are Cavalier King Charles Spaniels owned by Cmdr. Deborah Roy, NH Jax Nursing’s assistant director. They are the first Molly and Cmdr. Deborah dogs in the new Pet VisitaRoy help relieve patient Rose Thurman’s stress in tion program. Roy said, “The dogs the Emergency Room. provide a positive diversion from the normal hospital environment and help folks feel more at home. Many patients and visitors reminisce about their pets and their impact in their life. The visits provide stress relief and a positive interaction that does not involve the medical illness they are being treated for.” The dogs never approach patients, visitors or staff without their permission or if it is medically inappropriate. Roy is recruiting more volunteers and dogs. To participate, dogs should be at least one year old, any breed. They must hold a Canine Good Citizen certification, a simple obedience test available through the American Kennel Club. Go to AKC.org. Dogs must be on year-round flea/tick and heart worm prophylaxis and healthy. They are evaluated by the NAS Jax veterinarian annually. Dog owners will be interviewed for the program and will attend the NH Jax American Red Cross orientation program. Handlers are asked to volunteer for at least one hour per month. “It takes about one hour to complete a set of rounds and dogs get tired around that time,” Roy explained. According to the CDC, pets can help decrease blood pressure, cholesterol and triglyceride levels and feelings of loneliness. They increase opportunities for exercise, outdoor activities and socialization. Perhaps pets’ biggest benefit is unconditional love. To volunteer your pet call Roy at 542-7635.
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The Grapevine
Walker is NH Jax Sailor of the Year
By Loren Barnes “It is an unexpected honor to be selected as the overall Naval Hospital Jacksonville Sailor of the Year (SOY),” said Hospital Corpsman First Class Leilei L. Walker, who works in Naval Branch Health Clinic Kings Bay’s Dental Department. Also selected as the Senior Sailor of the Year for the hospital’s seven Naval Branch Health Clinics (NBHCs), HM1 Walker was named the command-wide SOY in December. Naval Hospital Jacksonville Commanding Officer Capt. Bruce Gillingham described Walker as a “hard charger” and the “number one” Sailor under his command. He said, “Petty Officer Walker has a cheerful, sincere, and professional attitude. She is always polite and courteous to seniors, and is demanding, considerate, and imaginative in her leadership of Sailors. A sincere belief in the Navy and tremendous potential describe her service and she is an outstanding example to any Sailor.” Walker is the leading petty officer (LPO) of NBHC Kings Bay’s Dental Department. The Quincy, Fla. native has been a stand-out since first enlisting in January 1993. Walker said one of the most challenging jobs she has filled was as the LPO deployed to Joint Medical Group Guantanamo Bay, Cuba from November, 2007 to May, 2008. There, she oversaw 60 hospital corpsmen supporting six doctors and 20 nurses. She said, “There was no other experience like it. It was the most unique in my career.” Back home she led the charge as NBHC Kings Bay became one of the first Navy clinics to merge dental and medical records functions. That task involved formulating and directing new operating procedures and cross training efforts after a $250,000 Outpatient Records renovation project. More than 29,000 medical and dental records were integrated. Described by her supervisors as a “Sailorization Csar,” Walker enjoys mentoring junior Sailors. “I push them to be the best they can be by emphasizing training. I want to be sure that we have Sailors who are not just trained to fill billets but to be successful in their healthcare roles.” Her mentorship resulted in a 98 percent enlisted retention rate and Sailors earning honors including Junior Sailor of the Year and Blue Jacket of the Year as well as selection to “C” schools. “I also look out for them on a personal basis,” she said. Walker is shooting for Chief Petty Officer. A graduate of the Naval School of Health and Science, Advanced Medical Laboratory Continued on page 10
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Staff highlights
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Civilians of the Year exemplify leadership
Kimberly Hanniford, a dental assistant at NBHC Alabany, Ga., was selected as the 2008 Category I Civilian of the Year. In an interview with Southwest Georgia’s Fox 31, Hanniford said, “I just put my best foot forward and strive for excellence in my personal life as well as professionally… When I took this job I thought it would be an opportunity to serve our patients here but also part of it is serving our country.” NBHC Albany’s Capt. William E. Butt, said “Nothing falls through the cracks when Hanniford is on duty. “For instance, she became the primary support for a visiting dental officer when the regularly assigned dentist was temporarily assigned duty elsewhere, empowering the dentist to meet normal production targets. She even took on fabricating stone casts and custom trays to allow the interim provider to deliver this specific care. This care comprised over 25 percent of the entire recorded October 2008 production, valued at $26,874. In addition she initiated and completed a much needed general supply inventory and reorganized the supply storeroom, allowing rapid, accurate visual inventory reviews. Lee Grose, a social worker in the hospital’s Substance Abuse and Rehabilitation Program (SARP) was named the Category II Civilian of the Year. “I was definitely thrilled and honored,” Grose said. “I believe everything I do is a reflection of the team we have here in the SARP.” In the third quarter of 2008, Grose assumed an additional 153 patient encounters and many hours of case management on behalf of 34 patients after they completed alcohol rehabilitation. He also improved overall patient care at SARP by integrating the best of Navy Medicine’s “Living in Balance” program into the clinic’s Continuing Care program. And he spearheaded integration of patient feedback into SARP’s clinical and administrative practices. At the same time, he became licensed as a clinical social worker, enabling the command to gain a licensed independent practitioner without additional cost. Lori Sipka, Lead Third Party Billing Agent for the Resource Management Directorate, took the Category III Contractor honors. Sipka, who is contracted through Lockheed Martin, said she sees this as a recognition of all eight members of the Third Party Billing team. The recognition focused on the fact that she led a team that netted the largest increase by dollars for third party insurance billing collections DoD-wide. The team saved taxpayers almost $3 million through this program last year. “I’m just thrilled that all our hard work has been recognized,” Sipka said.

Walker—from page 9 Technician School; she holds an Associate of Science Degree from Darton College, Albany, Ga. Walker, the Clinic’s Sexual Assault Victim Advocate, is helping stand up a Rape Recovery Task Force in Camden County to provide victim counseling and assistance. “There is a great need for this service. Victims currently have to travel to Jacksonville for support services,” she said. Walker is the Command Drug and Alcohol Program Advisor and volunteers with the command Recreation Committee, the Chapel Gospel Choir, the Poetry Club and the First and Second Class Petty Officer Associations. Walker said two people inspire her. “One is my 12-yearold daughter, Tyler, the light of my life. The other is my mother, Albesta, who is my rock.” Continuing Promise— From page 8 during their short stays but “all the people we saw were very happy, very appreciative and very helpful,” she said noting they always said “thank you.” That came from the poorest patients to high ranking dignitaries who visited clinics, including Guatemala’s president, she recalled. “This experience was the most rewarding I’ve had,” Finch said. On April 1, USNS Comfort , with 17 NH Jax IAs, picked up the torch, setting sail on a 120day SouthCom Operation Continuing Promise 2009 mission. The hope continues.

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Hospital, Branch Clinic’s Top Sailors honored
HM1 Robert J. Weber II, a Jacksonville, Fla. native, is the hospital core facility’s Senior Sailor of the Year. Weber is the leading petty officer in Material Management, and a vital leader in the Biomedical Equipment Repair shop. Since enlisting in 1991, Weber has served around the world from Rota, Spain and Tanzania, Africa to Sheppard Air Force Base, Texas. He first served as a general ward corpsman, then as a surgical technician and finally as a biomedical repair technician. As the Biomedical Repair floor supervisor, he keeps things moving efficiently, and is a great mentor to junior Sailors, according to the department’s Leading Chief Petty Officer (LCPO) HMC Abdon Deperalta. He described him as “a hard charger.” Supervising five Sailors and one civilian, Weber coordinates 200-300 preventive maintenance checks a month and repairs that keep hundreds of pieces of vital equipment up and running for the command. Weber voluntarily deployed to Joint Medical Group (JMG) Guantanamo Bay, Cuba from July 2007 – February 2008. His outstanding service as the JMG’s Biomedical Repair Technician was recognized with a Joint Service Achievement Medal and a Joint Service Commendation Medal. He was also the JMG’s Command Fitness Leader. His leadership in that role realized a 100 percent physical readiness pass rate for the group. His dedication to physical fitness continues at home where he serves as the Director for Administration Fitness Leader. HM2 Jerry R. Horton of Surgical Services is the core facility Junior Sailor of the Year. Horton hails from Roswell, N.M. Entering the Navy in 2000, he is a gifted surgical technologist. He also received basic emergency medicine technologist training at Trident Community College, Charleston, S.C. Horton has twice deployed in support of Operation Iraqi Freedom, once while assigned to NBHC Diego Garcia and again while assigned to NBHC Jacksonville from June 2007 – March 2008. He was deployed with 2nd Medical Battalion but detached to an Army Battalion in Anbar Province providing resuscitative surgical capabilities. He treated more than 300 casualties while
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there, caring for a range of military and civilian wounded. He came to the battalion during a hightempo period. At NH Jax he works in one of the hospital’s largest departments managing a tremendous workload. As the LPO in the main operating room, he supervised 44 junior Sailors and now, working in the Same Day Surgery Clinic, he mentors 13 junior Sailors and civilian personnel. Highly career motivated, he is currently completing an Associate’s Degree in Science from Florida Community College at Jacksonville. He is described by Ambulatory Procedures Unit Department Head Lt. Cmdr. Francisco Wonpat, as “an excellent leading petty officer who strives to take care of his people. HM2 Horton displays great leadership abilities in his daily routine as he is involved in multiple administrative tasks which require great attention to detail. Through his work and dedication, our staff has high morale which transfers to outstanding quality care of our customers/patients as evidenced by multiple positive comments submitted via the interactive customer evaluation system." HM3 Randy S. Cunningham, the Blue Jacket of the Year for the NH Jax core facility, is an Atlanta native raised in Birmingham, Ala. He is a stand-out in the hospital’s Directorate for Surgical Services. Cunningham brought with him a valuable educational background when he entered service in April 2007. He attended the University of North Alabama and trained at the prestigious Carraway Methodist Medical Center’s School of Radiology in Birmingham, Ala. to be a radiology technician. At NH Jax, he first worked as a general duty corpsman on the hospital’s 20-bed multiservice ward, caring for surgical, medical, psychiatric, cardiac and pediatric patients. He has since completed the training for certification in reading and recognizing Electrocardiograms (EKG) rhythms and arrhythmias. Currently working in the 18-bed, Same Day Surgery Unit he cares for surgical patients, two months to 93 years old. He is working toward becoming a nurse by taking courses at Florida Community College of Jacksonville and he aspires to become a Navy Nurse Corps Officer. Continued on page 12

Top Sailors—from page 11
Wonpat, who also heads the Same Day Surgery Clinic, described Cunningham as a "highly motivated individual who is an extraordinary team player. His dedication to our patients/ customers and staff have set him apart from his peers. He is highly sought after by the Endoscopy staff as well because they frequently request his support during times of need. HM3 Cunningham's pride and professionalism are demonstrated daily and are reinforced by the positive feedback from our interactive customer evaluation system. His ambition and work ethic will help him achieve his goal of becoming an excellent Nurse Corps Officer." HM2 Thomas J. Bolsega, the Naval Branch Health Clinics’ Junior Sailor of the Year, is from Orlando, Fla. He entered the Navy in 2001 and was a top graduate from Dental Technician “A” School with top graduate honors. Bolsega’s first war zone deployment was in Kuwait serving as a general duty corpsman with Bravo Surgical Company, 2d Medical Battalion, Camp Virginia in 2003. More recently, he deployed to Joint Medical Group Guantanamo Bay, Cuba from August 2007 to February 2008 where he served as the LPO and Supply Petty Officer for the Dental Department overseeing five hospital corpsmen in three clinics. They provided dental care to both detainees and U.S. service members. Back home, he is NBHC Jax’s Front Desk LPO and Assistant Floor Manager. Cmdr. Garry Schulte, who heads the Dental Branch Clinic at NBHC Jax described Bolsega as “a franchise player, the go-to person when you need something done right on short notice. He's a great young leader with interpersonal skills well beyond his peers.” An active volunteer, Bolsega served as the president of the clinic’s MWR Committee and as a member of the Naval Hospital Second Class Petty Officer Association. He’s also worked with Volunteer Jacksonville and recently voluntarily provided medical support for a three-day, Sixth Marine District, “Mini-Officer Candidate School (OCS)” training evolution. This was the second time for Bolsega to vie for the overall NBHC Junior SOY recognition. “It was good to go all the way this time,” he said. It’s been a great year for Bolsega. On top of this honor he became a new father in February. HM3 Aaron C. Bruening, also of NBHC Jax, is the NBHC Blue Jacket of the Year. Bruening, from Grangeville, Idaho, entered service in March 2007. Meritoriously promoted from boot camp, this promising Sailor completed Hospital Corps “A” School in May 2007 and came directly to NH Jax for his first duty station. He was promoted to Hospital Corpsman Third Class in January, 2008. Working as a general duty corpsman in NBHC Jacksonville’s Aviation Medicine Department, Bruening is a vital member of the clinic team. Bruening’s supervisor, Flight Surgeon Lt. Cmdr. Steve Maier, said, “HM3 came on board and immediately began a steep learning curve to take on assignments in the completion of aviation physicals and acting as a customer service liaison. His impact was felt right away, and was much appreciated by our team.”

First In Service

Naval Hospital Jacksonville recently recognized various teams for shepherding new initiatives that improve beneficiary care. Awardees were:
BHC Atlanta: Optimization of Warfighter Readiness and Service Availability Bronze: BHC Kings Bay: Telephone Consult Project TRICARE: Relocation of the Health Benefits Office With No Loss of Service to Their Customers

Gold : Mental Health: ImpleOB-GYN: Perinatal Education menting DoD Task Force recomNBHC Mayport: Clinical Primary mendations on Mental Health Prevention and Community Health Silver : Cardiology: Establish- Promotion ing a Semi-Formal Chest Pain Emergency Unit Room: Improving Radiology: 64 Slice MultiCustomer Satisfacdetector Computed Tomography tion (MDCT) Scanner
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Ready for anything
Response training, drills hone emergency response

Photos: Top —HM2 Jose Torres applies fake burns to a “victim’s” face . Top left —In the EOC, Disaster Preparedness Officer Dana Shropshire (left) leans in to confer with Mike Haytaian and IT2 Jacqulin Price of the hospital’s Information Technology Department. Meanwhile Cmdr. Tim Richardson, Resource Management director updates the EOC.

Naval Hospital Jacksonville medical staff constantly participate in local, regional and national drills and training evolutions so when the call goes out for “Corpsman Up!” medical assets are ready to respond to any kind of disaster. Whether it’s a natural event, a plane crash or a nuclear, biological or chemical incident, Navy Medicine’s best is ready. • The hospital’ s Emergency Operations Center (EOC) was stood up on the morning of March 3, as first responders rushed to the scene of a simulated fire near the antennae farm on the south end of NAS Jacksonville as part of a base-wide mass casualty exercise. • Just a few weeks earlier the hospital’s Security department secured the perimeter surrounding the hospital as Security personnel at installations throughout the Department of Defense participated in Operation Solid Curtain—Citadel Shield. That evolution took all DoD facilities through all threat levels as personnel responded with proper security protocols. • Ongoing training to make sure that hospital medical personnel are certified to handle decontamination of patients coming to the hospital following a nuclear, biological or chemical event was conducted on Jan. 12 –16. HM2 George Fricke of Emergency Preparedness said a total of 66 staff members qualified in the training evolution which included both classroom and actual field work with the equipment. More staff are scheduled to receive the training. While everyone hopes these skills are never called for, our staff knows that full preparation saves lives and is vital to the security of our people.

Center —A victim is assessed for extent of injuries by a medical team in the Naval Hospital Emergency Department as a Medical Evaluator observes for lessons learned. Included in the group is Dr. Michael Albus (left), Surgeon Lt. Cmdr. William Lechuga, HN Michael Parks, HN Jason Hyde and Respiratory Technician HM1 Edwin Edralin. Lower left —A “patient” is rushed from an ambulance into the Emergency Room. Accompanying the patient from the disaster scene is Flight Surgeon Lt Randy Fredrick. Top Right —NH Jax staff members scrub a “victim” in a line tent they assembled under the guidance of TVI Corp instructors. In the foreground is HMC Mike Flint and TVI Corp’s Brent Fenton. Photos by HN Jermaine Derrick and Loren Barnes
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Denton takes charge at NBHC Kings Bay
By MC3 Eric Tretter Periscope Staff

N

aval Submarine Base Kings Bay celebrated a Change of Charge January 14 in which Cmdr. Neil Heimer was relieved by Cmdr. Danny Denton as Officer in Charge of Naval Branch Health Clinic Kings Bay. Many civilian and Navy employees, alongside Kings Bay’s leaders and those from NH Jax stood witness. “I’m certainly glad to be here,” said Denton, who

Taking part in the NBHC Kings Bay Jan. 14 Change of Charge were, from left, Chaplain Aaron Jefferson, Cmdr. Neal Heimer, Cmdr. Danny Denton and Naval Hospital Jacksonville Commanding Officer Capt. Bruce Gillingham. (Photo courtesy Grace Mobbs)

celebrated his 20th year in the Navy in January. “I would hope that we can continue to provide safe, quality , effective care to all the beneficiaries. I look forward to great things happening here at Kings Bay Naval Branch Clinic.” Denton was “coaxed” to Kings Bay from Naval Medical Center Portsmouth, Va., with promises of warm weather by NH Jax Commanding Officer Capt. Bruce Gillingham, who spoke, during the ceremony, welcoming Denton to his new duty station. As for Heimer, he is headed to a Navy Medical Embedded Training Team at a yet unknown location.

New Officer in Charge at NBHC Albany
Story and photo by Art Powell MCLB Albany, Ga. Public Affairs mdr. Chidi U. Ekenna-Kalu was named officer in charge, Naval Branch Health Clinic, Marine Corps Logistics Base Albany, Ga., in ceremonies conducted March 16. She replaced Lt. Cmdr. Steven Shadley who is leaving the post after 20 months of service. “Lt. Cmdr. Shadley is deploying to Afghanistan and I think that’s reflective of the change in our mission since Sept. 11 in that many of our staff are forward deployed supporting the military forces out there and also for nation building,” said Capt. Bruce Gillingham, commanding officer, NH Jax. “His job will be to help establish health clinics in Afghanistan.” Gillingham cited the importance of assisting in nation building overseas but also looked at the local job done by the personnel at the Naval Branch Health Clinic. “We think the personnel here at the Albany Naval Branch Health Clinic do a great job for the Marine Corps Logistics Base and we feel that mission is very important,” he said. “We have many goals already in place and what I
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C

want to do is continue with those goals and improve what we need to improve and change as events come up,” said Ekenna-Kalu upon assuming her new responsibilities. “Because, in the military, you need Cmdr. Chidi U. Ekenna-Kalu, newly named Officer in Charge, Naval Branch Health to be ready for Clinic, Marine Corps Logistics Base Albany, changes.” speaks at the change of charge ceremony Ekenna-Kalu, conducted at MCLB Albany March 16. who was commissioned in 1989, has been serving at the Clinic as the resident optometrist. She said there was a lot for her to learn as OIC but she has a “lot of help” available. Shadley said he’s taking the experience he’s gained leading the 46 “excellent staff members” at the Clinic with him as he heads to Afghanistan later this year. “My job will be to go out and help the Afghani people build clinics and a health care system. So, I’m looking forward to taking the knowledge I’ve gained here and in other assignments over there to help them establish quality healthcare.”

Navy Junior Nurses gather for symposium
NH Jax Nurse Corps officer Lt. Michael Urton (left) points out the Perioperative nursing exhibit to the Deputy Director of the Navy Nurse Corps Capt. Kathleen Pierce (right) at the Navy Junior Nurse Corps Officers Symposium Feb. 11 at the NAS Jax Officer's Club. Addressing NH Jax nurses, Pierce said, "Junior Nurse Corps officers are our future. It is important to dialogue with junior nurses every chance you get. If I am given an opportunity to share my knowledge, then I take it." She thanked Director for Nursing Services Capt. Michael Vernere, Cmdr. Gene Truesdell, Lt. Cmdr. Kimberly Taylor and Urton for coordinating the event.
(Photo by Marsha Childs)

We want to hear from you!
Naval Hospital Jacksonville wants feedback from you about your clinic experience. Avenues of communication include the CO’s Careline (904) 5422273 and The Interactive Customer Evaluation (ICE) system, accessible in freestanding kiosks located in each clinic or from your home computer (See box above). Customer Service Representatives are located in each clinic and you can stop by the Customer Relations Office on the hospital’s 2nd deck (room 2025) for assistance in resolving issues, fill out a Customer Comment sheet or call (904) 542-9175.

NMCRS:

Support your shipmates: See your

Key Person to contribute to the 2009 Fund Drive

NBHC Mayport: Saturday Clinic hours
Naval Branch Health Clinic (NBHC) Mayport is making changes to the Saturday Clinic’s hours of operation. As of April 4, the new operating hours for the Saturday Clinic are 8 a.m. to noon—the period when most appointments are requested. The weekend clinic provides medical care to active duty personnel, retirees and family member over age 8 with urgent needs. The new schedule will expand the number of morning appointments by adding an additional medical provider. Patient appointments may be made through Central Appointments at (904) 5424677.

Pre-Deployment Debriefing
Avoiding the Tripwires:
Living easier outside the wire after deployment Third Wednesday of each month, 1-4 p.m., Branch Health Clinic, NAS Jax, (904) 542-3500, ext. 8837. (Letter available to request absence from command) Topics of this half-day class: Lights Out (Sleeping without anxiety) Fireworks (Controlling rage & irritability) Untraining the Brain (Being less on edge) Shaking the Blues (Finding motivation/desire) The War Within (Battling memories)

Naval Hospital Jacksonville and its Branch Health Clinics promote open communication. If you have any concerns about patient safety or the quality of care provided, you are encouraged to bring these concerns to the attention of your chain of command. If, in your opinion, the concerns about patient safety or quality of care remain unresolved, you may report them to the Joint Commission (JC) . Write to: One Renaissance Boulevard, Oakbrook Terrace, IL, 60181 or phone (800) 994-6610). You can e:mail: complaint@jcaho.org. The hospital will not take retaliatory disciplinary action against anyone who reports patient safety or quality-of-care concerns to the JC.

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Phone Directory
For appointments please use the Central Appointment Line for Family Medicine, Internal Medicine, OB/GYN, Pediatrics, Primary Care Group, and Branch Health Clinics Mayport., Kings Bay and Key West. Call 542-HOSP (4677) or 1-800-JAX-HOSP (529-4677) Monday - Friday (7 a.m. - 8 p.m.) or weekends and holidays, (7 a.m. - 8 p.m.) or weekends and holidays (7 a.m. 3:30 p.m.). Inpatient wards are restricted. For assistance call Hospital Information at 542-7300. Admissions....................................................................542-7811 Addictions Rehabilitation Clinic (ARC)..........................542-3473 American Red Cross.....................................................542-7525 Barber Shop..................................................................542-7788 Birth Certificates & Records..........................................542-7811 Branch Health Clinic Jacksonville.................................542-3500 Branch Health Clinic Mayport.......................................270-5303 Central Appointments (toll free)...........................800-JAX-HOSP Cent. Appt., Nurse Call & Referral Management..........542-4677 Chaplain’s Office...........................................................542-7532 Chiropractic Appointments.................................542-3500, ext. 1 Collection Agent...................................................542-7684/9776 CO’S CARE LINE..........................................................542-2273 Central Sterile Supply Room (CSSR)............................542-7333 Customer Relations Office............................................542-9175 Decedent Affairs............................................................542-7584 Dental (Naval Hospital).................................................542-7540 Dental (NBHC Jax)........................................................542-5441 Dental (Kings Bay)...............................................(912) 573-4212 Diabetic Education………………………………………..542-7431 Dietetic Education (Nutrition)........................................542-9783 Emergency Room..........................................................542-7340 Except. Family Member Coordinator.............................542-7348 Family Advocacy...........................................................542-7354 Family Medicine Appointments.....................................542-4677 Fleet Liaison/Med. Hold.................................................542-7557 Health Benefits Center..................................................542-9164 Health Promotions - Kings Bay..............................912-573-4237 Health Promotions Clinic - Mayport...............................270-5251 Hospital/Patient Information..........................................542-7300 Internal Medicine—Central Appointments…………….....542-4677 Laboratory.......................................................................542-7380 Mental Health.....................................................542-3474 ext.165 OB/GYN.................................................................542-7420/7419 Optometry Appointment Lines (local - active duty only): Optometry NAS Jax ...............................................542-3500 ext.1 Optometry Mayport ........................................................542-4677 Optometry Kings Bay, Ga. ....................................(912) 573-4227 Oral Surgery....................................................................542-7540 Outpatient Records.........................................................542-7425 Overseas Screening - BHC Jax............................542-3500 ext. 1 Pediatric Appointments...................................................542-4677 Pharmacy (Outpatient) ...................................................542-7405 Pharmacy Call-in Refills..................................................542-7410 Pharmacy Refills (nationwide toll free).....................800-628-7427 Poison Control (nationwide toll free)........................800-222-1222 Primary Care Group Appointments.................................542-4677 Pulse Editor.....................................................................542-7417 Radiology........................................................................542-7363 Retiree Liaison................................................................542-7477 Same Day Surgery..........................................................542-7747 Security (Hospital)..................................................542-7546/7545 Social Worker..................................................................542-7354 Substance Addictions Rehab Clinic................................542-3473 Teen Clinic Appointments...............................................542-4677 Third Party Collection Agent.............................542-7714 ext. 148 TRICARE Assist (NavHospJax)..................................542-9164 TRICARE Service Center........................................800-444-5445 Wellness Center………………………………………...….542-5292

Naval Hospital Jacksonville Customer Service: NHJAXCustomerService@med.navy.mil

For ON BASE or OFF BASE ambulance service dial 911
DEPARTMENT OF THE NAVY COMMANDING OFFICER NAVAL HOSPITAL 2080 CHILD STREET JACKSONVILLE, FL. 32214-5000 ATTN: PUBLIC AFFAIRS OFFICE PRSRT STD US POSTAGE PAID JACKSONVILLE, FL PERMIT NO. 2239

OFFICIAL BUSINESS

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