Facilities and infrastructure weren't maintained to acceptable standards at Walter Reed Army Medical Center, and the Pentagon leadership should have known about it, according to a report from an independent review board.
The study is the first Pentagon review since revelations of poor troop care and dilapidated facilities at Walter Reed. The report says military leaders neglected those problems because they knew the campus was slated for closure. (Walter Reed is set to merge in 2011 with the National Naval Medical Center in Bethesda, Md.)
"Leadership failed to provide clear direction, or place proper priority, on the management and treatment of outpatients at Walter Reed Army Medical Center," the study found, adding that the Pentagon made problems worse by insisting on keeping costs down.
"The existing facilities should not be allowed to 'die on the vine,'" the review said. It urged that Walter Reed's merger with the naval medical center be accelerated, that a senior officer be assigned to oversee the transition, and that Walter Reed receive the funding it needs to maintain full operations until that process is complete.
Here, a look at key findings and recommendations:
Case Management
Finding: Wounded troops receive excellent care from the time they're injured on the battlefield through their hospital stay. The problems begin once they leave the hospital, if they still need outpatient care.
Recommendation: Assign every wounded service member both a primary doctor and a case manager; the latter should also receive better training and new guidelines for keeping track of patients.
Traumatic Brain Injury
Finding: The Pentagon wasn't prepared to deal with the growing number of troops with traumatic brain injuries and post-traumatic stress disorder. Many of these injuries aren't identified as early as they should be, and medical staff lack training on how to treat them.
Recommendation: Create a new center that specializes in treating brain injuries, as well as post-traumatic stress disorder. Give service members new cognitive screening tests before and after deployment. Keep better record of those exposed to blasts.
Medical Staffing Shortages
Finding: Staffing shortages and inadequate training led to "compassion fatigue" among the medical staff at Walter Reed.
Recommendation: Review whether overworked staff get paid enough.
Evaluating Physical Disability
Finding: The system for rating a service member's disability is too complex and is applied inconsistently.
Recommendation: The system should be updated, so that, for example, a disability resulting from a burn would get evaluated similarly to one resulting from an amputation. The whole evaluation process should be revamped so that it's consistent across the military.
Assistance for Families
Recommendation: Leadership at Walter Reed should survey patients and family members about the services provided and the condition of facilities. Families should be educated about their entitlements, and an advocate should be assigned to each family.
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