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59th Medical Wing: Continuously improving access to care

Maj. (Dr.) John Stowers, 959th Medical Group general surgeon, performs a lipoma removal procedure June 23 at the Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland, Texas. Staffed with 11 personnel the section performs between eight and 24 procedures each month. The general surgery section is one of more than two dozen specialty care clinics in the WHASC. (U.S. Air Force photo/Staff Sgt. Jerilyn Quintanilla)

Maj. (Dr.) John Stowers, 959th Medical Group general surgeon, performs a lipoma removal procedure June 23 at the Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland, Texas. Staffed with 11 personnel the section performs between eight and 24 procedures each month. The general surgery section is one of more than two dozen specialty care clinics in the WHASC. (U.S. Air Force photo/Staff Sgt. Jerilyn Quintanilla)

Senior Airman Jherico Guerrero, 559th Medical Group Public Health Technician, checks a patient’s ear prior to administering a hearing test at the Deployment Related Health Clinic, part of the 59th Medical Wing Base Operational Medicine Clinic at the Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland, Texas, Feb 24. The DRHC will see approximately 250 members a month for deployment health assessments. (U.S. Air Force photo/Staff Sgt. Kevin Iinuma)

Senior Airman Jherico Guerrero, 559th Medical Group Public Health Technician, checks a patient’s ear prior to administering a hearing test at the Deployment Related Health Clinic, part of the 59th Medical Wing Base Operational Medicine Clinic at the Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland, Texas. By separating traditional clinical services from occupational medicine, the initiative is greatly increasing the number of appointments available to patients in family medicine. (U.S. Air Force photo/Staff Sgt. Kevin Iinuma)

JOINT BASE SAN ANTONIO-LACKLAND, Texas -- Process improvement initiatives continue improving patient access to care throughout 59th Medical Wing military treatment facilities.

“The entire wing is focused on dramatically improving all aspects of health care delivery. Over the past year, we have decreased wait times, increased access to care, and simplified processes for all beneficiaries, but much more improvement is still required. Consequently, the 59th Medical Wing is harnessing the innovative spirit of our Airmen to continuously improve patient access to safe, high-quality health care,” said Maj. Gen. Bart Iddins, 59th Medical Wing commander.

Initiatives include:

Base Operational Medicine Clinic

Open since February, the Base Operational Medicine Clinic, located on the second floor of the Wilford Hall Ambulatory Surgical Center, is greatly increasing the number of appointments available to patients. The initiative separates traditional clinical services from occupational medicine, letting medical providers devote more time to taking care of ill and injured patients.

Because BOMC now assumes responsibility of many administrative tasks, including preventative health assessments and medical profiles, administrators project the initiative to free up 3,000 appointments per year in family medicine, said Lt. Col. Todd Anderson, 559th Aerospace Medicine Squadron commander.

The clinic puts a focus on continuous process improvement and quality patient care by standardizing processes and increasing access for everybody, whether they are sick, injured or in need of administrative, occupational services. That standardization is on pace to save providers and technicians 2,300 telephone calls and 900 hours of administrative time annually – time that will be devoted back to patient care, Anderson said.

12,000 appointments added at Family Medical Clinic

The 59th Medical Wing added 12,000 more appointment slots at the Wilford Hall Family Health Clinic last year, which provides health care to 36,000 TRICARE beneficiaries annually.

When a surge of provider turnovers led to a shortage of appointments at the clinic, wing group practice managers took action. Changes resulting from the GPMs observations and analysis included increasing clinic leaders’ patient load, standardizing the time allotted for administrative duties, and restructuring staff schedules to bring more providers onto each shift.

As changes were made and other limiting factors were eliminated, the clinic recaptured lost time and put it back into patient care. The successful efforts at the clinic reflect the wing’s dedication to continuously look for ways to better the patient experience and increase access to care, said Maj. Ryan Yates, 59th MDW Group Practice Manager.

Modified Behavioral Health Optimization Program

A modified version of the Air Force Medical Operations Agency's Behavioral Health Optimization Program is bringing behavioral health consultation services directly to beneficiaries at primary health clinics across Joint Base San Antonio.

The initiative serves as the access point for all specialized behavioral health services and helps optimize a person's daily tasks and promote healthy lifestyles. The program also boosts patient deployment readiness and reduces unnecessary referrals to mental health specialties.

Over the past 18 months, the clinic has recorded 5,354 patient encounters, according to Tech. Sgt. Sadie Clark, 59th Medical Operations Squadron.

Diabetes Center of Excellence Immunizations Clinic

An immunization clinic inside the Diabetes Center of Excellence at Wilford Hall is also enhancing patient access to care.

Staff members at the Department of Defense DCOE recognized the need for improving vaccination services on site. The medical staff recognized that many patients of their patients were not current on vaccinations as recommended by the American Diabetes Association.

Using 59th MDW Lean Daily Management techniques – tools to identify and improve processes that affect daily operations – they discovered major factors to the problem. Patients were forgetting to get vaccinations, or deciding that going to the immunizations clinic was an inconvenience, said Dr. Tom Sauerwein, DCOE director.

The DCOE now offers vaccines in-house, making a tremendous difference. A majority of patients who were not vaccinated have since been identified and received their immunizations.

Specialty Booking Appointment Service

Another initiative, the new Specialty Booking Appointment Service Office, at Wilford Hall is helping patients understand and navigate the specialty care appointment process.

Located on the first floor next to the clinic pharmacy, the SBAS Office is one of several ideas the 59th Medical Wing has implemented in its quest to become a high-reliability organization, said Capt. Matthew Muncey, group practice manager with the 59th Medical Operations Group.

After reviewing appointment data, staff discovered that a large number of specialty care referrals were going unused and some patients were not getting the care they needed. Now, following their primary care appointment, patients can schedule specialty care appointments by visiting the SBAS Office before leaving the facility, said Muncey.

Specialty care services include general surgery, dermatology, cardiology, radiology and orthopedics. The office is helping about 50 to 60 patients each week and numbers continue to rise.

Pharmacy patient-centered process improvements

Patient-centered process improvements are reducing wait times for prescription services at 59th MDW pharmacies. Implemented simultaneously across Joint Base San Antonio, the changes decreased processing times by 48 percent over two months. The average prescription wait time at the main pharmacy on Wilford Hall is only 11 to 12 minutes.

Another improvement features embedding pharmacy technicians into clinics that issue the most prescriptions, including family health, internal medicine and pediatrics. The embedded technicians review prescriptions with the patient, talk about instructions and warnings, and verify that everything is correct before sending the prescription electronically to the pharmacy.

UCC virtual check-in options

Virtual check-in options at the Wilford Hall Urgent Care Center mean patients don’t have to wait as long in the lobby for medical care. The three check-in options offer simple, convenient ways to join the line from home, office, or on the go:

1. Visit https://kiosk.qless.com/kiosk/app/home/17353 and enter the requested information.

2. Text the phrase “Lackland AFB UCC” to 210-960-8404 on any mobile device.

3. Download the QLess application to an android smartphone, find Lackland AFB UCC, and join the line through the application. The application is currently not available for the iPhone.

Dental group services offered at SAMMC


Earlier this year, the 59th Dental Group expanded services to Airmen who work at Joint Base San Antonio’s Fort Sam Houston, potentially saving the San Antonio Military Healthcare System thousands of mission hours annually.

Working with the Army Dental Command, the 59th DG is sending three rotating teams to provide annual dental exams and cleanings for up to 12 Airmen from the 559th Medical Group each week. Airmen from the 559th MDG work alongside their Army counterparts to provide health care services to beneficiaries at the San Antonio Military Medical Center.

According to Maj. Steven Bennett, 59th Dental Squadron dental services flight commander, the initiative could save up to 2,000 mission hours annually – time better spent tending to patients.

Mom Strong program

Another program, Mom Strong, is tending to prenatal needs in the area. The wing’s new routine prenatal care program is moving expectant mothers out of the exam room and into a group setting. The program brings together expectant women and couples with similar due dates for regular two-hour meetings.

Held through pregnancy and birthing, the meetings provide parents with information on standard prenatal care, and participants get to share information related to pregnancy, childbirth, parenting, and personal growth.

Practitioners also provide the standard services – listening to the baby’s heartbeat, assessing uterine growth, and talking individually about specific problems and concerns. Importantly, health care providers get the opportunity to share information with their patients while spending more time getting to know them.

“You get more personal time. You get information that you normally wouldn’t receive during a regular checkup, (such as) guest speakers who talk to you about different things like breast feeding,” said Mom Strong member Tabitha Dahmen-Redd.

JBSA-Randolph Dermatology Services


The wing expanded dermatology services to the JBSA-Randolph Medical Clinic in May. The full-spectrum medical dermatology clinic focuses on skin cancer, acne, eczema, rosacea, rashes and psoriasis. Located in the family health clinic, it is open from 8 a.m. to noon Tuesday and Thursday.

The clinic includes two examination rooms and one procedures room to meet patient needs at the JBSA-Randolph Medical Clinic who would otherwise have to travel to Wilford Hall for dermatology services, said Maj. (Dr.) Thomas Beachkofsky, 59th Medical Specialty Squadron dermatologist.

For more information about 59th MDW initiatives and programs working toward the perfect patient experience, visit www.59mdw.af.mil and follow the wing at www.facebook.com/59mdw.
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