The U.S. Army Health Clinic-Schofield Barracks has been proudly serving the Soldiers and Family members of the Schofield Barracks community since 1909 when we were the 59th Ambulance Company, which became the 11th Medical Regiment. The first building of the current facility was opened in 1919. In 1928, the hospital was renamed the 26th Station Hospital with a 500-bed capacity; making it the largest military medical facility on Oahu. In 1941, the name was changed to the North Sector Hospital and treated the first 117 U.S. casualties associated with the Dec. 7 attacks at Wheeler Army Airfield that preceded the attacks on Pearl Harbor that infamous morning. During WWII, the facility expanded up to 2,000 beds and was used as a rehabilitation center. During the Korean war the facility was named Schofield Annex, Tripler Army Hospital, Ward 50 and became a 100-bed convalescent ward. Since 1965, the healthcare team has been focused on providing the best outpatient care to support the Soldiers, Family Members and Retirees in the northern portion of Oahu.
MEDICAL READINESS OF THE FORCE
Currently, the USAHC-SB supports the Soldiers and Family members of the 25th ID, 8th TSC, 516th Signal Brigade and 500th MI Brigade. Overall, USAHC-SB provides outpatient services for over 80 percent of all Soldiers stationed on Oahu. Over the last year, we successfully partnered with 25th ID and 8th TSC to improve medical readiness. Overall, we were able to successfully decrease non-deployable Soldiers in the MRC4 category to < 2 percent to meet the Chief of Staff of the Army’s MRC4 Reset target. We were also able to decrease non-deployable Soldiers in the MRC3B status by the integration of Nurse Case Management in support of the Brigade Surgeons. In the last year, over 11,000 Soldiers completed Soldier Readiness Processing in preparation for Pacific Pathways and other deployments for the 25th ID, 8th TSC, and other USARHAW organizations.
The Army Wellness Center (AWC) at Scofield Barracks has become one of the most productive medium-sized AWC in the Army based on a recently published analysis. The USAHC-SB AWC was ranked #2 of& 11 medium-sized AWC for number of clinic visits and ranked 3rd for number of unique people served. After a recent facility furniture redesign we expect the ability of the USAHC-SB AWC to continue to better serve our community. We have added AWC providers to Relay Health to improve their ability to leverage technology to coach, teach, and mentor those they serve.
QUALITY OF CARE
In this last year, USAHC-SB earned The Joint Commission’s Gold Seal for quality care. Additionally, our primary care clinics are all level 3 Certified by the National Committee for Quality Assurance. Our patients report over 93 percent average patient satisfaction with our health care providers scoring over 97 percent for their courtesy and respect. Overall quality of our clinic is measured against HEDIS (Healthcare Effectiveness Data and Information Set). The patient centered medical home received an overall composite score of 86 percent and the social centered medical home had a composite score of 96.7 percent; both exceeding Army Medicine standards. Our Patient Administration Division has been recognized for exceeding the standards and quality service for processing your treatment and dental records.
ACCESS TO CARE
Improving access to care for all of our patients remains a priority. This last year we were successful in decreasing the access to care for all primary care new appointments to < 0.8 days for a new appointment (Army Medicine’s goal is <1 day) and <4.1 percent days for follow-up appointments (Army Medicine’s goal is <7 days). To help meet patients on where they would like to be met – we have increased our use of RelayHealth and TRICARE Online. We have hired over 80 personnel and have another 170 hiring actions on-going to better serve the community. USAHC-SB Behavioral Health has tripled in size, expanding from three clinics to 10, growing from a staff of less than 40 to a staff of over 140 employees.
UNIQUE AND NEW SERVICES AT USAHC-SB
- Opened a new Women’s Health Clinic and a Patient Centering program to assist the pregnant women we serve. We added a mammography technician.
- Expanded the space and services of our pain clinic to better serve the community.
- Art Therapy is integrated into our Intensive Outpatient Programs and our Child and Family Behavioral Health Services.
- Integrated Substance Use Disorder Clinical Care into the USAHC-SB.
- Increased physical therapy assets with allowed us to open up physical therapy to family members.
- Integrated behavioral health into the primary care clinics (medical homes) to increase access to behavioral health services.
- Added a dietitian to the primary care clinic.
USAHC-SB continues to renovate and upgrade medical facilities and capabilities to provide healthcare to all eligible beneficiaries. USAHC-SB consists of 26 buildings with over 300,000 square feet of medical space. Eighteen of those buildings make up our main campus. To decrease confusion and improve navigation across our campus we updated the wayfinder package for the campus. This year we opened the 2nd Brigade Embedded Behavioral Health Clinic and the Aviation Medicine Clinic on Schofield Barracks. To improve parking we haves started a MILCON project that will add 429 parking spaces within a 5 story parking garage. The garage should open Spring of 2018. The next phase of the renovation will add a 3-story annex in the back of the campus that will house physical therapy, dental, and behavioral health. After that is completed the buildings within our main campus will be renovated to better serve our community.
To better meet the needs of our community, USAHC-SB leaders are actively engaged in the Community Health Promotion Council (CHPC). We are partnering with the community to help make the healthy choice the easy choice across the installation.
READINESS OF THE MEDICAL FORCE:
In addition to carrying for the needs of our community, our military medical team must be ready to support the force in deployed settings. In this last year, we deployed almost 20 percent of military personnel in support of 12 missions in the following countries: Korea, Japan, Sri Lanka, Malaysia, Cambodia, Thailand, Laos, Vietnam, and CENTCOM AOR. These missions supported such events as: ULCHI Freedom Guardian (UFG), Operations Key Resolve, Angkor Sentinel, Operation Spartan Shield, and joint operations with the Air Force for Pacific Angel 16-3.United States Army Health Clinic-Schofield Barracks
The mission of the United States Health Clinic- Schofield Barracks (USAHC-SB) is to improve the readiness and health of our community by delivering quality, effective, and holistic care. Our vision is to be the Pacific Region’s medical home of choice.
The USAHC-SB is located at Schofield Barracks, Hawaii, and is one of the 10 Army Medical Treatment Facilities (MTFs) that support a Division. We have the second largest number of enrollees, 34,598, in the Regional Health Command-Pacific (RHC-P), while maintaining the second lowest per-member/per-month cost in Tricare Regional Office-West for large clinics.
USAHC-SB supports its community by providing holistic health care across 10 service lines with 40 different clinics. The 10 service lines include: Soldier Centered Medical Home (SCMH), Patient Centered Medical Home (PCMH), Behavioral Health (BH), Sports Medicine, Brain Injury, Ancillary Services, Readiness Clinics, Allied Health, Acute Care Clinic, and Public Health. On an average day there are 4,488 health care encounters. Our pharmacy is easily one of the best in MEDCOM. The average wait time for Active Duty is 6.5 minutes and 8.3 minutes for family members. The pharmacy fills, on average 1,537 prescriptions daily. Our self-care program has saved beneficiaries $67,000 over a period of six months.
The USAHC-SB 10 primary care clinics see just over 1,000 patients per day. Both the Soldier (SCMH) and Patient (PCMH) medical homes hold the coveted level 3 accreditation from the National Committee for Quality Assurance (NCQA). PCMH earned their level 3 accreditation in December 2012, while maintaining the same level of quality for 48 months. SCMH recently earned their level 3 accreditation in February 2017. The NCQA assures that all patients receive a high standard and both departments are constantly working at full capacity to ensure that their patients receive nothing but the best possible care. The NCQA is a private organization whose goal is to improve the quality of health care. It was founded in 1990 with the sole purpose to bring attention to the rapidly increasing need of improved quality of health care. In order for a health clinic to receive the highly coveted NCQA certification, they must first pass a rigorous set of 60 standards and submit performance reports in 40 areas, and recorded performances in 157 factors. These factors are distributed between six program component areas; patient-centered access, team-based care, population health management, care management and support, care coordination and transitions, performance measurement and quality improvement. USAHC-SB SCMH proudly earned the national highest level (level 3) of accreditation and the NCQA certification.
The USAHC-SB Behavioral Health (BH) department has tripled in size, expanding from three clinics to 10; with a staff of less than 40 to a staff of over 140. Most recently, the 2nd Infantry Brigade Combat Team’s (2IBCT) Embedded Behavioral Health clinic was relocated to the 2IBCT footprint. At the opening ceremony, Colonel Deydre Teyhen, Commander of the USAHC-SB, stated, “We need to continue to decrease both, the stigma of seeking behavioral health care and the barriers to seeking care. Today’s opening of the 2nd Brigades Embedded Behavioral Health represents a very visible step in reaching those goals.” We continue to assist in eliminating the stigma of seeking BH care. We also opened the new Aviation Medicine Clinic on Wheeler Army Airfield. This new facility includes Combat Aviation Embedded Behavioral Health Clinic, SCMH, Physical Therapy, and Pharmacy. These moves allow Soldiers convenient access to BH care which could have prevented Soldiers from seeking care. We also continued to invest in more resources to support the children and family members of Schofield Barracks by growing the Child and Family Behavioral Health Services (CAFBHS). CAFBHS programs help families who need assistance and guidance with their children’s development. We also integrated the Substance Use Disorder Clinical Care into the USAHC-SB over the last year.
The USAHC-SB is continuously looking for ways to improve our care. We are transitioning from a health care system to a System for Heath. One major addition to our System for Health was made by incorporating Move to Health (M2H), powered by the Performance Triad (P3), into our facility. M2H is a holistic approach to improving the health and wellness of our staff and our community. M2H is designed to assist individuals change habits, which over time, will improve their overall life style. M2H covers nine aspects, which make up the M2H wheel, that are important to discuss during a patient encounter; sleep, activity, nutrition, personal development, surroundings, emotional, spiritual, family/social and mindfulness. By incorporating these eight lifestyle factors in patient encounters, providers will be able to get a full spectrum synopsis of their patient’s life which will allow them to assist them on multiple levels of care. By incorporating M2H in patient encounters, it opens a dialogue that acts as a gateway to gaining more information about the patient. It provides the provider a way to look at all aspects in the patient’s life. This allows the provider to identify a factor that might not have previously been considered, as a potential cause of illness.
USAHC-SB hosted the Office of the Surgeon General in support of training our staff in M2H. Leaders and medical providers attended the M2H Foundation course in June and again in January. This was a three day course that covered the M2H concepts and how to incorporate it into patient encounters, but also how in implement it in their daily life. There are two committees, one staff and the other patient focused, that facilitate goals and plans of implementation.
The staff and providers at USAHC-SB work diligently to provide our beneficiaries with the absolute best care possible. We are continually researching, and developing new methods to make every patient encounter positive and stress free as we move towards a System for Health.Second Lady Sees Art Therapy in Action at Schofield
By Lt. Jason Kilgore, Schofield Barracks Health Clinic and Ana Allen, Regional Health Command-Pacific
SCHOFIELD BARRACKS, Hawaii — The Second Lady of the United States, Karen Pence, visited with military and civilian leaders during a tour hosted by U.S. Health Clinic at Schofield Barracks, to talk about how a form of alternative therapy is being used to help military members and their families deal with difficulties, disabilities or diagnoses.
The tour took place outside of the clinic’s walls to where art therapists and patients have unfettered access to their tools: pens, paper, brushes, ceramics and more.
Pence, who is a champion for art therapy programs, visited the arts and crafts building on Schofield, where she spoke with patients currently enrolled in art therapy programs. “It’s very encouraging today to see at Schofield Barracks everything they’re doing to incorporate art therapy. From the family to volunteer programs, outpatient, we touched on music therapy and dance therapy, education, there were so many areas that we touched on today. This is a place that is really doing it right. This is a place that is really using art therapy to heal our Soldiers and their families”, stated Pence.
Col. Deydre Teyhen, the clinic commander, talked with Pence about how patients, from the clinic, enrolled in the intensive outpatient department, child-adolescent and family behavioral health services or mental health care can utilize the alternative care program in coordination with their providers. “For the right patient, art therapy becomes a powerful tool in the healing process,” said Teyhen, who led the discussion. “There’s incredible flexibility within the therapy program, which can be tailored to the needs, interests and capabilities of the patient and applied regardless of age. Both patients and providers express how vital the evidence based care is in the recovery process,” she said.
As an artist herself, Pence has seen firsthand the benefits to art therapy. “As an educator...I’m an art teacher and I don’t have the qualifications to do art therapy,” said Pence. “Art therapy is not arts and crafts. It’s not even someone like me with a master’s degree in art education. It’s not something I could do. So, art therapy is where you take these amazing professionals here who are therapists, who understand psychology and they understand how the mind works and they are using art as helping them with healing,” she said. “So if someone is not verbal, they are using visual art, they are using music, dance. These are ways that they are helping the Soldiers cope and we actually see how working through art therapy does heal the brain. It’s astonishing,” she said.
Dr. Lisa Gomes, a clinical psychologist and play therapist and Expressive Arts Group-Therapy facilitator, also discussed with Pence about how she is using art therapy with kids. “During our sessions...we like to keep our adolescent patients engaged by using forms of therapy that cater to their age,” said Gomes. One form of therapy that is popular among children is modeling clay. With an in-house kiln, it’s easy to have the patients create their pieces of art and immediately put it the kiln to be fired and then painted,” Gomes stated.
Tripler Army Medical Center Oncology Clinical Nurse Specialist, Dr. Patricia Nishimoto also shared information with Pence about Tripler’s annual Oncology on Canvas event, with April being the 11th year of engagement, which has proven to be a meaningful program for participants. During the event, oncology patients and their families use art therapy as a way to deal with the treatment of life-threatening diseases and impacts to the family.
“Art therapy is becoming more popular within the military medical community. However, this kind of care isn’t always feasible in a typical clinical room setting. It takes the community coming together to bring a wide range of therapy mediums to our patients,” said Teyhen.
For example, Resiliency Through Arts is a community partnership with Morale Welfare and Recreation and the clinic’s Intensive Outpatient Program, or IOP, where participants focus on the process of personal expression through art, in a small group setting at the arts and crafts center. “Through attending the IOP courses, I have learned a new appreciation for art. It is no longer just paint on canvas or charcoal on paper. It’s a feeling. When I created this picture,” said Staff Sgt. Bryan Roscoe, referring to his creation, “there was nothing there, nothing in my headspace. Then something amazing happened and it was clarity.”
Another Intensive Outpatient Program participant, Staff Sgt. Nate Hibbs, experienced similar success. “Being a part of this great program has given me a new perspective on life and many outlets for my anger and anxiety that I did not know I was capable of. The painting was my first ever and I truly enjoyed the peace and feeling of accomplishment that I get when I finish one,” hesaid.
Another community partnership program hosted by the Honolulu Museum of Art, entitled Warrior’s Eyes on Art, gives patients the opportunity to paint significant life events that are later shared and discussed in a group setting.
After hearing how key partnerships between the medical community and organizations on and off the installation are making art therapy possible for patients, Pence provided her perspective. “That’s a part of it that sometimes gets left out, is that you can work with an art museum, they can work with community leaders, churches, and this base is doing that. Sometimes we do things isolated and we don’t understand that someone right around the corner is doing a similar thing...is someone I could partner with. I would just say they are doing everything right here. They have got the whole pie they are working with,” she said.
Pence also emphasized the effectiveness of such programs, describing a moment when she saw art therapy make a difference during the tour. “I hear from art therapists, I heard from several today that art therapy saves lives. It can take someone who is contemplating suicide and turn them right around and flip it right over, “said the second lady. “I heard a Soldier say today, ‘I was in a hole and working with clay helped me come out of that hole. I am completely healed, I am not on any medications.’ Just to see people tell these testimonies to me, to say it actually saved my life is just a powerful, powerful tool,” said Pence.
As leaders wrapped up their visit with the second lady, Pence shared her three hopes for the future of art therapy within the military medical setting. “Number one, I want to lift up the profession of art therapy. You have people here at Schofield Barracks that actually are trained art therapists,” stated Pence. “Number two, I want people to go into the profession. There are so many people who are saying, ‘I like art. I like psychology. Maybe this is something I could go into.’ We are never going to have enough art therapists. And third. I want people to understand that this is an avenue for you. If you are someone who feels like you are in that hole, if you feel like you need help, art therapy might be the thing that would help you step out of that hole that you are in. My desire would be for more and more of our military families to know there is help out there,” said Pence.
Art therapy resources are available to TRICARE beneficiaries through a doctor referral.
For more information on art therapy programs and other initiatives, visit army.mil/rhcpacific.