Naval Hospital Bremerton to Enhance Patient-Centered Care

By Douglas H Stutz, Naval Hospital Bremerton Public Affairs


The legacy of Naval Hospital Bremerton (NHB) has been to provide patient-centered care, concern and compassion since 1897. That tradition will continue as the command reshapes and re-aligns resources to better serve the beneficiary population.

NHB will focus on offering timely outpatient services with increased inpatient and ambulatory surgery to support the enrolled population. The bottom line: NHB will maximize resources to maintain mission readiness, provide value and continue quality patient-centered health care to all patients.

“We are not closing our hospital nor are we discontinuing services,” said Capt. Christopher Quarles, Naval Hospital Bremerton commanding officer.

Perhaps the most noticeable transitional change for NHB will be the conversion of the emergency department to an Urgent Care Center (UCC). NHB’s emergency department has traditionally maintained a low volume (less than three percent) of actual sight, limb or life-threatening medical emergencies. An UCC provides the ability to deal with a wide spectrum of medical ailments from a mild case of poison ivy to minor burns or bruises. The NHB UCC will be available to beneficiaries 24 hours a day, seven days a week, with acute care needs handled on a case-by-case basis. In emergency cases, patients will be transferred via ambulance to the local ER at a community hospital such as Harrison Medical Center.

In addition to medical services at the UCC, NHB will offer extended hours through the Medical Home Port teams and encourages all beneficiaries to utilize this convenient service.

“The best course of action that any of our patients should do is first start off with seeing their regular health care provider/Medical Home Port team. Providing patient and family-centric care is what they do,” stated Quarles, noting that NHB’s Medical Home Port teams deliver basic care for common ailments and illnesses, minor injuries and routine health exams, as well as help every patient manage their health care.

According to Quarles, every patient should use their Medical Home Port team to schedule appointments for such medical needs as common illnesses as flu and fever; minor injuries such as sprains and strains; and regular physicals, prescription refills, vaccinations and screenings.

“But when it’s after hours or on the weekend, and someone’s regular health care provider isn’t available, our Urgent Care Clinic is here to handle our patient’s needs,” Quarles said.

There are approximately 60,000 eligible beneficiaries of active duty service members, retirees, and their families in the West Puget Sound, of which nearly 30,000 are enrolled at NHB, with another 1,730 in TRICARE Plus.

From 2011 to 2013, the U.S. Navy Bureau of Medicine and Surgery conducted a study on nine Navy military treatment facilities (MTF) across the U.S. and evaluated their patient population needs, which showed advances in clinical medicine along with technology, resulted in a migration of care from inpatient to predominately outpatient services and provided an opportunity to shift to ensure there is a correct mix of personnel and service to meet the needs of Sailors, Marines, family members and retirees.

Other notable alterations to NHB include the closing of the intensive care unit (ICU) due to low patient usage. Those in need of admission to an ICU will be referred to a local area hospital in June, 2014.

Additionally, the command’s Family Medicine Graduate Military Education program will be gradually phased out with residents redistributed to other MTFs through 2016.

NHB will continue to offer a broad spectrum of needed and necessary inpatient services such as Northwest Beginnings Family Birth Center & OB/GYN services, Ortho, Main OR, Radiology (Mammography, MRI, X-Ray, CT. Nuclear Medicine) Physical Therapy, ENT Clinic, Audiologist, Ophthalmology (Lasik), Oral Surgery, Urology, Optometry, Pharmacy, Internal Medicine (GI/Endoscopy, Pulmonary/Respiratory Therapy, Cardiology, Neurology), Dermatology; Mental Health (Substance Abuse Rehabilitation Program), and Pediatrics Department.

Primary care services have transitioned these last several years from the individual patient/provider model to a standardized primary care team model to provide better access, continuity, wellness, and disease management for patients.

By standardizing primary care services and enhancing access and continuity, NHB has improved the partnership between the patient, his/her primary care provider and their primary care team, and where appropriate, the patient’s family. This partnership has focused on sustaining and enhancing wellness for patients as well as provide efficient delivery of comprehensive health care services, based on the needs of our patients. This effort aligns with civilian models of enhanced primary care known as Patient-Centered Medical Home (PCMH). In Navy Medicine, PCMH is known as “Medical Home Port.”

What is a Medical Home Port Team? By reorganizing our primary care clinics into smaller group practices, or “Medical Home Port Teams,” your healthcare team will work together to assure your care is provided in a coordinated, comprehensive manner. Team-based Healthcare: You will have an entire team responsible for your healthcare. In addition to your primary care manager, a registered nurse and a hospital corpsman and/or medical assistant will be part of your healthcare team. Additional physicians/providers are also part of the team to fill in during absences. This team will partner with you to fulfill administrative requests and provide additional medical services.

How do I get assigned to a Medical Home Team? If you are already enrolled in TRICARE Prime at Naval Hospital Bremerton, you do not need to do anything. Medical Home Port Teams are being implemented throughout the primary care clinics at the naval hospital and our branch health clinics and you will automatically be assigned.

How do I schedule an appointment with my Medical Home Port Team? You do not need to do anything different than you have in the past. Contact the TRICARE Regional Appointment Center (TRAC) at 1-800-404-4506 to schedule an appointment.

Additional ways to reach your PCM and Team: If you have a question that doesn’t require an appointment, you may contact the clinic directly to speak with your Medical Home Port Team.