Physical Exams: Process Improvement Ensures Individual Medical Readiness

By Jennifer Zingalie, Naval Hospital Guam

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Service members are required to ensure they are in good physical health and keep up-to-date personal files, medical and dental records.

Those serving in the U.S. Navy are familiar with the Sailors Creed.  Phrases in the creed state, “I will support and defend the Constitution of the United States of America … I represent the fighting spirit of the Navy … I proudly serve … I am committed to excellence …” Every military branch has a similar creed, with a similar value structure by which service members live and work by.

For individuals joining the armed forces it may mean a number of things to them, from serving their country, gaining further education, travel, benefits, and receiving specialized training. It also means service members continuously need to meet the standards required of them to uphold the military’s values like the ones stated in each branches creed. One of these standards is being prepared to deploy, in the interest of national military strategy, at any given time. In the military this is known as readiness.

Improving the PHA process also provided the physical exams department the extra time needed to devote to other duties.
Improving the PHA process also provided the physical exams department the extra time needed to devote to other duties.

Although readiness encompasses the military as a whole, where manning, equipment, and training are concerned, it is also comprised of individual medical readiness. Service members are required to ensure they are in good physical health and keep up-to-date personal files, medical and dental records.

They are required to complete a periodic health assessment (PHA) along with the Fleet and Marine Corps Health Risk Assessment, which looks at their health status. It’s important because commands need to be able to evaluate their physical requirements, medical requirements and health assessments because it can impact operational readiness. PHAs are good for 12 months and are typically done during a member’s birth month.

Naval Base Guam’s Branch Clinic Physical Exams Department provides PHAs not only for hospital staff members, but for many of the Navy tenant commands on Guam, as well as Coast Guard and Army commands. PHAs identify whether or not members have completed all of their health care and deployment health requirements and if they have unresolved health issues. It is also required to be completed before a service member can participate in the physical fitness assessment (PFA).

Naval Base Guam’s Branch Clinic Physical Exams Department provides PHAs not only for hospital staff members, but for many of the Navy tenant commands on Guam, as well as Coast Guard and Army commands.
Naval Base Guam’s Branch Clinic Physical Exams Department provides PHAs not only for hospital staff members, but for many of the Navy tenant commands on Guam, as well as Coast Guard and Army commands.

In a high reliability organization, process improvement is essential to patient safety. Recently, the physical exams department reviewed their process to complete PHA’s for hospital staff, and found it wasn’t as efficient as it could be. It was because the majority of the staff was getting their PHA’s done about a month before their PFA, versus doing it on their birth month.

Over the last several years it has become the standard at most military treatment facilities. Although the department offers walk-in services for PHA’s, resources are needed to fulfill the demand which can become difficult when there is a large influx of patients needing PHA’s at one time.   Realizing the need to remedy this, the department quickly aligned the process to match the Navy standard. They began by reaching out to staff through telephone calls and email messages to quickly smooth out the process.

Although most PHA’s were being conducted at the branch clinic they also opened up availability, approximately three days a week, for hospital staff which allowed those that work at the hospital the ease and convenience of getting their PHA around their work schedules.

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PHA’s ensures overall readiness of commands as well as helps the Navy identify possible issues for individuals so they can prevent them before they turn into something serious such as a chronic illness or injury.

It was discerned that spreading out PHAs not only empowered staff to be medically ready to provide care, but also ensured access to care is readily available for all patients throughout the year. It’s especially important because the hospital sees approximately 25,000 patients, consisting of active duty, veterans, retirees, and beneficiaries.

It’s also important for medical staff to be ready, not only to provide consistent and safe medical care, but also to be ready to deploy at any given time in support of operational and humanitarian missions. Improving the PHA process also provided the physical exams department the extra time needed to devote to other duties. Along with PHA’s, the department conducts separation and retirement physicals. Likewise they serve as part of the military entrance processing station for Guam, providing physical exams to those recruited into the military from Guam and surrounding islands.

The department processes approximately 100 recruits per month. As of March 20 the hospital and all of the commands they serve were at an 87 percent readiness level. PHA’s ensures overall readiness of commands as well as helps the Navy identify possible issues for individuals so they can prevent them before they turn into something serious such as a chronic illness or injury. The PHA empowers Sailors to become more involved with the healthcare process and take responsibility to maintain the standards they agreed to abide by when joining the military. Although it seems like such a simple task, the PHA is directly related to the combat readiness of any military organization.