U.S. Naval Hospital Okinawa, Japan, earns two DoD awards

by Joseph Andes, U.S. Naval Hospital Okinawa, Japan and Airman 1st Class Nicholas Emerick, 18th Wing Public Affairs
U.S. Air Force

CAMP FOSTER, Japan  -- United States Naval Hospital Okinawa (USNHO), Japan was recently recognized in the 2015 Department of Defense Quality and Patient Safety Awards. The program recognizes efforts designed to decrease harm and improve the care delivered within the military health system.

Two program submissions from USNHO, "Prevention of Hypothermia in Preterm Newborn" and "Reduction of Not-In-Stock Medication Levels", were selected as winning entries.

According to Lieutenant James Neipp (USN), USNHO's head of Pharmacy Services and the project lead for "Reduction of Not-In-Stock Medication Levels", the aim of the project was to provide the highest level of care to the patient.

"Not having one medication available can affect the care of more than twenty patients," said Neipp. "So by having these medications readily available, we are able to meet the patient needs as well as reduce any increased costs from having to change to more expensive alternative therapies."

The pharmacy department's project began life as a Lean Six Sigma project to reduce the number of medications "not-in-stock" (NIS) for patient care.  Not having adequate medications to treat inpatient and outpatient persons can lead to adverse events, cancelled procedures, delayed care, increased facility cost, and ultimately, increased frustrations for patients and providers. Another aim was to make the medication ordering system as cost-efficient as possible.

"With the process improvements in place, the pharmacy supply team has been able to achieve the project goal of an average of less than 20 NIS items per month and thus meet our patient needs" said Neipp.

As pharmaceutical expenditures make up a significant portion of the DoD's medical health budget, the project also demonstrated the financial benefits of having the prescribed medication on-hand and of having the most cost-efficient ordering system.  The efforts of Neipp and his team resulted in a potential annual cost savings of more than $500,000 for USNHO.

"Reduction of Not-In-Stock Medication Levels" was chosen in the category of "Improvements Across the Continuum of Care and Presentable Readmissions".
"This recognition is on behalf of our entire Pharmacy Department team," says Neipp. "Without the pharmacy technicians and supply technicians, the department would not have been able to achieve this outstanding accomplishment."

USNHO's other award winning entry, "Prevention of Hypothermia in Preterm Newborn", was chosen in the "Reducing Harm and Healthcare Acquired Conditions" category.

The goal of this project was to decrease the number of preterm infants being admitted to the neonatal intensive care unit (NICU) hypothermic, according to Major (Dr.) Angela Fagiana, USNHO's neonatal intensive care unit medical director.

"Preterm babies are at increased risk of hypothermia after delivery because they are small, have less brown fat (the special body fat that babies need to help keep them warm) and are immature in their ability to regulate their temperature," said Fagiana. "One of the big things we did was, in collaboration with the Mother Infant Care Center (MICC), we identified a specific operative delivery room that would be designated for delivery of our preterm babies. The temperature in that room was set to be 5-6 degrees Fahrenheit warmer than the other operative delivery room."

According to Fagiana, hypothermia has a potentially serious but preventable morbidity risk for infants, and it is an ongoing challenge to keep those babies who are born preterm and very small warm immediately after delivery. With just the two changes in the approach to temperature regulation of preterm infants in the delivery room, an approximate 25 percent decrease was seen in preterm hypothermia on admission to the NICU over a 12 month period.

"It is an honor to be recognized," said Fagiana. "I also think that it provides a platform to share what we have learned with others and hopefully encourage another labor and delivery unit, nursery, or NICU to re-evaluate and/or change their practices to improve patient care."

All military treatment facilities within the military health system were invited to submit applications for this year's awards. According to the DoD Quality and Patient Safety Award website, the winners were selected based on an average score which evaluated the abstract, design methods, results, conclusion, sustainability, and replication of the submitted initiative.

U.S. Naval Hospital Okinawa, Japan is the largest overseas military treatment facility in the Navy, serving a beneficiary population of 55,000 active duty personnel, family members, civilian employees, contract personnel, and retirees.  The facility also provides referral services for over 189,000 beneficiaries throughout the western Pacific.
For more news and information about U. S. Naval Hospital Okinawa, Japan visit our web page at www.navy.mil/sites/nhoki or our official Facebook page at www.facebook.com/usnho.

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