IACH reaches pinnacle of Army safety

Irwin Army Community Hospital is the second hospital in Regional Health Command – Central (Provisional), and one of 30 from 120 hospitals military-wide, to earn the Army Star Strong flag.
Irwin Army Community Hospital is the second hospital in Regional Health Command – Central (Provisional), and one of 30 from 120 hospitals military-wide, to earn the Army Star Strong flag.

Irwin Army Community Hospital Irwin Army Community Hospital earned the distinguished Army Safety and Occupational Health Star Strong flag award and was recognized for its commitment to safety during a ceremony June 22.

Maj. Gen. Thomas R. Tempel, Jr., Commanding General, Regional Health Command – Central (Provisional) presented the award to IACH leaders and staff.

“To earn this recognition shows a commitment to safety,” said Tempel. “Safety is not about checking a box or a monthly briefing; it’s a culture change. This says you have a world class health system and that safety is part of your culture.”

IACH is the second hospital in RHC-C, and one of 30 from 120 hospitals military-wide to earn the Army Star Strong flag.

“To get certified and earn this star says a tremendous amount about the IACH leadership and how much they care about the people they serve,” he said.

The Army Star Strong flag recognizes organizations that go beyond the standard set for patient and organizational safety. Attaining the certification involves a three-year journey of collaboration, commitment and change for every member of the organization. There are 243 task specific elements of performance that must be understood and modeled at every level.

“The key to earning star status is keeping safety at the forefront of everything we do. Staff must remain accountable to each other, leaders provide support and direction for safety performance and outcomes,” said Ron Knight, IACH Safety & Occupational Health Manager. “Initial achievement momentum can be easily lost; leaders and staff must truly buy into the vision to continually energize it.”

Getting everyone in the organization to recognize unsafe conditions and then personally take action to correct the hazard is only part of changing the culture. Actively managing even the smallest risks must become second nature to all staff. That is the ultimate success. That’s what the flag indicates.

“From top to bottom, the organization must continually renew its efforts to go beyond the minimum standard to maintain a culture of safety. We no longer accept the old adage of ‘it’s someone else’s job.’ IACH staff take it upon themselves to provide a safe working environment, promote safety, reduce workplace injuries and hold each other accountable for safety performance,” said Knight.


January is Cervical Cancer Awareness Month

Kaya Sparks receives her first dose of the human papillomavirus vaccine. Young adults and children 9-26 years old can protect themselves from HPV related cancers with the HPV vaccine.

No woman should die of cervical cancer according to the Centers for Disease Control and Prevention. Cervical cancer, which is caused by the human papillomavirus or HPV, remains the most preventable cancer in women who have regular screening tests to include yearly well woman exams and Pap tests, said Ramona Derousseau, IACH Well Woman Clinic nurse practitioner.

The Pap test looks for precancers, which are cell changes on the cervix that might become cancerous if not treated. Women should get Pap tests regularly starting at age 21. Routine screening is recommended every three years for women 21-65 years who have a normal Pap test with a negative HPV test according to the CDC. Women who are 30 years and older with an unclear Pap test are also tested for HPV.

Women of all ages should also have yearly well woman exams for their reproductive health care needs, Derousseau said.

“I recommend all women have yearly well woman exams because a Pap test doesn’t tell us if the ovaries are normal size or if there are any changes to the uterus,” she said.

The well woman exam includes a breast and pelvic examination, a Pap test if needed, a review of labs and medications, a review of family history and testing for sexually transmitted diseases.

If a Pap test comes back abnormal or if a woman is diagnosed positive for HPV, it does not mean cervical cancer is present, according to the CDC. HPV can cause normal cells on the cervix to turn abnormal. Over many years, abnormal cells can turn into cancer if they are not found or treated.

“I tell women it only takes one encounter to get HPV and once you are exposed it stays in your body. Your body takes up to two years or more to suppress the virus. We monitor it to make sure it stays suppressed,” Derousseau said.

Young adults and youth may also protect themselves from HPV related cancers with the HPV vaccine.

The CDC recommends youth begin all three doses of the HPV vaccine at age 11 or 12, the vaccine is most effective when all does are received before a person has their first sexual encounter.

Youth and young adults up to age 26 are encouraged to get vaccinated.

TRICARE coverage of the HPV vaccine starts at age 9 through 26. For more information on the HPV vaccine, contact your medical team through Secure Messaging Services at https://app.relayhealth.com/.

To schedule a well woman exam or Pap test, visit http://www.tricareonline.com, or call the appointment line at 785-239-DOCS (3627).


The Joint Commission Re-Accredits IACH

Irwin Army Community Hospital received its long-awaited Gold Seal of Approval in December.

The accreditation document is awarded by The Joint Commission for demonstrating continuous compliance with performance standaGoldSeal_4colorrds. It reflects a hospital’s commitment to providing safe and effective patient care.

“We are delighted to have earned our three-year hospital accreditation from The Joint Commission,” said COL Risa Ware, IACH Commander. “The IACH team underwent a rigorous on-site survey to re-accredit the hospital. The achievement demonstrates the high quality and commitment of all our providers and staff.”

The Joint Commission evaluates and accredits more than 20,500 health care organizations and programs in the United States. It has accredited hospitals for more than 60 years. The Joint Commission’s hospital standards are developed in consultation with health care experts and providers, measurement experts, and patients. The standards are informed by scientific literature and expert consensus to help hospitals measure, assess and improve performance.

A team of five Joint Commission expert surveyors evaluated IACH for compliance with hospital standards related to several areas, including provision of care, emergency management, environment of care and facilities, infection prevention and control, leadership, patient safety, and medication management.

“Joint Commission accreditation provides hospitals with the processes needed to improve in a variety of areas from the enhancement of staff education to the improvement of daily business operations,” said Mark G. Pelletier, Chief Operating Officer, Division of Accreditation and Certification Operations, The Joint Commission. “In addition, our accreditation helps hospitals enhance their risk management and risk reduction strategies. We commend Irwin Army Community Hospital for its efforts to become a quality improvement organization.”

TRICARE Pharmacy Copays Change February 1

2016-Copays-ChangesOn Feb 1, 2016, most copays for prescription drugs at Home Delivery and retail network pharmacies will increase slightly.

Military pharmacies and TRICARE Pharmacy Home Delivery will remain the lowest cost pharmacy option for TRICARE beneficiaries when some TRICARE pharmacy copays change in 2016.

The 2016 National Defense Authorization Act requires TRICARE to change its prescription copays. All drugs at military pharmacies, and generic drugs through Home Delivery, are still available at no cost to beneficiaries. Copays for brand name drugs through Home Delivery increase from $16 to $20, for up to a 90-day supply. At retail pharmacies, generic drug copays go from $8 to $10, and brand name drug copays go from $20 to $24 dollars, for up to a 30-day supply. Copays for non-formulary drugs and for drugs at non-network pharmacies will also change.

Beneficiaries can save up to $208 in 2016 for each brand name prescription drug they switch from retail pharmacy to Home Delivery. Home Delivery offers safe and convenient delivery of your prescription drugs right to your mailbox.

To see the new TRICARE pharmacy copays, learn more about the TRICARE Pharmacy benefit, or move your prescription to Home Delivery, visit www.tricare.mil/pharmacy.

Hooking Youth on Cotton Candy Nicotine

Pvt. Hunter Chubb had already quit smoking. Basic Combat Training left him no choice.

The marketings efforts of the electronic cigarette industry are catching the attention of a new generation of consumers: youth. Pvt. Hunter Chubb, a former vaper, believes that’s on purpose.
The marketing efforts of the electronic cigarette industry are catching the attention of a new generation of consumers: youth. Pvt. Hunter Chubb, a former vaper, believes that’s on purpose.

“That was a good thing,” said the preventive medicine specialist with the Fort Riley Public Health Department. “I came to appreciate my new found freedom.”

Weeks after completing boot camp his freedom was cut short. A friend introduced him to the electronic cigarette. It wasn’t the first time he’d seen the device. But there was something different.

“It looked really cool,” said Chubb, “similar to owning a flip phone and seeing a smartphone for the first time. You just really want it.”

An array of juices, or flavored nicotine, also made vaping an appealing recreation.

“’Vaping’ and ‘juices’ are terms the industry uses to distinguish the activity from smoking or tobacco consumption,” said Wayne Darsow, Fort Riley Public Health Nurse Practitioner.

Chubb said his initial interest in the electronic device was more about the technology and social lures.

“I didn’t have a desire for nicotine so I started with the lightest level available,” he said.

He began vaping at 6 mg/mL of chocolate flavored nicotine, which is considered entry-level strength. A week later he increased it to 12. A month later to 18.

“I wanted to keep feeling the effect from when I first started,” Chubb said.

Darsow said Chubb’s description is typical of a smoker who gradually develops a nicotine tolerance. To maintain the euphoric effect, smokers increase the number of cigarettes they smoke to intensify the levels of nicotine. With electronic devices, vapers increase the nicotine strength level in the juice.

“After a while I started smoking cigarettes because vaping wasn’t enough,” Chubb said.

He was back to where he was before he joined the Army.


Electronic nicotine devices, or e-cigarettes, are marketed as healthy alternatives to smoking, Darsow said.

Advertisements for e-cigarettes report they are free from chemicals that cause cancer and other respiratory diseases.

“E-cigarette ads are also attracting a younger population,” Darsow said. “YouTube commercials for e-cigarettes show attractive people promoting the latest features. Their message is that vaping is glamorous, independent, and high tech. And this appeals to youth.”

Darsow said he doubts that vape juice flavors like cotton candy and chocolate are targeted to adults.

“It’s no accident that e-cigarette use among youth is increasing,” Darsow said. “It’s very easy for students to vape in schools without teachers suspecting a thing. Vaping leaves no smell behind.”

Data from the Center for Disease Control indicates that e-cigarette use among middle and high school students tripled from 2013 to 2014.

The upward trend among youth usage is a serious public health problem, Darsow said.

“We don’t want our kids experimenting with vaping. Nicotine exposure at an early age permanently alters neuro-receptors in the brain that then manifest into an addiction,” said Darsow.

Currently e-cigarettes are not officially deemed tobacco products by the federal government. That means there is little regulation on the marketing of e-cigarettes, Darsow said.

In November, the Kansas City metro area adopted ordinances raising the legal age to purchase cigarettes, e-cigarettes, and related products to 21. But in spite of these local and regional movements to curb sales among youth, e-cigarettes are not subject to the same marketing restrictions as traditional cigarettes.

“E-cigarettes are the perfect machine luring a new generation of young people to lifelong nicotine dependence. We as a community must be vigiliant to protect our youth through education while policies and regulations catch up,” Darsow said.


“I wholeheartedly believe that vaping is more addictive than cigarettes,” Chubb said.

In October 2015, Chubb learned about the Fort Riley Tobacco Cessation Support Program and enrolled. The news of becoming a father gave him the motivation to quit – again.

“This time I’m quitting for good,” he said. “But if I relapse it won’t be because of the latest features on an electronic device. I know better now. ”

Taking the Leap — Tobacco Free Living

IAC_8520 copyAbout five months ago the last smoking shack on the Irwin Army Community Hospital campus closed – for good.

Although the ban on smoking in federal government buildings has been in force since 1997, Army Medicine is now taking the next step.

As of June 2015, IACH and its outlying clinics, the Dental Activity and Veterinary Services have banned the use of tobacco on their campuses, including the grassy areas that could be as far as 100 yards away from a medical facility.

In addition, Army Regulation 600-63 published in April 2015 prohibits the use of tobacco by military medical personnel while on duty or in uniform, regardless of location.

“These efforts are part of an Army Medicine leadership campaign to create momentum toward Tobacco Free Living,” said. Col. Paul Benne, the Fort Riley Department of Public Health Chief.

“We have a come a long way from a time when cigarettes were part of Army C-Rations. Over the years hospitals have been reducing the number of smoking shacks. Now we have reached a point where the last smoking shack at IACH has been sealed off,” Benne said.

“Tobacco Free Living not only promotes a healthy environment for patients, visitors and employees of the hospital, it also supports one of the Army’s top priorities – military readiness,” said Benne.

“Oral surgeons indicate that patients who do not use tobacco heal faster. Cardiovascular cases are more common for smokers. Soldiers perform better on a two-mile run after they quit smoking. And that’s only part of the look at the negative effects of tobacco on our Soldiers,” said Benne.

For IACH leadership, “promoting the standard of a tobacco-free environment is consistent with the Army Medicine goal of increasing healthy behaviors,” said Col. Risa Ware, IACH Commander. “Tobacco-free living is part of a larger strategy to improve medical readiness, along with the prevention of drug abuse and excessive alcohol use.”

Tobacco consumption is a key topic because of the high rates of Soldiers who smoke when compared with the general population.

About 18 percent of American adults aged 18 years or older smoke cigarettes compared to 30 percent of Soldiers. Smoking costs the Department of Defense an estimated $1.6 billion a year in medical care through increased hospitalization and missed work days resulting from smoking-related illnesses, said Benne.

“The biggest obstacle to reducing tobacco consumption is our culture. We have to counter it with another way of life – Tobacco Free Living. We start with our medical facilities and our medical personnel,” Benne said.

“Our tobacco-free campus policy has the potential to improve the health of thousands and support the goals of a medically ready force and a healthy resilient community,” said Ware. “Our policy is designed to create a tobacco-free workplace and healthy environment for our patients and visitors. Access to safe, quality care is at the heart of every decision we make.”

Ware said she recognizes the difficulty of quitting and for that reason medical support is available to TRICARE beneficiaries and Medical Department Activity employees. The IACH Army Public Health Nursing Clinic runs a four-week Tobacco Cessation Support Program beginning the first Thursday of every month 11 a.m. – noon, at Caldwell Clinic. It provides group counseling sessions and medication.

Fort Riley employees who are not TRICARE beneficiaries may participate in the coaching and counseling sessions.

Caldwell Clinic is located at Normandy Drive, Building 7665. To enroll in the Tobacco Cessation Support Program, call (785) 239-7323. The next session begins Jan. 7, 2016. Limited seats are available.

No-Shows Hurt Other Patients

Ever had trouble making an appointment when you or your family were sick? It turns out that in many cases there are more than enough appointments available.

Don’t be a no-show. A missed appointment wastes time and resources. And it’s a missed opportunity for other patients.
Don’t be a no-show. A missed appointment wastes time and resources. And it’s a missed opportunity for other patients.

The problem is too many patients fail to cancel their appointments ahead of time. They simply choose not to show up. This means patients who really need to see their provider can’t.

Patients who can’t keep their appointments should free up their time slot and let someone else have a chance to see that provider, says Lillian Goddard, Irwin Army Community Hospital (IACH) Access to Care manager.

“Soldiers, Family members, and retirees who miss appointments cost fellow beneficiaries an opportunity to receive care,” she adds.

In the month of September 1,355 patients missed their appointments, and a total of 14,702 patients missed appointments in Fiscal Year 2015 at IACH alone. Imagine if those appointments had been available for those who really needed them.

“When patients get frustrated that there are no appointments available, we get frustrated too,” Goddard said. “We get frustrated because we know we have a percentage of no-shows and we want to get patients seen.”

Goddard recommends that patients cancel unneeded appointments four hours before a primary care appointment or 24 hours before a specialty care appointment to allow others a chance to use that time.

There are several ways to cancel an appointment. TRICAREOnline.com offers patients a quick option that provides a text confirmation of the cancellation.

Patients also have the option of calling the 24-hour appointment cancellation line at 239-8428 or responding to the Patient Automated Reminder System. However, using the PARS system requires patients to remain on the call until the cancellation has been confirmed.

“Patients often end the call after the prompt to cancel the appointment and they are considered a no-show because it wasn’t confirmed,” Goddard said.

For more information on booking, canceling and receiving appointment reminders through e-mail or text online, visit www.tricareonline.com.