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Improving Class VIII Management at Brigade Level

To support units medically, a logistician relies on his ability to assess the situation and rapidly adapt to accomplish the mission.

The success of supporting the ongoing medical mission is influenced by both an understanding of medical logistics and a personal desire to help define its role. With increased demand and, often, insufficient personnel and equipment, our ingenuity and capabilities are repeatedly tested. The future of medical logistics depends on the partnerships and collaboration that can be delivered only by cross-leveling existing resources in order to increase the capability to integrate logistics solutions in austere scenarios. Establishing parameters by which units become self-sufficient is a major challenge for logisticians during predeployment planning. The role of the medical logistician is changing significantly because of the complexity of today’s battlefield. In this article, I will address actions a brigade medical supply officer can make to improve medical logistics.

Considerations

Studying lessons learned, planning, and coordinating serve as crucial tools for forecasting unit requirements. When forecasting requirements for medical operations, you must consider the mission, the location, the medical threat, and the medical assets available in the area of operations. Determining multiple courses of action and methods of execution will ensure accessibility of supplies and the frequency of their delivery. Coordination must include all levels of command. You should establish standards and enforce their implementation to guarantee that tasks are met. The medical materiel management section under the division surgeon’s office revises a wide-range of reference materials when preparing for a potential deployment. Documents, like old standing operating procedures, information papers, and after-action reports, will assist in the planning process.

Networking

Network! Network! Network! Establish a division or post medical logistics council to discuss medical logistics issues unique to your location and mission. This will facilitate the cross-leveling of information, lessons learned, and experiences among your peers and senior logisticians. Use your medical materiel management officer at the division surgeon’s office to endorse and head this council. Be sure to include the medical logistics staff from your installation medical supply activity (IMSA); they will provide a different insight on what is going on within the Army Medical Department (AMEDD). While deployed, try to continue this endeavor.

As a leader, it is your responsibility to mentor your subordinates. This will motivate the troops and increase productivity that, in turn, will ensure the success of your organization.

Identifying Unit Needs

Establishing rigorous readiness inspections improves the unit’s posture and identifies last-minute discrepancies. As a medical logistician, you must conduct a primary assessment to identify unit standings through a complete layout of the medical equipment sets. Use updated authorized stockage lists or component listings to assist in the inventory process. Compile a shortage annex once discrepancies are recognized. Conduct semi-annual authorized stockage list reviews with your clinicians. Provide guidelines for the units to follow while conducting those inspections, and set a suspense date for completing fills of sets, kits, and outfits. Present the outcomes of the survey to the unit’s chain of command, and offer recommendations on how to improve the unit’s operation.

Provide the 6th Medical Logistics Management Center (MLMC) and your IMSA with the brigade’s top critical items lists. These items can be identified based on the number of demands accumulated during a designated timeframe. The “MEDSUP” module on the Theater Army Medical Materiel Information System (TAMMIS) can create a “Critical Items Report.” Providing this information to either supply activity will ensure availability and accessibility in short turn-around times. You also can identify those items available in theater by using the mission essential equipment list or request for information format through the U.S. Army Medical Materiel Agency (USAMMA) Emergency Operations Center (EOC) or the Office of The Surgeon General EOC.

Prime vendors play a significant role in the way we conduct business in today’s Army. Schedule an appointment through the IMSA’s chief of logistics or chief of supply to meet with the prime vendor representative for your area. Creating good communication with your vendors, suppliers, and customers will directly affect your success.

Contingency Stocks and Standardization

A unit’s reaction time increases when contingency stocks are kept for urgent situations. Contingency stocks can be configured into sets for a specific brigade combat team (BCT) medical support activity, such as an infantry battalion aid station (BAS), a special troops battalion BAS, or a brigade support medical company. These sets are organized mainly by the potency and date of the items. The brigade surgeon, in collaboration with the division’s primary healthcare providers, determines the composition of these sets. The unit authorization list, found on the USAMMA website or in the unit data repository, can serve as a guide for determining set composition. These sets are managed and maintained by the brigade medical supply office (BMSO) and will be pushed to the BCT after it receives deployment orders.

Compile a critical and chronic medication list. This will guarantee accessibility to hard-to-come-by medications, especially when you are forward deployed. Plan, configure, and deploy a 3-day supply of sick call sets and trauma #2 sets with each battalion surgeon to ensure that your clinicians have immediate access to medications once they arrive in theater and are waiting for their medical equipment sets to arrive. Implementing these simple measures will increase medical support capabilities and Soldiers’ survivability.

Fund Forecasting and Procurement

Coordinate through the chain of command to ensure that unit requirements are legitimately recognized for the allocation of funds to procure stock replenishments. The brigade surgeon and the comptroller play a major role in this process. The BMSO is responsible for processing regular requests, tracking orders, and issuing stocks to customer units.

With the assistance of your brigade S–4, battalion surgeons, physician’s assistants, and medical platoon leaders, determine the top 10 projects for special requirements. The brigade surgeon’s office is responsible for compiling a brigade requirements list and processing the purchase request through contracting.

Use historical data to determine the next fiscal year’s funding requirements. Establish a means of tracking requirements and expenditures, provide visibility to your chain of command for all class VIII expenditures, and institute situational awareness reports on medical supply issues.

New Equipment and Potential Fielding

The USAMMA website provides information on future equipment upgrades, new equipment fieldings, and unit qualification procedures. Unit deployment packages are available for echelons-above-division units, including forward surgical teams and air ambulance companies. These packages include only the potency and dated items authorized for their corresponding medical equipment sets. Units should formally request required equipment through USAMMA. When items are issued, coordinate with the property book office to update hand receipts. Then, coordinate through USAMMA or the equipment manufacturer for operator-level training.

Participate in medical symposiums endorsed by USAMMA and AMEDD. They provide great sources of information, permit direct interaction with vendors, and allow you to learn about new technologies and medical supplies. Invite vendors and manufacturers to come to your home station. Coordinate with exhibitors to allow you to test their products during training events to ensure their effectiveness under austere conditions. Provide feedback on your findings to Defense Supply Center Philadelphia for potential Army-wide implementation.

Establishing an Account

Once your unit receives deployment orders, contact the property book office or your brigade S–4 and request a derivative or deployable Department of Defense activity address code and an account processing code. This funding site will ensure that you can order in the theater of operations. Contact the international merchant purchase authorization card (IMPAC) section at your installation contracting office and make sure that your account is up to date. You should also make sure that your type address code is accurate to guarantee correct delivery of supplies to your forward location.

Training

Training is a key element in the success of your mission. The military occupational specialties 68J (medical logistics specialist) and 68A (biomedical specialist) are some of the most highly skilled personnel in the Army. Training is essential to ensuring your Soldiers are technically qualified. Coordinate with your chain of command to allow your section to conduct at least 4 hours of low-density training once a month. Forecast for additional training funds for off-site training. You should also establish a memorandum of agreement with the combat support hospital, establishing an on-the-job training program for your 68A Soldiers. This effort will expose your 68A Soldiers to all the pieces of medical equipment available in the Army inventory.

Your staff’s proficiency is only as good as their understanding of the operating systems that support their mission. Thus, your Soldiers should be acquainted with TAMMIS, the TAMMIS Customer-Assisted Module, and the Defense Combat Assistance Module. The USAMMA Materiel Acquisition Division has learning modules and training materials available to help meet this training need.

Assistance Visits

Conduct assistance visits to the medical activities in the brigade to share procedural changes and catch last-minute needs. The BMSO will process these requirements immediately. You should also provide tactics, techniques, and procedures for handling push packages, line requisitions, and blood requests once engaged in the battle. Continue to set the standard for focused medical logistics. Medical units need to stand ready for all new challenges. Create an inspection sheet that incorporates all of your unit requirements, and establish a rating system to classify medical readiness status and to ensure that medical supply procedures are followed. Provide the results of your inspections to the unit’s commander to keep him aware of the situation.

Modern warfare is extraordinarily diverse and full of theoretically possible variations. Experiences from others can have a positive impact on the mission. To stay abreast of new ideas and procedures, use sources that are objective and informative, such as the AMEDD Lessons Learned webpage, the General Dennis J. Reimer Training and Doctrine Digital Library, and Army Logistician. Identify any guidance that can be adapted to current operations. The bottom line is to learn from other’s mistakes and benefit from other’s knowledge.
ALOG

Captain Edwin H. Rodriguez is the Chief of Logistics Plans and Readiness for the Office of the Deputy Chief of Staff for Logistics, Army Medical Research and Materiel Command, at Fort Detrick, Maryland. He holds a bachelor’s degree in biology from Inter American University of Puerto Rico and a master’s degree in health service management from Webster University. He is a graduate of the Medical Logistics Management Internship Program and a member of the Association for Healthcare Resource and Materials Management.