Estimating sustaining base-hospital personnel requirements during extended operations.

This case study provides a unique method for estimating sustaining base military hospital personnel requirements during combat and stability operations while underscoring the need for such analysis before the commencement of combat operations. The requirement estimates are based on a major combat operation (MCO) scenario, which was extended to simulate stability operations. The scenario selected derived from Department of Defense strategic planning guidance as modeled by the Total Army Analysis (TAA). Since casualties experienced in combat result in additional workload for military hospitals, a mechanism for estimating that workload is required. A single scenario generated as part of an analysis for the acting Army surgeon general produced a median requirement of 1,299 additional full-time equivalents (FTEs) over the course of 36 months, highlighting a significant gap between capabilities and requirements.

A Monte Carlo simulation of air ambulance requirements during major combat operations.

In this study, we evaluate rules of allocation and planning factors that have an effect on requirements for Army air ambulance companies. The Army uses rules of allocation in scenarios drawn from strategic planning documents to determine how many units of each type are required. Army planners use these rules for determining the number of units required to support specific operational and tactical scenarios. Unrealistic rules result in unrealistic unit requirements. We evaluate quantitatively (via Monte Carlo simulation) planning considerations for air ambulance units during major combat operations (MCO) and estimate that 0.4 airframes per admission would be a reasonable planning factor.

Skip policy: road to Force Health Protection 2010.

The 2010 Force Health Protection Capstone concept envisions a single level of theater hospitalization and a greater reliance on the strategic movement of casualties from the theater. A significant Force Health Protection implication is 100% of the combat zone patients leaving theater will not have a second stay at an echelon/level IV hospital. In 2000, the Army began moving toward the Force Health Protection concept by using a skip policy for determining 2007 medical force structure requirements. Implementing the skip policy avoids (eliminates) the second echelon/level IV hospital length of stay for a percentage of combat zone patients leaving theater. The Army's decision to implement a skip policy exposed the complexities associated with determining deployable medical force structure requirements and the inherent inter-relatedness of the services medical mission.