Annual Report the Surgeon General United States Army Fiscal Year 1960
MANAGEMENT
Management Improvement Exchange Program
The Army Medical Service has established a system whereby its hospitals and dispensaries can report noteworthy improvements developed in the management of their facilities to the Office of The Surgeon General. This office will consolidate and publish lists of information concerning these improvements and distribute them to each
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hospital and dispensary. This exchange of management information among Army medical treatment facilities was announced in Department of the Army letter, dated 10 February 1960, file AGAM-P (M) 310.1 (7 Jan 60) MEDDD-HM, subject: 'Hospital Methods Improvement.' The objective is to provide better patient care, which, the letter points out, can be more readily achieved by constantly striving to improve methods, procedures, and equipment throughout the entire hospital and dispensary system. The information lists are to be published on a continuing basis and efforts will be made to include improvements accomplished in medical facilities of other Federal agencies as well as some civilian hospitals. The first list was published and distributed, on 5 May 1960, in DA Circular 40-9, entitled 'Hospital and Dispensary Methods Improvement.'
Mechanical Reproduction of Medical Examination Reports
As the result of a study conducted in the OTSG during the fiscal year, the Department of the Army approved the utilization of a mechanical process for reproducing the required copies of reports of medical examinations (Standard Form 88) and other types of medical reports. The study determined that the mechanical method is not only feasible but also expeditious, effective, and economical because it eliminates the necessity for repetitive typing of medical reports and expedites final processing. The mechanical processing system requires special equipment and its use by Army medical facilities is optional. Instructions regarding procedures to be followed in implementing the system are contained in DA Circular 40-5, dated 11 April 1960, which was distributed throughout the Army.
Centralized Materiel Section Manual
Technical Manual 8-275, Centralized Materiel Section, was revised and is scheduled for publication early in fiscal year 1961. This manual covers those activities which are performed in the hospital centralized materiel section, including the deviations and methods peculiar to TOE hospitals. It includes the organization of the centralized materiel section work areas, operational techniques, preparation of supplies, care of equipment, and basic tray setups. The manual will assist and guide inexperienced nursing service and other hospital personnel in peacetime and mobilization operations and on-the-job training.
Handling and Control of Narcotics and Drugs
A more accurate and efficient register procedure to account for narcotics and controlled drugs at the ward level in Army hospitals was established during the fiscal year. This improved method is designed
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to remove chances of errors through the use of standard terminology and of standard units of all drugs accountable by law.
Prepackaged cartridges of selected antibiotics and a new type of narcotics drug counter and dispenser were developed during the year.These items are now listed in the supply catalog.
Budgeting
There was introduced into the budgeting system for the first time the Cost and Performance Summary Report (RCS MEDOC-277) in accordance with the provisions of AR 11-46, Army Command Management System Cost and Performance Summary, dated 4 June 1959. The objectives of this report are to provide (1) a basis for the financial adjustments of Army Medical Service Programs, (2) information for the financial evaluation of program accomplishments, and (3) information for the distribution of available resources and for the development and defense of budget estimates.
Mechanized Accounting
The Army Medical Service continued its program for modernization of accounting operations through mechanization. Procedures and equipment, which were pilot tested at WRAMC during the previous year, were installed at Letterman, Madigan, and Valley Forge General Hospitals in fiscal year 1960. Preliminary planning and action directed toward the mechanization of the remaining class II hospital finance and accounting offices (at Fitzsimons and William Beaumont General Hospitals and at Brooke Army Medical Center) were concluded. Also, during the year, the finance and accounting procedures being installed in the class II hospital system were modified for compatibility with automatic data processing equipment at the Louisville Medical Depot. These procedures were tested by the depot during the fourth quarter of the fiscal year, with 1 July 1960 as the target date for discontinuance of manual accounting operations.
This program was initiated in order to improve the quality and timeliness of the financial data supplied to management personnel at all levels of command. The system's design is adaptable to future utilization of electronic computers wherever feasible. The electrical accounting machine element of this improvement, which utilizes conventional carriage-type accounting machines for posting subsidiary ledgers, with the simultaneous preparation of punched-paper tapes, permits the preparation of most internal and external reports by punchcard methods, resulting in more accurate and timely financial data from field installations.
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Automatic Data Processing Systems
Recommendations of The Surgeon General's Ad Hoc Committee on ADPS (automatic data processing systems) were approved and implemented during fiscal year 1960. Included in these recommendations was a proposal that the ADPS Project Group conduct studies to determine specific applications of ADPS within the OTSG and the methodology for conducting these studies. Although considerable progress has been made on the studies concerning applications in the OTSG, much additional work remains to be accomplished.
The Surgeon General authorized a study concerning the desirability of utilizing ADPS in AMEDS class II activities. The objective is to determine whether the manual or mechanized business-type procedures presently in use can be improved with ADPS from the standpoint of economy, timely availability of required data, and a potential for expansion during mobilization. This study is being conducted by a task group, composed of personnel from Walter Reed and Brooke Army Medical Centers and Fitzsimons General Hospital, which is working at the Walter Reed Army Medical Center, with the executive officer of the Center as chairman, under the general surveillance of The Surgeon General's ADPS Committee. The study encompasses the fields of supply, financial, and personnel accounting, and medical statistics. The task group will review administrative procedures, determine data requirements, and evaluate the utilization of the latest mechanical devices and electronic computers to fulfill these requirements. The study is expected to be completed in December 1960.
Study of Army Medical Service Reports
An intensive review of medical reports, a project initiated during the previous year as part of a comprehensive, long-range study of Army reporting under the monitorship of the Comptroller of the Army, was completed by the OTSG in fiscal year 1960. To conduct the project, The Surgeon General established a committee on AMEDS reports with broad responsibility for complete review of the medical reporting system. The committee reviewed a group of 23 reports, representing 90 percent of the workload generated by medical reports, and achieved substantial reductions in the workload as well as improvement in the quality of the reports. Of the 23 reports analyzed, 13 were found in need of revision. Revised regulations for the reports have been published except for three report revisions awaiting clearance or review in Office of the Secretary of Defense. When all these actions are completed, the annual report workloads will be reduced by an estimated 390,000 manhours, or about 20 percent.
