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DOD Needs Better Assessment of Military Hospitals' Capabilities To Care for Wartime Casualties

HRD-81-56 Published: May 19, 1981. Publicly Released: May 19, 1981.
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Highlights

GAO reviewed the Department of Defense's (DOD) efforts to provide medical facilities for American casualties who would be returned to the United States for medical care in the event of a war in an overseas area.

Recommendations

Matter for Congressional Consideration

Matter Status Comments

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Defense The Secretary of Defense should provide guidance to the military services by permitting sufficient floor space in one-bed rooms to accommodate expansion flexibility for two beds.
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Defense The Secretary of Defense should provide guidance to the military services by permitting inclusion of medical utilities to support expansion beds in military hospitals planned for readiness areas.
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Defense The Secretary of Defense should require the services to complete planned capability assessments in conjunction with the updating of mobilization plans being completed in 1981.
Closed – Implemented
The military services periodically complete capability assessments.
Department of Defense The Secretary of Defense should provide guidance to the military services by requiring that economic feasibility studies assess and weigh, in conjunction with peacetime requirements, the mobilization implications of each construction alternative under active consideration.
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Defense The Secretary of Defense should provide guidance to the military services by requiring that design concept studies identify bed expansion capacity targets, within peacetime sizing constraints, for building the flexibility to expand for mobilization into military hospitals.
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Defense The Secretary of Defense should provide guidance to the military services by basing the distribution of one-, two-, and four-bed rooms on an assessment of expected peacetime patient needs and mobilization requirements.
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Defense The Secretary of Defense should provide guidance to the military services by reducing, where appropriate, the number of one-bed rooms in favor of two-bed rooms to improve mobilization capacity of key readiness hospitals.
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Defense The Secretary of Defense should develop criteria for services' use in determining which military facilities, such as on-post barracks, housing, or schools, are suitable for medical readiness use to augment military hospitals.
Closed – Not Implemented
GAO believes that, without a policy which standardizes the definition of auxiliary on-post facilities to augment hospitals in case of war, DOD may have a difficult time in providing an accurate assessment of facilities available for mobilization. DOD stated that the feasibility of using nonmedical facilities for mobilization is governed by other standards and no other guidance is needed.
Department of Defense The Secretary of Defense should provide guidance to the military services by identifying adjustments in normal hospital operation procedures for nursing units and central surgical and medical support areas necessary to accommodate emergency expansion and compressed bed spacing during mobilization.
Closed – Implemented
DOD recognized that it did not have adequate instructions for the services to follow in developing mobilization plans. DOD issued a directive on mobilization planning in April 1986, and created a Defense Medical Facilities Office in 1987 which, among other things, will develop a long-range plan for medical facilities.
Department of Defense The Secretary of Defense should instruct the services to remove from their mobilization plans such designated commercial buildings as hotels and motels that have been designated for conversion to hospitals.
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Defense The Secretary of Defense should develop, as part of a 5-year construction plan submitted to Congress, information necessary to assess the impact on mobilization of each hospital to be replaced. For hospital replacements not included in the current DOD construction year, information provided should be identified as preliminary pending approval of planning funds for more detailed design development.
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Defense The Secretary of Defense should assess past hospital design concept studies undertaken by DOD and new hospital design concepts being implemented in civilian hospitals to identify hospital construction design practices that would enhance flexibility for mobilization expansion. Design practices found useful for this purpose could be utilized by the military services for designing future hospitals.
Closed – Not Implemented
Congress established a panel to review the criteria for sizing military hospitals. Because this panel could recommend significant changes in the criteria, this recommendation, at this time, is no longer valid.
Department of Defense The Secretary of Defense should require the military services to reassess mobilization plans to determine if hospitals and augmenting buildings are in adequate physical condition and are operationally configured to function at planned mobilization expansion capacity.
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Defense The Secretary of Defense should instruct the services to remove from their mobilization plans those inactive hospitals that cannot be efficiently equipped and operated under expanded wartime requirements, and retain rights to newer hospitals that have been excessed, but offer additional operating potential.
Closed – Not Implemented
DOD concurred that mobilization plans should include only those inactive hospitals that can be mobilized quickly in case of war. However, DOD believes that its current criteria is sufficient to determine which inactive hospitals are adequate for combat casualty care. Consequently, DOD does not feel that it is necessary to issue more guidance on this matter.
Department of Defense The Secretary of Defense should provide criteria for the military services to use in developing mobilization transition plans for each hospital that provide for the: (1) conversion of facilities to wartime configurations; (2) stockpiling for war readiness of beds and materials to support expansion capacity; (3) phasing out of peacetime patient work loads; and (4) transition of hospital operations to designated mobilization staffs.
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
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Topics

Employment
Defense contingency planningFacility constructionHealth care planningHealth care programsMilitary facility constructionMilitary hospitalsMobilizationWarfareVeterans hospitalsHospitals