Reconfigurable Army Hospital by Trisha Cobb

Trisha completed her thesis at NPS in December 2013.  Trisha's thesis deals with creating a force structure that would allow an army hospital to re-configure easily as the situation on the ground changes.

Executive Summary

 We will never know the operational environment of the future, so the Army Chief of Staff directed the planning of future forces to be flexible and agile so that it can conform to any hybrid environment and threat. The current role 3 medical treatment facility (MTF) is not 100% mobile which hinders its agility. The current role 3 MTF was created to support division/corps centric forces, however the Army has transitioned and invested in the agile and independently capable brigade centric combatant force. In order to be an integrated and versatile combat multiplier that is adaptive to the current situation, the role 3 MTF asset doctrinally needs a flexible and agile task organization.

We introduce a multistage optimization model that serves as a support tool to determine the optimal hospital configuration at each phase of a combat scenario. We utilize parameter data for recent contingency operations from the Center for AMEDD Strategic Studies and include input parameters for the commander’s assessment of the conflict development. We constrain the model to fixed sizes of medical wards and ensure we meet 95 percentile patient admission rates in each ward at each stage.

Based on our analysis, the current 248-bed role 3 MTF is over-capacitated for a brigade centric force structure. If we sustain the current ward configurations, a hospital with 124-beds (84-beds and minimal care ward augmentation) would be sufficient to support a brigade centric task force. However, the large ward sizes create unnecessary excess. If we created more flexible wards that are half the current sizes and optimally deploy our medical assets, we can reduce the deployment by 16 to 36 beds per deployment and hospital. Half-suite sizes provide a potential means to improve the rigidity and excess deployment of the current combat support hospital (CSH). A hospital minimally requires 44-beds to support 20,000 soldiers. If we saw twice the battle injury rates in Operation Iraqi Freedom (OIF), a 70-bed hospital would be optimal. The current 248-bed CSH far exceeds the capacity required to handle three times the OIF battle injury rates. Our multistage optimization model allows us to explore the ability of the CSH ward structure to adapt to a changing combat environment. We find that half-sized wards perform well in the notional combat scenarios we explore.

Our analysis shows that a robust role 3 MTF is between 44-beds and 124-beds, with smaller wards and the capability to independently deploy or combine to another hospital. The agile and flexible hospital we explore utilizes a constructive means to build an appropriate hospital size, rather than the current process of deconstructing a CSH to match the conflict. If the AMEDD utilized an optimized role 3 MTF of about 60-beds, similar to the mobile surgical hospital, the increased quantity of smaller efficient hospitals is capable of supporting the Army’s evolution to a regionally aligned force. The current CSH configuration will not support a sustained regional alignment of role 3 MTF.

Complete Thesis

Cobb, T. A. (2013).  Multistage Deployment of the Army Theater Hospital(Masters Thesis).  Naval Postgraduate School.

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