us air force military-civilian partnerships · 2020. 9. 4. · unclassified...

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UNCLASSIFIED US Air Force Military-Civilian Partnerships STARS-P, C-STARS and SMART Jeremy W. Cannon, MD, SM, FACS Col, US Air Force Reserve, MC Health Affairs, DHHQ, Falls Church, VA Traumatology, SCC & Emergency Surgery Perelman School of Medicine at the Univ of Pennsylvania [email protected]

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  • UNCLASSIFIED

    US Air Force Military-Civilian Partnerships

    STARS-P, C-STARS and SMART

    Jeremy W. Cannon, MD, SM, FACSCol, US Air Force Reserve, MCHealth Affairs, DHHQ, Falls Church, VATraumatology, SCC & Emergency SurgeryPerelman School of Medicine at the Univ of [email protected]

  • [email protected]

    DisclosureCol Jeremy Cannon, MD, SM, FACSI have financial relationship with the following organizations:

    UpToDate Author: REBOA, Extremity InjuriesACS, SESAP Author, SESAP 16, 17 & Audio CompanionCDMRP Research funding, Grant reviewer

    None of these relationships are directly relevant to this presentation.

    Commercial support was not received for this activity.

    These are MY OPINIONS and do not represent an official statement or endorsement by the US Air Force, Health Affairs, or the Department of Defense. This presentation was reviewed, approved by PAO.

  • [email protected]

    Learning OutcomesDescribe the history of US Air Force

    Military-Civilian Partnerships (MCPs)

    Understand the current complement of US Air Force MCPs

    Explain the challenges and successes of US Air Force MCPs Acknowledgments: Col Sampson (AF Surg Cnslnt),

    Col Ward (HA), Dr. Fildes/Col Snook (SMART)

  • [email protected]

    Overview Historic Air Force Mil-Civ Partner Sites Current Mil-Civ Partner Sites Challenges & Successes Air Force Future Plans for Mil-Civ Partnerships Air Force Summary

  • [email protected]

    Historic Perspective

    Post-Gulf War Introspection• Col Don Trunkey, MD

    – Lessons (Not) Learned– FAILURE of All Volunteer SVC

    • C-STARS sites selected 2001

    LTC Loyal Davis, MD• Chair of Surgery at Northwestern• Neurosurgery Consultant in WWII• Innovations in helmets and frostbite

    LTC DavisPMM-Lined

    Aviation Helmet

    Arch Surg 1993;128:261-4

  • [email protected]

    Current Mil-Civ Partner SitesCenter for Sustainment of Trauma And

    Readiness Skills (C-STARS)• Embedded Faculty & Staff

    – Trauma, Anesthesia, EM, GS– Nursing, Resp Therapy

    • Rotating Teams– Baltimore: Trauma, Critical Care– St. Louis: Trauma, Pediatric– Cincinnati: CCATT

  • [email protected]

    Current Mil-Civ Partner Sites

    Other STARS-P/SMART Examples• 60 MDG Travis AFB + UC Davis

    – Integrated Residency– US Air Force Surgeons = Adjunct Faculty

    • 6 MDG +Tampa General Hospital– US Air Force Trauma Surgeon

    Sustained Medical and Readiness Trained (SMART)• STARS-P replacement across AFMS (2015)• Local/Regional Partnerships for faculty• 99 MDG Nellis AFB + Univ Med Ctr Las Vegas

    99 MDG SMART ProgramJan 2015

    Feb 2016

  • [email protected]

    Current Mil-Civ Partner Sites Brooke Army Medical Center

    • Flagship DOD Trauma Center• ROBUST Trauma Volume + ECMO Transport Team• Partnership with UTHSCSA and STRAC InvaluableDOD ECMO TEAM

  • [email protected]

    Challenges & Successes w/MCPs Successes (Scalea, Galante)

    • 4000+ Personnel Trained at C-STARS Baltimore alone

    • Cadre = Embedded/Adjunct Faculty– Academic Productivity– Research Funding– Civilian Mentors

    Challenges (Scalea, Fildes)• Licensing• Malpractice Insurance, TRICARE Patients• Military Advancement/Promotion• Survey Results (Tyler, Schwab)

    JACS 2015;221:235-54

    2007;357(26):2723-7

    2017;152(9):891-3

    30-40% Across All Services

  • [email protected]

    Future Plans for MCPs

    C-STARS• Evolve to emphasize cadre benefit; coordinate TEAM training

    SMART• EVERY MTF to ensure trauma currency for CWS’s• Grow within the framework outlined in the SMART CONOPS

    How does a Commanderstart the process?

    1) AFI 41-106, Medical Readiness Program Management 2) SMART CONOPS

    Health Affairs Perspective: Enterprise Solution• Staffing shortages: Recruitment/Retention• Currency as measured by KSAs

    C-STARSRotators

    SMARTC-STARS

    (cadre)

  • [email protected]

    Air Force MCP Summary Military-Civilian partnerships represent a paradigm with historic

    roots and a bright future We were unprepared for Gulf War 1

    • Failed the 1st test of the all volunteer Military Medical System AFMS relies on C-STARS, SMART/TAAs

    • + Flagship partnership of BAMC/UHTSCSA/STRAC Challenges remain largely unchanged since 1998

    • Where is the WILL to fix these? (malpractice, licensing, curriculum variations) Successes are abundant, benefits are clear Playbook codified in AFI/CONOPS for future generations

  • UNCLASSIFIED

    US Air Force Military-Civilian Partnerships

    STARS-P, C-STARS and SMART

    Jeremy W. Cannon, MD, SM, FACSCol, US Air Force Reserve, MCHealth Affairs, DHHQ, Falls Church, VATraumatology, SCC & Emergency SurgeryPerelman School of Medicine at the Univ of [email protected]

    US Air Force Military-Civilian PartnershipsDisclosureLearning OutcomesOverviewHistoric PerspectiveCurrent Mil-Civ Partner SitesCurrent Mil-Civ Partner SitesCurrent Mil-Civ Partner SitesChallenges & Successes w/MCPsFuture Plans for MCPsAir Force MCP SummaryUS Air Force Military-Civilian Partnerships