Breaking News: DoD Admits New Walter Reed Not World-Class

DoD Photo Deputy Secretary of Defense Lynn

The Department of Defense informed Congress late last month that the new Walter Reed National Military Medical Center (WRNMMC) will not be a world-class facility after all. This stunning admission came from Deputy Secretary of Defense William J. Lynn, III in a letter to congressional defense committees:

"While Congress has specified that the new WRNMMC and FBCH should be designed and constructed to be world-class military medical facilities, this is not an underlying requirement of BRAC 2005 recommendations. Instead the development of these facilities as world-class military medical facilities in collaboration with our academic and clinical partners such as the Uniformed Services University of the Health Sciences (USUHS), National Institutes of Health, and Veterans Administration will be an ongoing requiring continuous improvement and bench marking to commercial best practices. "

Finally, in black and white, the Department of Defense admits that after spending the approximately 400 million dollars budgeted and an additional already huge billion dollar cost overrun, the new Walter Reed National Military Medical Center will fall far short of world-class status. The new Walter Reed will not even possess all the capabilities now available at the Current Walter Reed. Rather, this new facility will have significant shortcomings: too few and too small operating rooms, infection spreading two person rooms which are no longer even state of the art for medical centers and completely inadequate patient and employee parking. These are just a few challenges facing this construction debacle; there are many more. One other point, a quote from a US healthcare analyst who will remain nameless:

"...if best commercial practices in health care are so good how did America dig itself into such a hole by using them? Military health care has some unique characteristics and requirements and we need to wake up and understand them."

On 18 October, I asked:

"It is long past time, for DoD, the Navy and the Joint Chiefs to review the entire project. They must admit that the construction of a true world class facility cannot be accomplished within the time and funding constraints established by Congress. Will our military and civilian defense leadership display both the character and the integrity to guarantee our military receives the world class facility promised by Congress or will they saddle our military with an inadequate facility and hidden costs far into the future? "

Secretary Lynn's answer followed both paths. He acknowledged that the new Walter Reed will not be world-class but then proposes continuing on a path carrying cost overruns far into the future, if the facility is ever to become world-class.

What I find amazing is that in addition to apparently condoning the mismanagement of the entire National Military Medical Center project, there is no failure admitted or proposals for correction. In essence, the Department of Defense kicked the can far into future budget cycles. In the meantime our troops and their families will be deprived of Walter Reed and shoehorned into a facility that may not even achieve state of the art for modern medical centers.

Congress should halt further construction as soon as possible. Guarantee the needs of our military are properly met and tax payers dollars not squandered further. As an "Air Force guy" with no axe to grind, DoD should assign the Bethesda project lead to the US Army as the Navy clearly is not up to the task.

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Comments

[catuskoti]

Great article, Hal. It looks like Obama is turning his back on every constituency that got him elected (with one glaring exception).

[Military Physician]

Mr Hahn, the present operating rooms at Bethesda navy hospital are too small. The existing OR Complex has 15 rooms that were constructed in the mid 70's, and since they were constructed no major renovations have occurred! This planned new hospital is presently a shoebox operation. There is internicine fighting, and the capable leaders of this undertaking are being manipulated by politics. The JTF CAP MED is not really in the hands of the people who should be running the project.

In addition, there is presently no plan to have an additional Ambulatory Surgery Center constructed on the WRNMMC campus! This "oversight" is one where ambulatory procedures must be carried out in the main operating rooms and thus compete for OR time with other major surgical procedures.

Mr Hahn, take a trip to Memorial Sloan-Kettering Medical Center if you really want to see operating rooms of the future. All the rhetoric about what is being built in Bethesda falls far short of the mark in the 21st century.

[Hal Donahue - Huffpost Blogger]

Exactly! The new Walter Reed was never designed to be world-class. Why not take time and actually define a world-class institution that will last the military another 100 years?

[Pablo Manriquez - Huffpost Blogger]

Who should be running the project?

[Hal Donahue - Huffpost Blogger]

Please read again

[James Hahn]

Walter Reed will be second to none.. and I challenge you to show me a better, newer facility.s not the Old WR nor the Old Navy Medical. for every thing you show me it doesn't have I'll show you 5 new things it does.. Like operating rooms( since it was mentioned) that measure every facet of the environment and patient status.. with instruments that 5 years ago were but a dream. smaller more efficient and no doctor will ever take the old version. From an insurance and Risk Management view.. state of the art and World Class. Lastly, Your conclusion that this should be assigned to the Army just shows your lack.. They are doing a good job as is the Navy in trying to put this Hugh program together, peoples lives are involved here.. But this is not a Navy problem or any problem I can see; this is guided and directed by Joint Task Force, as always there are some problems with Administration. People are involved and the services they love and are loyal to.. But to just give it to ARMY as is your solution just shows howr blind to your own loyalty. This change is, painful " World Class Military Medicine".. Show me better,!!!! I can't even begin to tell you how great I think its going to be.. How many military lives are going to be impacted?? and there will be a time that Pride to be at this facility will reign. I'm Biased

[Hal Donahue - Huffpost Blogger]

Then fine. Why do you object to a pause and a look see? The FACT is some parts will indeed be awesome but other parts will not even match up to what exists now. I have no loyalty to the Army as I pointed out. My concerns are that some portions of the new complex do not even meet state of the art. Let's pause and assess. Quite frankly the Navy has not delivered a BILLION dollar cost over run and expenses into the out years are proof. Prove me wrong. Let's stop and access.

[James Hahn]

I was a little disappointed in the article.. find it a stretch for sensationalism and always love the unidentified sources.. two patients to a room is common and as the new thinking goes a single patient to a room is preferred from a infection standpoint, ( hospitals have more contagious infections then any place) but new thinking has found the infection problem to be a problem that needs to be solved elsewhere.. building costs for providing single patient rooms with one john, oxygen hook-ups and the additional electric needs of a room are almost cost preventive. except in the most private hospitals.. there iso discussion regarding patient interaction in the latter stages of recovery that might aid the healing process, someone laughed at the idea to get better, to get away from your new roomy. Parking issue at the new hospital has been addressed. World class is in the eye of the beholder but when there is talk of the New Walter Reed having a research and education facility to study brain trauma and all its implications not only from a soldiers standpoint but for application on everything from football to auto accidents.The common language used is World Class.. a great facilityy .. its size is amazing .. the facilities being built are top notch and I say this after being a viewer of the Fitzsimons Army Hospital facility in Aurora, Co. with both Private and Military ( New VA Hospital) Children's Hospital and University of Colorado Med Center.

[Hal Donahue - Huffpost Blogger]

First, I have no need for sensationalism. The facts speak for themselves. As does the report from the Defense Health Board subcommittee if you care to review it. Two patients to a room is being phased out everywhere from both a privacy and a infection standard. Infections indeed need to be solved elsewhere but they are helped spread by the two person room. This may set your hair on fire but cost was not a factor. The direction was to build a world-class facility; the Navy by the admission of DoD failed that mission. The parking is not "solved" and then shall I mention the disappearing rooms for family staying with the sick and wounded? The Navy "lost" over 100 rooms for family forcing them to stay on the very high cost economy. I have seen the very worst ( I was in inpatient at Walter Reed during the last abuse of troops incident) and the best (walking the wards at Walter Reed). I want accountability. Why did the Navy fail. Let's cut off all funding until we know. The new Walter Reed should indeed be world-class and as DoD says right now it will not meet that standard.

[tompoe]

Better we focus on Baghdad embassy, with its pools and amenities. The DoD has priorities, you know.

[Hal Donahue - Huffpost Blogger]

The embassy is state Department at least nominally. I think it is just a continuation of the incompetence of the last regime. The damage done by David Chu and Donald Arthur, retired Navy surgeon general, lives beyond them. It will take a very concerted effort to root out the ingrained culture of incompetence. Difficult to believe but Chu is burrowed into DOD some place...