Written by LTC Kenneth Reed
On 17 October 2019, FORSCOM executed a Chief of Staff of the Army EDRE program which directed the XVIII Airborne Corps to conduct a no-notice Level III Emergency Deployment Readiness Exercise (EDRE) for the 531st Hospital Center (HC) (44th Medical Brigade — Ft. Campbell, KY). The 531st HC, comprised of the 586th Field Hospital (FH), 175th Surgical Augmentation Detachment, 41st Medical Detachment and 431st Medical Detachment (Intermediate Care Ward) deployed 336 Soldiers to Sierra Army Depot (SIAD) from 22 Oct to 6 Nov 19. The exercise (a no-notice EDRE) tested the unit’s ability to deploy in support of large scale contingency operations (LSCO). Additionally, Fort Campbell’s installation capabilities were tested to provide outload support of a tenant unit with the 101st Airborne Division (AASLT) Emergency Operations Center taking lead for Mission Command.
Once on ground, the 531st HC replicated the draw of Army Prepositioned Stock (APS) by way of the Medical Material Readiness Program (MMRP) located at SIAD; a 148-bed 1/1/1/1/1 configuration. Once initial operating capability (IOC) was met, the 531st HC assumed OPCON of the 115th FH (Ft. Polk, LA — 1st MED BDE) and 198th Medical Detachment (ICW) (Ft. Hood, TX — 1st MED BDE) at the National Training Center (NTC), Ft. Irwin, CA as they supported 3rd Cavalry Regiment’s 20.02 Rotation. This is the first FORSCOM Medical Exercise to test the 1/2/1/1/2 doctrinal configuration with a HC providing Command and Control over two geographically dispersed FHs with 240 total Beds. An explanation of the 1/1/1/1/1 and 1/2/1/1/2 doctrinal HC/FH modularity concepts is found in ST 4–02.10 (Field Hospital Operations). An illustration of the configuration is provided below.
The 531st HC conducted 16 days of medical/hospital training including live air evacuation training with USAF fixed wing assets. Patients were decompressed from NTC to SIAD and ultimately to a Role 4 platform at Brooke Army Medical Center, Joint Base San Antonio, TX. Effects and enablers were provided as enhancements to injects by the Medical Readiness Training Command (MRTC — ARMEDCOM) providing an array of SIM-MAN manikins, and live role players utilizing “cut suits” which enabled surgical teams to perform realistic procedures on role players as casualties entered the facilities at both locations. Additionally, contracted audio/visual support provided real-time / live video recording of both internal and external operations at the 586th FH and 115th FH to include time lapse video footage of the hospital complexing. The video footage enabled Observer Controllers, key stakeholders, and leadership involved in the exercise to view hospital operations without even stepping foot into the facility.
In addition to training, the TRADOC Capability Manager for Army Health Systems (TCM-AHS) evaluated medical maintenance and clinical systems employment as well as collecting comments pertaining to doctrine, organization, training, materiel, leadership and education, personnel, facilities, and policy (DOTMLPF-P) to drive future adjustments to HC doctrine. TCM-AHS is a newly established organization which coordinates with all Army commands, all Active and Reserve component Medical Commands/Brigades, the Medical Center of Excellence Capabilities Development and Integration Directorate (CDID), and program/product managers for centralized management of TRADOC fielded force integration activities related to all Army field medical units. A hospital conversion AAR and equipping review for the 531st HC is currently scheduled for a brief with the FORSCOM G4 in early January. This AAR will spearhead the discussion topics moving into the HC Conversion Summit scheduled for late January 2020. Additionally, FORSCOM G3 will host the formal EDRE AAR with all stakeholders in late January 2020 via SVTC to evaluate each phase of the EDRE and to assign roles and responsibilities for improving future EDREs.
During the EDRE, the unit was exposed to a mock Unit Deployment Package (UDP) configured by the 44th Medical Brigade and encompassed over 80 Tri-walls of CL VIII including Potency and Dated items to allow the FH to outfit and fully stock each section of the hospital to reach Full Operating Capability (FOC). For many personnel in the FH, this was their first time breaking down a UDP and drawing MMRP.
From a medical operations perspective, it is important to keep in mind certain planning factors when employing a FH / HC with MMRP/APS (Army Prepositioned Stock). While many planning factors were identified during this EDRE, the following are identified as critical planning factors.
Functional Preparation and Packing
USAMMA does not “functionally pack” durable and non-expendable items within the MMRP however, CLVIII UDPs (expendables) are functionally packed by the hospital section. The term “functionally packed” is commonly used with Combat Support Hospitals (CSHs) and FH to explain how organic MTOE equipment is configured to ensure it is delivered in the order in which the hospital should be complexed. For example, after staking is complete, ensuring all of the emergency medical treatment section and ISO containers for the hospital are delivered first (to include power/water distribution) is one method of establishment.
This is critical to achieving IOC/FOC as there can otherwise be significant delays which need to be clearly articulated to the
CCMD Commander thus affecting capacity and capability. One such delay encountered during the EDRE involved the repackaging and sterilization of
surgical instruments. FHs typically have instrument sets pre-built; however, in utilizing MMRP, each set had to be built as instruments were configured for inventorying purposes only.
Mission Command Systems
The establishment and synchronization of MC systems such as Command Post of the Future (CPOF) and Command Post Computing Environment (CPCE) are critical to the warfighter and the HC. Within the medical community it is imperative to continue to train on these MC systems as they allow for predictive analysis of potential patients and visibility of higher, lower, and adjacent units within the Area of Operations. Populations at risk, and assets available for employment are continuously assessed throughout medical planning and should remain nested with the warfighter. Furthermore, although these systems were exercised at SIAD and NTC, simple modifications to hardware and/or software can make the sharing of a common operation picture between units challenging.
The excellent partnership of all stakeholders created a challenging and realistic environment to test the unit’s readiness and ability to perform operations in support of LSCO.
Overall, LTG Quintas (DCG FORSCOM) and LTG Dingle (Surgeon General, U.S. Army) deemed the exercise a remarkable success. The excellent partnership of all stakeholders created a challenging and realistic environment to test the unit’s readiness and ability to perform operations in support of LSCO. It is clear the EDRE program truly tests a unit’s ability to respond to contingency operations while adapting to the ever changing operational environment. Maximizing unit readiness remains the #1 priority for FORSCOM. This exercise validated that the 531st Hospital Center is ready to fight tonight!