Attachment_J-10,_Medical_Capability_Reports.docx

A. Location Overview and Geographic Scope

B. Standard of Health Care Provide an overview of the current health care status and the drivers that may be causing any deficiency. Include details on the country medical risk rating.

1. Outpatient Care Describe the general outpatient capabilities and what generally should not be handled locally

2. Inpatient Care Describe the general inpatient capabilities and what can and should not be handled locally

3. Dental Care Describe the general dental capabilities and what can and should not be handled locally

4. Medications Describe the ability to get quality medications in the area.

5. Diagnostics Provide an overview of the diagnostic services that can be provided around the location and provide alternatives to any deficiencies in capabilities.

6. Blood Supplies Describe the current status and quality of blood supplies in area. Provide guidance on the use of local blood.

C. Paying for Health Care Describe the customary and reasonable charges for paying for healthcare in the location.

D. Recommendations for Care

1. Trauma

2. Transfusions

3. Routine Care

4. Dental Service

5. Gaps in any medical or emergency capabilities and recommended mitigation strategies.

E. Hospitals: Complete a hospital fact list as specified in Attachment J-10, Addendum 1, Hospital Information Sheet, for all hospitals in the location specified in the MCR request.

Medical Capability Summary (summary of all hospitals in area)

F. Medical Transports

1. Airport Information (Nearest, Hours of Operation, etc)

2. Air Ambulance Availability

3. Availability of Commercial Medical Transports

G. Urgent/Emergent Care Procedures

1. Emergency Contact Details

2. Emergency Medical Procedures

Section J Attachment J-10 Medical Capability Reporting

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Addendum 1, Hospital Information Sheet

General Overview

· Facility name and address

· Main Phone, Fax# (if available), Website Address

· Main Administrative Contact

· General description of the hospital languages spoken; availability of interpreters

· Specialty of the hospital and whether Public/Private/Military

· Existence of Backup power source

· Hours of Operation (Outpatient and Emergency)

· Facility Level of Care

· Facility Accreditation

· Accreditation

· Overview Nursing-level of education

· Cultural Rules of Engagement

· Female patients

· Male patients

· Minors

· Clothing/Dress

· Escorts requirement/Non-medical attendant requirement (In some countries nursing care is performed by family members)

· Berthing/Dining accommodations

Proximity Information

· Geographic coordinates of city

· UTM Distance from the airport

· Distance from bus or train station

· Distance from port (if applicable)

Medical Overview

· Overview of wards (number of beds)

· Types of beds (ICU, CCU, Etc)

· Internal Credentialing Policy of Providers Operating room capabilities

Medical Specialties

· List of Medical Departments/Specialties and rehabilitation services

Emergency & Trauma

· ER/Trauma capabilities, (# of beds, mass casualty capability, ambulance overview)

· Helicopter landing zone (maximum weight allowance)

· Casualty evacuation plan

· Decontamination capability

· Ambulance Overview: Must be precise on capability (ie. Transport may not have resuscitative care capability)

Surgical Capability

· Number of Operating Rooms (OR)

· Number and types of Surgeons

· Number and types of Anesthesia Providers

Blood

· Blood capacity on hand (average for hospital)

· Blood types on hand

Intensive Care Unit (ICU) Beds

· Number of Intensive Care Providers

· Number of Intensive Care Nurses

· Number of ventilators

· Number of respiratory therapist nursing staff

Intermediate Care Ward (ICW) Beds

· Number of Intermediate Care Beds

· Number of Intermediate Care Nurse Staff

· Number of Intermediate Care Nurse Assistant Staff

Sub-Specialty Surgeons or Specialty Medicine Providers

Imaging and Specialty Equipment

· X-Rays, CT Scan, MRI capability

· Other Imaging Equipment

· Other specialty equipment

· Hyperbaric chamber-capabilities (if any)

Laboratory and Pharmacy capabilities

· On-Site Laboratory capability

· Blood bank Information

· Tests that can be performed

· On-Site Pharmacy capability

Preventative Medicine Section

· Food, Water, Sanitation and Hygiene

· Quarantine capability

Decedent Affairs Protocols

· Morgue availability (refrigerated?)

· Requirements/procedure for release of remains

Medical Records

· Procedures in obtaining medical records at discharge

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