A Strategic Approach to Humanitarian Medical Manpower Planning

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A Strategic Approach to Humanitarian Medical
Manpower Planning

• LT Kathleen Cooperman
• CDR Linda Houde
• Advisors
• Anke Richter, Ph.D.
• Paula Konoske, Ph.D. (NHRC San Diego)
• Sponsor N1

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Introduction
TA-H Peacetime Requirements Proactive
TA-H Wartime Requirements Reactive
Certainty Health Statistics-based Country
Health Capacity Disease Prevention
Response Partnerships NGO/PVO Allied Militaries
ROC/POE Uncertainty Scenario-based Platform
Capacity Combat Casualty Care Disaster
Relief Readiness Training
Vs.
Combat disaster injuries / illnesses may be
proportionately different during peace time
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Introduction

• Relevance
• GWOT expands mission focus to preventive
• Aligns with transformational strategic doctrine
• Supports global partnering, intra-agency
  coordination, and horizontal integration with
  stakeholders
• Research Question
• How can available country data health
  information be utilized to estimate manpower
  requirements for Humanitarian Medical Missions?

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Issue

• Current HA manpower model
• Based on ROC/POE and expert opinion
• CNA studies
• Level III Platforms based on uncertainty tied
  to capability
• Priority of medical services is unclear
• Volunteer participation based on availability,
  not on requirements
• Target population important for strategic impact

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Data Information Sources

• Country Profile WHO, UNICEF, World Bank
• Standard Health indicators
• Demographic Health Survey data
• Country Cooperative Strategy
• Workload Estimation Military Health System
  (M-2)
• International Classification of Disease (ICD-9)
• Current Procedure Terminology (CPT)
• Relative Value Unit (RVU)
• Navy Medicine Benchmarks

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Conceptual Model
INPUT
THROUGHPUT
RESULTS
Outputs
Outcomes

• Mission objectives
• Standard Health Statistics per 1,000
• Data
• ICD-9
• CPT
• RVU
• Navy Medicine
• Workload Benchmarks

1. Country Health Needs 2. Types of
Procedures 3. Medical Specialties 4. Number
of Providers
Information Translation
Estimated Medical Manpower Requirement
Align to Country Health Needs Measurable
Objectives Partnership
Check For Strategic Alignment
Model Adapted from Fleet Requirements
Determination Process
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Example Eye Disease

• International Classification for Disease (ICD-9)
• Trachoma (blindness due to scarring)
• Current Procedural Terminology (CPT)
• Eye exam
• Educate patient on self-management
• Relative Value Unit (RVU)
• 0.88 RVUs for an Eye exam
• 0.02 RVUs to Educate patient on self-management

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Example Eye Disease

• Kenya
• Prevalence of Trachoma (in lt age 10) 30
• Total Country Workload 270 RVUs
• Total Daily Provider RVU Benchmark 27.53
• Thus, estimated number Providers 9.8 FTE

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Kenya Example
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Conclusions

• The Model is a starting place for at least
• five improvements
• Aligning mission to country need
• Identifying of required medical services
• Estimating manpower requirements
• Identifying staffing gaps
• Cultivating partnerships
• NHRC Model Pilot test

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Recommendations

• Adopt a country centric approach to HA medical
  manpower planning
• Prioritize core medical services for
  humanitarian medical assistance
• Standardized data collection in order to develop
  measures of effectiveness

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Questions?