The vibrant green, gold and maroon that symbolize the Army’s iconic hospital, Walter Reed Army Medical Center, flew as flags for the last time July 27, before being slipped into black cases and formally retired.
In their place, color guards revealed flags of maroon and white, to represent the hospitals at Fort Belvoir and Bethesda that rise from the end of Walter Reed.
Though the name Walter Reed will live on, for many staff members and leaders, the ceremonial end to the historic Army hospital felt like a funeral, with only kind words spoken of the 102-year-old medical facility.
“For most of our employees, this is family. This is very, very personal for them,” said Walter Reed’s commander, Col. Norvell Coots.
But there was also hope — hope that, as six years of planning comes to a head, the patient benefit and medical advancement promised with the federally mandated merger of Walter Reed and National Naval Medical Center in Bethesda will come to fruition.
Walter Reed National Military Medical Center is on schedule to formally open Sept. 15, as construction on campus winds down, staff begin training for their new daily routine and hundreds of patients move to Bethesda this month. The hospital will bring together the amputee services Walter Reed excelled in and the brain injury and research that thrive at Navy Med in a military medical facility that will more efficiently care for all an injured service members’ needs.
Walter Reed’s closure is part of the 2005 Base Realignment and Closure, a federal mandate to close or consolidate military facilities across the country. About 60 percent of Walter Reed’s staff will move to Bethesda, with the remainder moving to a new hospital in Fort Belvoir, Va. The Bethesda campus will gain 2,500 employees, for a total of 10,500, and increase annual visits from 600,000 to 1 million. The new hospital will have a total of 345 beds, up from Navy Med’s 257.
The move is one that requires detailed plans for transporting up to 150 injured service members staying at Walter Reed through Washington, D.C., area traffic. About 18 months of planning has gone into preparing for the inpatient move — spreadsheets note every piece of equipment that must move with each patient, routes have been timed and rehearsed, according to Thomas Fitzpatrick, deputy commander for integration and transition at Walter Reed.
But in addition to the logistics of how to move patients and equipment, the hospital merger requires special attention to the 2,500 staff who will be uprooted from the historic Army hospital and put to work in Bethesda, at a hospital that integrates all branches of the military.
Not only will Walter Reed National Military Medical Center be larger — about 1 million square feet of medical and support facilities were built to accommodate the merger — and offer more services than Navy Med or Walter Reed, the hospital will comingle the hospitals’ respective military branches, the Navy and the Army. The change is one that transition planners are paying special attention to — the character of the Army, as well as the Air Force and Marine Corps, which will also be represented at the hospital, must mesh with the existing Navy culture, while maintaining its integrity.
“We’re going to be creating things that are important to all of us,” said Capt. David Bitonti, chief of staff for integration and transition at Navy Med. “Aside from what we’re creating here, our staff are going to go back to their institutions and we need to make sure we support them.”
Planners are helping staff feel at home in their own uniform at the hospital with orientation days, complete with ice breakers; medical training days, in which Navy Med staff show newcomers the procedures for completing charts, documenting medicine dosages and operating the computer system; and emergency drills, to learn the quickest routes to get to emergency room locations.
The drills and medical training serve a dual purpose — while hospital staff get a chance to meet colleagues, they also learn operating procedures that are essential to an efficient hospital, said Navy Capt. Wanda Richards, the assistant deputy commander for BRAC and nursing integration.
“We need to practice this in order to be familiar with this rather than you walking in cold turkey, not knowing where you’re going,” Richards said.
At a training session this month, Army nurses followed mock patients from their arrival at the emergency room, through tests and scans, to their hospital bed. Navy hospital employees showed their Army colleagues how to input patient data into the computer near the hospital bed, which hallway to take to make the fewest turns and where the laboratories are located.
“It was comforting to see things are going to be a lot smoother; things weren’t as different,” said Army 2nd Lt. Angela Heroux, 22, of Hyattsville, a nurse at Walter Reed.
Most of the procedures were similar to what Heroux does at Walter Reed, but a few details were new — Navy Med writes down more information about each patient, the keystrokes to input data on the computer were slightly different, she said.
Equally important, the training day showed Army nurses that working with the Navy won’t be so bad.
“I particularly was concerned about how we were going to integrate with the Navy. Coming here and seeing they’re on the same page is comforting,” said Paul McLemore, 27, of Silver Spring. McLemore works as the assistant head nurse of the neuroscience unit at Walter Reed.
The Big Move
Outpatient facilities are moving to Bethesda this month. As those facilities move, the patients and the staff for those departments are also reassigned to Bethesda. Patients who come to clinics need to learn new phone numbers and office locations for their doctors, which the hospital is trying to simplify with fliers and articles in military newspapers and campus newsletters, Bitonti said.
Walter Reed’s inpatients, those whose injuries are too severe to go home after their doctor’s visits, will be moved all at once, in a coordinated effort that is planned to the minute. Patients whose families have also been staying on Walter Reed’s campus will relocate to Bethesda in advance, so they can get settled before their family members arrive, Fitzpatrick said.
On move day, scheduled for late August, 30 ambulances will run between Walter Reed and Bethesda, each transporting a patient and the medical equipment he or she must have at all times. Three routes have been planned, including a primary route that can be changed if needed, Fitzpatrick said. Those routes are not being disclosed, but the total travel time from a bed at Walter Reed to a bed in Bethesda is expected to take between 30 and 40 minutes. Roads will not be closed.
Fitzpatrick estimates they will move about 20 patients an hour — 20 ambulances on the road at once, with 10 queued at Walter Reed’s entrance to load patients to allow for a constant flow out of Walter Reed and without any wait time after arriving in Bethesda. Montgomery County police will man intersections, to ensure the ambulances don’t encounter any trouble, but the vehicles will also be tracked by GPS, as an extra precaution, he said.
Montgomery County police spokesman Officer Howard Hersh declined to say how many officers would assist.
To further ensure a smooth flow, Walter Reed staff will alternate loading critically injured patients with more stable patients, each moving from their rooms, to the lobby, to an ambulance in three minute intervals, Fitzpatrick said.
“We want to make sure the patients remain safe at all times. We need to know what their requirements are and make sure we can meet those requirements,” Fitzpatrick said.
Transition will be a process
Even after the patients are moved, staff settled in their offices and the gates of Walter Reed Army Medical Center closed, the transition will continue, Bitonti said.
He said he expects kinks in the system, the need for unexpected changes and growing pains.
“It’s a very intricate process,” Bitonti said. “I don’t think there’s anyone who’s moved into a new house, built a new house, where everything is 100 percent perfect.”
The key, he said, will be a commitment to continuing transition efforts long after the lights and cameras recede from the hospital’s debut.