Welcome to DGMC!  You are at a special place where miracles happen every day and where warrior medics provide the "Best C.A.R.E. Anywhere" -- both here and worldwide.

DGMC is the Air Force Medical Service's "Flagship" military treatment facility in the continental United States, providing a full spectrum of care to a prime service area population of more than 130,000 eligible TRICARE beneficiaries in the immediate San Francisco-Sacramento vicinity and more than 377,000 Department of Veterans Affairs Northern California Health Care System patients.

DGMC's Vision is: "A premier national medical center, fostering innovation, setting benchmarks...preparing warriors for today and tomorrow."  The success of any organization depends upon first envisioning its future state.  A sound strategy must then be developed to serve as a roadmap for that journey.  This process often takes considerable effort, but is a hallmark of growing, vibrant institutions.

For the past couple of years, we have changed our planning efforts considerably, aligning with the latest Air Force Smart Operations for the 21st Century ideas and tools instead of relying on traditional goals and objectives.  We have deliberately focused our energies on issues of critical importance.  It does not mean that other things are not important . . . just that we feel those chosen are most crucial to our success in the coming year.  We have made significant progress with AFSO21, but we still have much to learn.  We will continue to refine our understanding and use of AFSO21 tools as we roll out and execute this plan in the years ahead.  Despite the many challenges and obstacles that we face, I am confident that all of us are up to this task and that we will continue to polish our reputation as the Air Force's finest!

Bearing in mind that we are extremely busy with the Global War on Terrorism -- and that we do not have unlimited resources -- we have limited our planning to only three Annual Improvement Priorities. This is an ambitious agenda that will require all of our focus and attention to make each targeted improvement a reality.  All of our upcoming resource and program decisions will use this strategy deployment as our fundamental sight picture.

You've probably noticed quite a few changes as a result.  We have become a specialty care referral hub for Northern California Veterans Health Administration patients with inpatient/outpatient care and facility sharing agreements.  Our VA/DoD Joint Venture programs -- the best in the medical partnership nationwide -- include the $1.6 million Hemodialysis and $607,000 Peritoneal Dialysis units.  A $5.5 million Joint Spine and Neurosurgery service was added in 2007.  A $5.9 million Joint Inpatient Mental Health Unit was upgraded to state-of-the-art services in 2009 while we had a "Grand Re-Opening" of our $5.7 million Joint Radiation Oncology Center in March 2010.  An expanded Joint Hemodialysis Center came online in June 2010. 

Meanwhile, a unique state-of-the-art hybrid $4.4 million Cardiovascular Care Center -- the first of its kind in the Air Force -- opened in October 2010 with its first open heart case.  In Nov. 2010, a new Ophthalmology Clinic and Eye Surgery Center relocated to the fourth floor, featuring state-of-the-art ophthalmic and laser refractive services all consolidated under a "one stop" department. A new Customer Service Center, Infusion Pharmacy and Inpatient Pharmacy opened in Spring 2011, to be followed by a new and greatly expanded Outpatient Pharmacy by mid-year.  In July 2011, DGMC will begin a year-long, phased upgrade to our 24/7/365 Hyperbaric Medicine department which provides support for VA San Francisco and VA Palo Alto Medical Centers. We ask you to "pardon our dust" as these and other new changes take place in the year ahead.

During the week of July 18-22, 2011, a Health Services Inspection was conducted by Headquarters Air Force Inspection Agency, Directorate of Medical Operations. Their outbrief at the end of the week-long inspection left our medical staff drained, but in high spirits. In addition to successfully passing a "no-notice" inspection, your home for health care also received full accreditation from The Joint Commission. DGMC scored an overall military treatment facility rating of 89 percent out of a possible 100 from the HSI. It matches a previous "Excellent" rating we received after an advance notice inspection conducted in December 2008. As a result of this unannounced visit, DGMC -- which is now officially the largest Air Force medical center in the nation -- will not see another major AFIA inspection for four years.

The HSI assesses the functioning and execution of Air Force Medical Service programs and processes at the local level in order to provide senior leadership with accurate data upon which to base policy decisions. HSIs also assess the ability of Air Force medical units to fulfill their peacetime and wartime missions, including provision of medical care and support of the host wing mission in accordance with Air Force Instruction 90-201, Inspector General Activities.

The HSI is timed to coincide with an accreditation survey by the Joint Commission, a pre-eminent national accrediting organization. The Joint Commission evaluates and accredits more than 15,000 health care organizations and programs in the United States. An independent, not-for-profit organization, the Joint Commission is the nation's predominant standards-setting and accrediting body in health care. Since 1951, the Joint Commission has maintained state-of-the-art standards that focus on improving the quality and safety of care provided by health care organizations. The Joint Commission's comprehensive accreditation process evaluates an organization's compliance with these standards and other accreditation requirements.

Although the HSI and JC survey are separate entities, the combined visit improves efficiency by eliminating the need for separate visits by each team. Both inspections fulfill Department of Defense and Air Force requirements for inpatient facilities across the Military Health Service and are similar to the unit compliance inspections the 60th Air Mobility Wing periodically undergoes. The nine-member team performed their rigorous, comprehensive inspection of DGMC's operational support functions in three major categories, 16 areas, 105 elements and 13 focus elements, measuring 1,657 criteria as directed by the Air Force Surgeon General office.

You want to talk about being scrubbed? We have been scrubbed! These inspection teams purposely look for problems, but they could not find any programmatic failures or critical discrepancies. They also report not seeing any repeat findings from our last inspection. The three major categories reviewed during the HSI included Expeditionary Medical Operations, which was rated "Excellent"; In-Garrison Medical Operations, also rated "Excellent" and Leadership, which was rated "Outstanding." Exemplary programs include Contract Management, Blood Borne Pathogens, Family Advocacy, Patient Safety and the Simulation Center.

DGMC's latest accreditation results are a matter of public record and accessible on the internet via the Joint Commission's Quality Check® website.

This was simply awesome and we all have done wonderful. We are 'The Best' at getting better!


Col Brian Hayes, USAF, MC, CFS
60th Medical Group Commander

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