Transition Spotlight: Chief Master Sgt. Julie Bottroff Published Oct. 16, 2019 Air Force Surgeon General Public Affairs FALLS CHURCH, Va. -- The Defense Health Agency is in the process of assuming administration and management of all U.S.-based military treatment facilities. This transition is expected to have minimal impact to medical staff and patients, but is the next major step in a process that should improve patient care and readiness across the Military Health System. U.S. Air Force Chief Master Sgt. Julie Bottroff, the senior enlisted advisor for the Defense Health Agency's Education and Training Directorate reflects on her roles and view on the transition of all military treatment facilities to DHA. (U.S. Air Force illustration) Photo Details / Download Hi-Res 1. What are your duties at DHA? I advocate for education and training across the MHS, advising the Deputy Assistant Director for Education and Training on strategic direction for DHA’s Education and Training functions, support, and programs. I work to identify inter-service opportunities and processes, consolidating education and training in response to changing requirements and medical skill maintenance within the MHS. When we deploy, we are in a joint environment. Our office builds an understanding of each service’s training resources and brings them together to work more effectively in those joint environments. 2. What role do you play in the transition of military treatment facilities to the DHA? I oversee the collaborative development and implementation of standards, metrics and reporting requirements for MTF education and training departments, all enlisted medical training at the Medical Enlisted Training Campus, and the continuum of joint professional development in support of the DHA mission. DHA’s Education and Training Directorate works with our market leads to streamline and standardize life support, programs, and MTF core training. We also support the services’ medical readiness training policy and requirements through hospital-based training programs, medical modernization and simulation, continuing education, and life support program oversight and execution. 3. What impact will the transition have on medical service members? As functional capabilities become standardized across the services, they should notice that it takes less time to get things done. We will be able to reduce variances across the services and create an environment that is much more conducive to patient safety and allows medics to focus on patient care. 4. Will there be changes in education and training as it relates to the MTF transition to DHA? There will be changes. We are really focused on supporting our market leads as they will be directly supporting MTFs. Instead of operating independently, MTFs will now be looking across the markets to distribute resources and personnel as needed, and Education and Training is a part of that. Things like scheduling your life support training will be centralized, creating flexibility for the staff member. Identifying opportunities to share simulation equipment will reside with the market leads. DHA’s Education and Training Directorate will assist markets with that as well. We are here to make it easier, not harder. It’s also important for MTFs to remember that this change won’t happen all at once. We are still building out capabilities at the headquarters level. The market standups will begin once we have those headquarters functions stood up. So, don’t expect the changes to happen overnight, but in the long run, we expect to have more efficient, effective training and educational opportunities. 5. What lessons did DHA’s Education and Training Directorate learn from the transitional MTFs that moved to DHA in October 2018? We have already been working with the MTFs that transitioned to DHA in 2018 - Keesler Air Force Base, Mississippi; Fort Bragg, North Carolina; Naval Air Station Jacksonville, Florida; and Joint Base Charleston, South Carolina - to identify ways we can reduce redundancies and save time to allow personnel to focus on patient care. A good example is MTF core training. That is geared towards all employees assigned to an MTF and is something we are working with the services to make more efficient. We went to the services and asked about their onboarding process and they shared the training and requirements needed for a service member to work at an MTF. We found that each of the services had varying requirements and we were able to go in and reconcile the variances, standardize frequency, and allow members to onboard much quicker and get into their duty sections. This re-alignment of training is expected to save 68,000 to 191,000 hours of training annually. Over the next 3 years, learners will spend 40% less time on MTF core training. 6. What opportunities and benefits do you think this transition will bring to those working at MTFs? As DHA defines and standardizes processes throughout this transition, we can help ensure patient safety, reduce redundancies, and reduce feelings of task saturation. This delivers an environment that supports the MTF’s ability to operate as a highly reliable organization. Patient safety and delivering high quality Trusted Care remains vital in all we do. The MTF training I discussed earlier is a great example of how the transition will improve processes. We can save a lot of time and it allows those working at MTFs to focus on what they do best – delivering a medically ready force and ready medical force. 7. What benefit will this have on the patient population as a whole? Everything we are doing is about the patient and the patient experience. The more time we can give back to MTFs is more time staff have for patient care. I once had an MTF commander say this and it just stuck with me: “The patient visit is our sortie.” Every patient visit is a chance for us to identify successes or challenges and this is how we get better. Each education and training department across the MHS strives to deliver superior training and DHA’s Education and Training Directorate is driven to help synchronize those efforts. 8. What advice do you have for our medical Airmen as changes come to their MTFs? Your day-to-day activities remain the same. The changes that are coming are systematic, but your mission will not change: delivering Trusted Care to each and every patient. The DHA is a partner with you. 9. What advice do you have for leadership at MTFs? I advise leaders at all levels to remain supportive of the transition and think of DHA as a partner. I think being transparent is also important. Many are uncertain of the future and communicating change will be vital. Taking time to answer those questions or finding those answers is will be helpful for those at the MTFs. Any issues or concerns from the MTF should be channeled to the appropriate functional area within DHA. 10. What are some hurdles that we have to overcome as we become an effective, integrated Military Health System that can better support the warfighter and their families? The biggest concern is that people worry that this transition will change their ability to provide and deliver safe, quality care for their patients. Across the MHS, we have 9.5 million beneficiaries, and people want to do the right thing and take care of patients. They worry that the changes that are coming will impact their ability to do that. It is important for those at the MTFs know that in the Education and Training Directorate and across the entire MHS, we value the critical role of our partnership with the markets and MTFs. This partnership lets us work through hurdles or concerns before implementing change. We truly believe that there is no better way to support our MTFs than to work with them and support them. Introducing and tackling change effectively, and frequently checking with staff to determine how they are doing with the changes are vital to ensure a successful transition. DHA is a young organization, so the relationship we have with the services and MTFs is something we continue to develop and work on. The MTFs that transitioned in 2018 have already shared some of their successes and challenges. We know that with input, ideas, and support from the MTFs, we can develop a true partnership. DHA is here to support the medics at the MTFs to help them do what they do best – taking care of our patients.