The Robert E. Bush NavalHospital recently selectedits Officers, Sailors and

Civilians of the Quarter for theperiod from Apr. 1 through June30, 2011.

Ensign Jenna Dimaggio aNurse Corps officer assigned tothe Maternal-Infant NursingDepartment has been selected asthe Officer of the Quarter.

According to Dimaggio’s cita-tion,“Your exceptional motiva-tion, positive attitude and energydramatically impacted internaland external customer relations.After being hand-selected forthe Commanding Officer’sCustomer Relations Goal Team,you immediately began to dis-seminate the information youacquired to your inpatient nurs-ing staff colleagues. To dateyou have provided customerservice training to 25 staff mem-bers in the department. This ini-tiative once in full swing willsignificantly improve staffmorale and potentially increaseretention in the naval service.Additionally, you seek out otherresponsibilities within thedepartment, and eagerly obtainnew skills and knowledge thatimprove operations and increas-es patient safety and satisfactionwith the birth experience.”

HM1 Omar Provencio, tem-plate manager at the BranchClinic China Lake, Calif., hasbeen named Senior Sailor of the

QuarterThis standout Sailor’s citation

reads in part, “As an expert tem-plate manager, you skillfullycoordinated four provider sched-ules which included 40 AHLTAtemplates. Your efforts ensuredthat the clinic’s productivity wastracked and documented. AsCommand Fitness Leader yousustained a 100 percent PFApass rate for Branch Health

Clinic China Lake.”Mr. Steve Romero, Laboratory

Quality Assurance Coordinatorin the hospital’s LaboratoryDepartment has been selected asthe Senior Civilian of theQuarter.

This outstanding civilianemployee’s citation read“...you

THE EXAMINER

Volume 19, No. 10 October 2011C

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Did you know?...

Robert E. Bush Naval Hospital

“Serving with Pride and Professionalism since 1993”

You have the right toexpress your concerns

about patient safety and qual-ity of care.

There are several avenuesopen to you:

* Through the ICE web-site.

* Through the NavalHospital Customer CommentCards.

* The Hospital’s CustomerRelations Officer at 760-830-2475, or any of the CustomerRelations representatives inthe hospital’s clinics.

Or Directly to the JointCommission via:

E-mail atcomplaint@jointcomission.org

Fax:Office of Quality Monitoring630-792-5636

Mail:Office of Quality MonitoringThe Joint CommissionOak Renaissance BoulevardOakbrook Terrace, IL 60181

http://www.med.navy.mil/sites/nhtp/pages/default.aspx

An Award Winning Publication

Patients seen in August -- 13,395Appointment No Shows in August -- 935

August shows a percentage of 6.5 percent of patients still notshowing up for appointments. We have to keep the appoint-ments we make, or cancel in enough time for someone else touse the slot... Don’t let your neighbors down by denying themaccess to needed health care.

To make an appointment call -- 760-830-2752To cancel an appointment call -- 760-830-2369

People of the Quarter Honored at the Naval Hospital

Not showing up or being late for an appointment is never fashionable

It is Socially Unacceptable!

By Dan Barber, Public Affairs OfficerRobert E. Bush Naval Hospital

Showing up late or not showing up at all for medical appoint-ments is an ongoing challenge for Naval Hospital TwentyninePalms in trying to manage a productive clinic schedule.

The hospital’s clinics are run on an appointment basis, and they tryto stay on schedule. At times there may be an opportunity for apatient to walk-in and be seen... usually because someone else failedto show up for their appointment.

Occasional emergencies arise, or a procedure takes longer thananticipated which delays some appointments. However, over theyears, it has been shown that when patientsare kept waiting beyond their appointed time,

Ensign Jenna Dimaggio

HM1 Omar Provencio

Steve Romero

Continued on page 8

Continued on page 2

By Martha Hunt, MA CAMFHealth Promotion and WellnessRobert E. Bush Naval Hospital

Job-related stress harms bothemployees and employers.

A recent survey of Canadianworkers indicates that people inmedium-to-high stress jobs visithealth care providers more oftenthan workers in low stress jobs.

The survey conducted by theCanadian National PopulationHealth Survey shows thatincreased job stress causesworkers to increasingly seekhelp from health professionalsfor physical, mental and emo-tional ailments linked to jobstress.

This same survey estimatedthat workplace stress relatedhealth care costs U.S. compa-nies $68 billion annually andreduces profits by 10 percent.This indicates that reducingworkplace stress could savemoney, improve morale,increase productivity, reduceabsenteeism, and diminishemployee turnover.

Closer to home, the Centersfor Disease Control andPrevention National Institute forOccupational Safety and Health(NIOSH) offers a clear explana-tion of workplace stress and thecosts in lives.

* Early warning signs of jobstress include: headache, sleepproblems, difficulty concentrat-ing, short temper, upset stom-ach, job dissatisfaction and low

morale. * Long term job stress leads

to a wide range of ill health out-comes.

* Cardiovascular disease: psy-chologically demanding jobsthat allow employees little con-trol over the work processincrease the risk of cardiovascu-lar disease.

* Musculoskeletal disorders:job stress increases the risk fordevelopment of back and upper-extremity musculoskeletal disor-ders.

* Psychological Disorders:several studies suggest that dif-ferences in rates of mentalhealth problems (such as depres-sion and burnout) for variousoccupations are due partly todifferences in job stress levels.

* Workplace Injury: stressfulworking conditions interferewith safe work practices and setthe stage for injuries at work.

Suicide, diabetes, cancer,ulcers, and impaired immunefunction have also been linkedto high levels of workplacestress, according to NIOSH.Also, studies from the Centersfor Disease Control indicate thatjob stress may also heightenrisky behaviors such as smok-ing, drug and alcohol abuse, anddiscourage healthy behaviorssuch as physical activity andproper diet.

How can you reduce workplace stress?

Find a balance between workand family or personal life.

Create a support network offriends and coworkers and try tokeep a relaxed and positive out-look.What are some tips for coping?

Talk it out with someone youtrust. Identify your true feelings-- what is the real issue? If youcan’t figure out exactly what isstressing you out, you can’tchange it. Get enough rest, andeat a balanced diet. If you areexhausted and malnourished,you can’t fight off the negativeeffects of stress. Remove stres-sors when possible. Do yourbest to filter out who or what isstressing you out and leavework at work and home athome. Give in occasionally --sometimes it isn’t worth arguingover. Escape for brief periods oftime and give yourself privatetime to be alone.

Live in the present moment.People who constantly dredgeup the past can’t get past it andcan’t move forward in life.Don’t carry around emotionalbaggage. Emotional baggage

prevents you from enjoying newpeople, relationships and situa-tions. Don’t see things as justeither good or bad. There arealways more than two sides toevery story and when you don’tknow all of the details, you havea skewed view of the issue andrisk misjudging the situation orperson.

Don’t automatically anticipatethe worst of any situation. If youthink it is going to hurt, it will.If you think that a certain personis always a bad person, then thatis all you will ever see of thatperson and you risk not gettingto know someone who may sim-ply be the victim of gossip.Don’t focus on only the badthings - enjoy the good things aswell.

Start a program of physicalactivity as exercise has beenshown to help with depression,anxiety and a wealth of otherhealth problems. Make a com-mitment to change, to deal withstress on your own terms. Findwhat works for you when you

are looking for ways to dealwith stress.

Learn proper relaxation tech-niques so that your body can riditself of the extra adrenaline thatremains pooled in your bodywhen you are stressed out.

Practice muscle relaxation --this flushes out the adrenalinethat is stored in your muscles soit can be released into yourblood stream and cleared fromyour body.

Do deep breathing -- thischanges the ph of your blood soyou breathe out the adrenalinethat was just released from yourtense muscles. Breathingthrough your belly rather thanyour chest also stimulates thepart of your brain related torelaxation.

Call (760) 830-2814 for moreinformation. Or you can contactthe DSTRESS line at 1-877-476-7734, “...which was devel-oped by the Marine Corps forMarines, attached Sailors, andfamilies when it’s needed most.”

2 -- The Examiner -- October 2011

Published by Hi-Desert Publishing, a private firm in no way connected with the Department of Defense, the UnitedStates Marine Corps, United States Navy or Naval Hospital, Twentynine Palms under exclusive written contract withthe Marine Air Ground Task Force Training Command. The appearance of advertising in this publication, includinginserts or supplements, does not constitute endorsement by the Department of Defense, the United States MarineCorps, the United States Navy or Hi-Desert Publishing of the products or services advertised. Everything advertisedin this publication shall be made available for purchase, use, or patronage without regard to race, color, religion, sex,national origin, age, marital status, physical handicap, political affiliation, or any other non-merit factor of the pur-chaser, user or patron. If a violation or rejection of this equal opportunity policy by an advertiser is confirmed, thepublisher shall refuse to print advertising from that source until the violation is corrected. Editorial content is preparedby the Public Affairs Office, Naval Hospital, Twentynine Palms, Calif.

Commanding OfficerCaptain Ann Bobeck, MSC, USN

Executive OfficerCaptain Cynthia Gantt, NC, USN

Command Master ChiefHMCM (SW/FMF) Rodney Ruth, USN

Public Affairs Officer/EditorDan Barber

Command OmbudsmanValatina Ruth

Care Line 830-2716Cell Phone (760) 910-2050

The Examiner welcomes your comments and suggestions concerning the publication. Deadline for submission ofarticles is the 15th of each month for the following month’s edition. Any format is welcome, however, the preferredmethod of submission is by e-mail or by computer disk.

How to reach us...Commanding Officer Naval HospitalPublic Affairs OfficeBox 788250 MAGTFTCTwentynine Palms, CA 92278-8250Com: (760) 830-2362DSN: 230-2362FAX: (760) 830-2385E-mail: dan.barber@med.navy.milHi-Desert Publishing Company56445 Twentynine Palms HighwayYucca Valley, CA 92284Com: (760) 365-3315FAX: (760) 365-8686

it is usually because a previous patient showed up late. If this hap-pens the clinics can both see the late patient and keep everyone afterthem waiting, rush through the appointment which our providers haveindicated they will not do, or reschedule the appointment for anothertime.

If late for an appointment, the clinic will see you if the schedule per-mits but you may have to wait and/or see another provider. If this isnot possible for you or the clinic, you will be asked to reschedule. Ifyou or your family member’s condition is deemed serious, arrange-ments will be made to be seen in the Emergency Department, and if itdoes not negatively impact other patient care. If the provider feelsthat seeing you late will cause an inconvenience for others, then youwill be asked to reschedule.

If unable to keep an appointment, please give the hospital as muchnotice as possible. This is in consideration of the hospital staff thathas scheduled their time around your expected visit.

Here are some tips that will help you become more punctual; Giveyourself extra time, just in case you are delayed by weather, traffic orother circumstances. Keep only one planner; carry it between yourhome, workplace, or daily appointments. Use a watch, or an electron-ic organizer with a beeper to provide you with reminders.

If you know that an appointment can’t be kept, give the clinic asmuch notice as possible by calling 760-830-2752 or visit the hospitalweb site at http://www.med.navy.mil/sites/nhtp/Pages/default.aspx

Socially Unacceptable...Continued from page 1

Survey Shows the Costs of Workplace Stress to People and Profit

By Donna MilesAmerican Forces Press Service

WASHINGTON, Sept. 15,2011 - A dispute betweenWalgreens and a TRICARE con-tractor will not stop beneficiar-ies from getting their prescrip-tions filled, despite a Walgreen’sad campaign to the contrary, aTRICARE official said today.

Don’t let that advertising, let-ter and Internet outreach cam-paign scare you, Navy RearAdm. Christine Hunter, deputydirector of the TRICAREManagement Agency, said. Evenif contract renewal negotiationsfall through and Walgreensdrops out of TRICARE's retailpharmacy network on Jan. 1,

beneficiaries still will have plen-ty of other options for gettingtheir prescriptions filled.

Hunter called the disputebetween Walgreens and ExpressScripts, Inc., the contractor forTRICARE's retail pharmacy andpharmacy home delivery pro-grams “a business matter”between the two companies.

A similar impasse between thetwo companies in 2008 ulti-mately was resolved by mid-November, about six weeksbefore the new contract was totake effect, she noted.

Walgreens is a big player inthe TRICARE pharmacy net-work, with about 7,000 partici-pating outlets that Hunter saidhave filled prescriptions for onein 10 TRICARE beneficiaries at

one time or another.Concerned about a campaign

that has alarmed some TRI-CARE beneficiaries, Hunter

offered assurance today thatregardless of how this year’snegotiations go, patients willalways have access to the med-ications they need.

“If Walgreens does drop out orfail to renew their relationshipwith ESI so they are not includ-

ed in the network, patients willstill have 56,000 other pharma-cies to obtain their medicationsat retail,” she said. “We have a

very, very broad network” that,for the vast majority of benefici-aries, ensures them access to aparticipating pharmacy withintwo miles of their homes.

Meanwhile, Hunter empha-sized other options TRICAREbeneficiaries can use to get theirmedications: a TRICARE mili-tary treatment facility or theincreasingly popular mail- orderand home-delivery plans.

Hunter is a big proponent ofthe mail-order and home-deliv-ery program, helping boost par-ticipation by 9.9 percent thisyear alone as retail pharmacyuse grew by just 1.6 percent.Delivering medications directlyto the beneficiary’s homeassures an uninterrupted supplyof medication, she said, whilesaving money for beneficiariesas well as the DefenseDepartment.

“I would recommend that thisis a great time to consider TRI-CARE [Pharmacy] HomeDelivery for chronic medica-tions,” Hunter said.

But with more than threemonths left on Walgreen’s cur-rent contract with ESI, sheemphasized, “There is no emer-gency, and there is time for peo-

ple to understand and considertheir options.”

Those who elect to stay withthe retail pharmacy option butare concerned that Walgreenscould drop out of the TRICAREpharmacy network also have theoption of moving their prescrip-tions to another pharmacy in theTRICARE network now.

“We are not taking a positionabout whether patients shouldmove their prescriptions,”Hunter said. “We are allowingthis issue to play itself out, butthose who want to can do so,and that will absolutely be hon-ored.”

Because all prescription infor-mation is centralized, the onlything patients need to do tomove their prescriptions is totake their medication bottle ortube to another pharmacy. “Theydon’t need another prescriptionor visit to a doctor,” Huntersaid.

Beneficiaries also can elect touse pharmacies not included inthe TRICARE network.However, Hunter offered areminder that these users willreceive only partial reimburse-ment for their out-of-pocketcosts and could have to file theirown insurance claim, where net-work pharmacies do that auto-matically.

“Our focus is on ensuringpatients have access to the carethey need,” including reliableaccess to their prescription med-ications, she said. “Our goal isto be sure people have the infor-mation they need so that theyget their medications in a timelyfashion.”

The Examiner -- October 2011-- 3

Atlas2X3

October is Domestic Violence Awareness MonthBy Martha Hunt, MA, CAMFHealth Promotion and Wellness Robert E. Bush Naval Hospital

It is important that peopleunderstand what a healthyrelationship is so the risk of

ending up in a violent situationis reduced.

The State of CaliforniaDepartment of Public HealthDomestic Violence Preventionprogram helps people to under-stand what a healthy relation-ship is. Sometimes people findthemselves in relationships thatare not safe. When that happens,the risk of the relationshipbecoming emotionally and/orverbally abusive increases dra-matically.

What are some of the ques-tions to ask yourself to see ifyou are in an unhealthy relation-ship?

Can I be myself? Someonewho loves you will listen toyou, support you and let you beyourself. If you can feel at homewith someone and relaxed, thenthat is a sign of a healthy rela-tionship. That doesn’t mean thatyou accept someone as they areif they are abusive. “You knew Iwas this way when you marriedme” is simply an excuse some-one will use to not get the helpthey need for their own emo-tional problems.

What do I believe? Everyonehas an idea of how people in aloving relationship should treateach other.

However, sometimes thosebeliefs may not be what youbelieve and you will have todecide if your differences areunhealthy or not. Can yourspouse tell you who to talk to?Does your spouse always decidewhat activities to do on yourfree time? Should you alwaysobey what your spouse tells youto do regardless of whether it isright or wrong? Is it ok for yourspouse to pressure you to giveup your friends, hobbies, etc?The answer to all these ques-tions should be no.

If you don’t want to drink orengage in other unhealthybehaviors, your spouse shouldrespect that. You should be ableto go out with your friends. You

TRICARE Promises Continued Access to Prescription Meds

Meanwhile, Hunter emphasized other options TRI-CARE beneficiaries can use to get their medications: aTRICARE military treatment facility or the increasinglypopular mail- order and home-delivery plans.

Continued on page 6

Base Runner Delivery

Ball Season is here3X3

4 -- The Examiner -- October 2011

Super Stars...

CS3 Pheara Dy, Combined Food Operations, take the oath at hisrecent reenlistment ceremony.

Hospitalman Raven Crook, OB/GYN Clinic, receives a Navy andMarine Corps Achievement Medal from Captain Ann Bobeck,Commanding Officer, Naval Hospital, Twentynine Palms. Crookwas also promoted to HM3 through the Combat MeritoriousAdvancement Program.

HMC Gil McGillivray,Manpower, receives a Navyand Marine CorpsCommendation Medal.

Lt. Cmdr. Georgiana Miller,Staff Physician in FamilyMedicine receives a Navy andMarine Corps CommendationMedal.

HM3 Meghan Hurtado, OB/GYN Clinic, takes the oath at herrecent reenlistment ceremony.

HN Antonio Castillo, OB/GYNClinic, recently reenlisted.

HM1 Ray Martinez, PublicHealth Dept., receives a Navyand Marine CorpsCommendation Medal.

Lt. Cmdr. Julianne Palumbo, astaff physician in the FamilyMedicine Clinic, receives aNavy and Marine CorpsCommendation Medal.

HM2 Andy Rogero, Manpower,receives a gold star in lieu ofhis second Navy and MarineCorps Achievement Medal.

HM1 Justin Vecere, AdultMedical Care Clinic, receives aNavy and Marine CorpsCommendation Medal.

HM2 Robert Waters, Radiology Dept. is piped ashore at his recentretirement ceremony.

The Examiner -- October 2011 -- 5

Lt. Cmdr. Amy Sulog, Comptroller, takes the oath at his recent promotion ceremony to his current rank.

CSCS Gener Cunanan, Material Management Dept., takes the oathat his recent reenlistment ceremony.

HM2 Daniel Whaley,Optometry, is promoted tohis current rank.

Lt. Amber Wilson, Maternal Infant Nursing Department, takes theoath at her recent promotion ceremony.

Lt. Andrew Olson, Dept. Head of Materials Management Dept. takes the oath at his recent promotionceremony to his current rank.

By Sharon FosterTRICARE Management Activity

Diabetes is one of the most common chronicdiseases in school-aged children, affectingabout 200,000 young people in the United

States, according to the Department of Health andHuman Services (HHS). About 19,000 youths arediagnosed with type 1 and type 2 diabetes eachyear.

Diabetes is a serious chronic disease in whichblood glucose (sugar) levels are too high due todefects in insulin production, insulin action orboth. Because of this, diabetes must be managed24 hours a day, 7 days a week.

For students with type 1 and a few with type 2diabetes, that means careful monitoring of theirblood glucose levels throughout the school dayand administering multiple doses of insulin byinjection or with an insulin pump to control theirblood glucose and minimize complications.

To help TRICARE kids with diabetes get readyfor the first day of school and the rest of theschool year, effective diabetes management is cru-cial. Here are a few key tips for parents from theCenters for Disease Control and Prevention(CDC):

* Create a diabetes management plan with the

school. Meet with staff prior to the start of theschool year to learn more about how the schoolhelps students care for diabetes and handles anydiabetes-related emergencies.

* Check for necessary diabetes supplies. It isimperative that children have access to suppliesneeded to manage diabetes and to treat anyepisodes of high or low blood sugar. Parents andchildren can work together to create a care pack-age to take in his or her backpack. Check with theschool to see what supplies or medications a childis allowed to keep with them and which must bekept in the school clinic.

Also, be sure school nurses have a glucagonemergency kit and know how to use it if a childexperiences an emergency.

* Encourage children to eat healthy foods.Parents should prepare a healthy breakfast, whichwill help their child stay focused and active. Ifsending lunch, parents should pack a healthy mealthat contains whole grains and fresh fruits andvegetables.

For a complete list of CDC’s tips, go towww.cdc.gov/Features/DiabetesInSchool.

TRICARE covers outpatient diabetes self-man-agement and training programs for children andadults when the services are provided by a TRI-CARE-authorized provider who is also certified byMedicare or the National Standards for DiabetesSelf-Management Education programs to providediabetes outpatient self-management training serv-ices

If a beneficiary’s child has diabetes and requiresmedication, they should be mindful that adjust-ments may be necessary to maintain good controlif they stray from his or her usual diet.Beneficiaries should discuss their child’s needswith their physician and school nurse.

If beneficiaries have not enrolled, TRICAREencourages them to take advantage of the TRI-CARE Pharmacy Home Delivery(www.tricare.mil/homedelivery) for all theirchild’s maintenance medications, which can helpthem save money. For more coverage informationon managing and living with diabetes, beneficiar-ies can go to TRICARE’s website, www.tricare.milor contact their regional health care contractor.

6 -- The Examiner -- October 2011

Sub Offer3X3

Managing Diabetes at School TRICARE Beneficiaries Save on Prescription Delivery VaccinesBy Terri Moon CronkAmerican Forces Press Service

WASHINGTON, Aug. 30, 2011 - Beneficiaries of the TRICAREmilitary health plan can obtain 90 days of home-delivered medica-tion with no copayment and can get free vaccinations at participat-ing pharmacies without seeing a doctor.

These measures can make life a bit simpler for beneficiaries ofthe military health plan, Navy Rear Adm. (Dr.) Christine Hunter,TRICARE Management Activity’s deputy director, said in an Aug.26 interview.

“We’re trying to encourage people to use TRICARE’s homedelivery for a 90-day supply of generic medication, because byOct. 1, there will be no copay,” she said.

Many people get their prescriptions filled at military treatmentfacilities, which remains “our referred place for people to go,”Hunter said. No changes exist in the cost of prescriptions frommilContinued on page 7

can say no to intimacy. You should have time to yourself. Is it power or respect? In a healthy relationship, one person should

not have more power than the other. Both of you have feelings andopinions that are important. Respect goes both ways in any relation-ship. Love is about caring for and supporting each other. Abuse isabout controlling and having power over the other person.

There are control issues if your spouse wants to control your friendsand free time or doesn’t listen to your thoughts and opinions. Theseare all signs of abuse.

What do I want? Take time to think about what you want in a rela-tionship.

What would your ideal relationship be like? What do you look for in a spouse? What comes to your mind when you think of a healthy relationship? What comes to mind when you think of someone who is abusive? People need and want love. When it is love, you trust each other and

respect each other’s feelings and opinions. When it is love, you makedecisions together and are honest with each other.

Who can you turn to? If you are in immediate danger, call 911immediately! You may also call the Family Advocacy VictimAdvocates at (760) 799-0273. The victim advocates are trained tohelp you get to safety if need be and to help you get counseling orother services that will help you be safe.

Domestic Violence Awareness...Continued from page 3

By Linwood Outlaw IIITRICARE Management Activity

Though most surgeries aresuccessful, they are notdevoid of risks.

Surgical site infection (SSI) isone risk that can delay recovery.Beneficiaries should talk to theirhealth care providers about safe-ty measures that will help pro-tect them from infections duringsurgery.

According to the Centers forDisease Control and Prevention(CDC), SSIs can occur duringor after an operation in the partof the body where the procedure

took place. In some cases, theseinfections only affect the skin.

More serious infections canimpact other tissue, organs andimplanted materials, symptomsof SSIs include fever, redness,pain, and drainage of fluid fromthe surgical wound. Most SSIscan be treated with antibiotics.If antibiotics don’t help, patientsmay need additional surgery totreat the infection.

Prior to surgery, health careproviders will take severalmeasures to help patients avoidSSIs, including cleaning theirhands and arms up to theirelbows with antiseptic agents,wearing masks and gloves,

cleaning the patient’s skin withantibacterial soap, and givingthe patient antibiotics when nec-essary. Patients should discussthese and other options withtheir doctors before surgery tomake sure the proper CDCguidelines will be followed.

According to CDC, patientsshould also tell their doctorabout any health-related issuesthat may affect their surgery andtreatment, such as diabetes, pre-existing infections and cigaretteor steroid use. Patients mustavoid smoking before surgery,as it can increase the chances ofgetting an infection.

Additionally, CDC suggests

that patients not shave withrazors near areas on the bodywhere surgery is to take place.Razors can irritate the skin, put-ting patients at greater risk ofbecoming infected.

According to CDC, patientsshould do the following thingsafter surgery:

* Remind healthcare providersto thoroughly clean their handsbefore examining the wound

* Tell family and friends not to

touch the wound* Follow the wound care

instructions the health careprovider gives

For more information aboutsurgeries covered by TRICARE,visit www.tricare.mil/covered-services. To learn about surgicalsite infections, visitwww.cdc.gov/Features/SafeSurgery/.

The Examiner -- October 2011 -- 7

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itary hospital pharmacies, shesaid. Some 70 percent of TRI-CARE beneficiaries obtain genericmedications, and those kinds ofmedications will be home-deliv-ered in a 90-day supply at nocopayment, Hunter said.For beneficiaries who use TRI-CARE pharmacies, however,the retail cost of generic med-ications will increase from $3 to$5 for a 30-day supply, Huntersaid, and brand-name medica-tions will increase from $9 to$12 for a 30-day supply.

According to TRICARE’swebsite, DoD established a uni-form list of covered brand-nameand generic drugs, as well as athird tier of drugs designated as“non-formulary.” Prescriptionsfor non-formulary medicationscan be dispensed, but at highercost to benefi-ciares, unless the provider canestablish medical necessity.

Hunter said a one-month sup-ply of a non-formulary medica-tion will cost $25 at a TRI-CARE pharmacy. “So, it’salways better to use TRICAREhome delivery for any chronicmedications,” she said.

Hunter suggested that peopleuse home delivery “when theyknow they can tolerate a newmedication, know they’re goingto be on it awhile, or it’s some-thing they've been taking.”

The home delivery plan savestime and money for beneficiar-ies, and the government alsobenefits from the savings,

Hunter noted.“When you get your medica-

tions through TRICARE homedelivery, the government gets avolume discount,” sheexplained. “And it’s cheaper forour beneficiaries, because theyget a 90-day supply for zerocopay.”

TRICARE’s mail orders forprescriptions grew by about 10percent in 2010, the admiralsaid. At the same time, sheadded, retail growth decreasedabout 3.9 percent, producing amedication savings of $30 mil-lion, and people received theirmedications more convenientlyat home.

In addition to prescriptionhome-delivery savings, Huntersaid, TRICARE offers benefici-aries seasonal flu shots, schoolvaccinations and other immu-nizations.

Beneficiaries can get most oftheir vaccinations from partici-pating TRICARE pharmacies,eliminating the need to scheduleclinic appointments, Huntersaid.

“It’s also a great time toupdate your family [vaccine]checklist so you keep everyonehealthy,” Hunter said.

Many schools require anupdate on vaccines and immu-nizations before children returnto school, she noted. Parentstypically look at a tetanus boost-er and other immunizations fortheir children, she said, and themeningococcal vaccine for chil-dren going off to college.

People who plan to travel mightconsider a hepatitis vaccine, sheadded.

“Flu shots are recommendedfor just about everybody thesedays, and are available at ourTRICARE pharmacies,” Huntersaid. “But what people mightnot know is the pertussis[whooping cough] vaccine isrecommended for more andmore adults, especially for thosewith small children.”

In the past year or so, Hunterand her staff began to make alimited number of vaccinesavailable at TRICARE pharma-cies for flu shots, the influenzaA [subtype H1N1] virus, andthe pneumonia vaccine. TRI-CARE provided 300,000 vac-cines that first year, she said,and the program has expandedto all immunizations normallycovered under the TRICAREpreventive medicine benefitwith no copayment.

Some limitations exist, Hunternoted. Pharmacy participationvaries, some facilities stockonly certain vaccines, and somedon’t immunize children. Othersprovide vaccinations only oncertain days and times, sheexplained.

“Call ahead to make sure theyhave the vaccine, and if some-one’s there to give it,” Huntersaid. “There is no copay. It ispart of TRICARE’s preventivecare, and we want people to beable to get it conveniently andeasily.”

Prescription Delivery Saves...Continued from page 6

TRICARE Helps Beneficiaries to Avoid Surgical Site Infections

8 -- The Examiner -- October 2011

5X3VIP

110786

diligently authored ten valida-tion plans resulting in the suc-cessful implementation of newassays, equipment, and StandardOperating Procedures (SOPs)for the laboratory. As a result ofthe ten validations, the laborato-ry was able to bring fiveChemistry tests in-house signifi-cantly reducing turnaroundtimes for critical patients, andallowed daily laboratory dutiesin Microbiology andHematology to be performedwith ease and accuracy. As thePoint-of-Care Testing programcoordinator, you implementednew processes to decrease thedeficiency rate by 50 percent inall nine Point-of-Care Testingsites managed by the LaboratoryDepartment. All nine Point-of-Care Testing sites are 100 per-cent compliant with JointCommission and College ofAmerican Pathologists regula-tion standards.”

HM2 Matthew Geisler,General Duty Corpsman at theBranch Clinic Bridgeport,Calif., has been selected as theJunior Sailor of the Quarter.

His supervisor wrote in hiscitation, “...you consistently per-formed your duties in a highlyprofessional manner. Your lead-ership of seven HospitalCorpsmen played a vital role inthe revision of five StandardOperating Procedures thatimproved the services providedto 250 active duty Marines andover 2,000 personnel from visit-ing training units. Yourapproach to perform numeroustasks as a Sick and InjuredCoordinator, radiology coveragein the absence of the technician,

preventive medicine representa-tive and a watch bill coordina-tor, increased the clinic’s com-pliance for Joint Commissionstandards and customer satisfac-tion. As a physical fitness pro-gram leader, you developed per-sonalized physical training pro-grams for the clinic staff whichresulted in 15 outstanding, eightexcellent and three good highPFA results with zero PFA fail-ures. Your outstanding militarybearing and commendable uni-form appearance promoted apositive image for the command

and the Navy in the community.In addition to your demandingduties, you volunteered 54 offduty hours in the planning andticket sales that helped raise

$24,000 for the 113th HospitalCorpsman Ball.”

Mrs. Rebecca Kyle, MedicalLaboratory Technician in thehospital’s Laboratory

Department has been selected asthe Junior Civilian of theQuarter.

Kyle stands out from her peersas indicated in her citation,“...you performed five valida-tions in the Hematology andUrinalysis sections of the labo-ratory resulting in the imple-mentation of five new pieces ofequipment. Since the comple-tion of each validation, your fel-low laboratory technicians wereable to significantly reduce turn-around times for critical patientsand perform daily laboratoryduties in Microbiology andHematology with ease and accu-

racy. As a primary trainer formore than half of the technicalareas of the Laboratory, youtrained three newly reportingtechnicians resulting in theirsuccessful completion of theirPersonal QualificationStandards. Due to your method-ical and expeditious trainingskills, three technicians wereable to stand weekend and nightduties to support other laborato-ry staff members. In addition toyour normal responsibilities,you resolved over 180 bloodproduct status discrepancies inthe Defense Blood StandardSystem. Your efforts resulted in100 percent compliance with theCollege of AmericanPathologists, the Food and DrugAdministration, and AABB reg-ulation standards.”

Hospitalman Daniel Dobrick,General Duty Corpsman in thehospital’s Maternal-InfantNursing Department has beennamed as the Blue Jacket of theQuarter.

Dobrick was praised in hiscitation with, “...you consistent-ly performed your duties in ahighly professional manner.Your leadership with 12 HMsplayed a vital role in the suc-cessful delivery of 1,875 routineand emergent medical proce-dures for 375 patients. Your per-sistent approach asDepartmental Training Officerincreased the Directorate’s com-pliance from 90 percent to 97percent. Your outstanding mili-tary bearing, commendable uni-form appearance and participa-tion as member of the NHTPHonor Guard promoted a posi-tive image for the command andthe Navy in the TwentyninePalms, CA community. In addi-

tion to your demanding duties,you volunteered six hours in theplanning and ticket sales thathelped raise forty-seven thou-sand dollars for the HospitalCorpsman Ball.”

Congratulations to these superstars!

HM2 Matthew Geisler

Rebecca Kyle

People of the Quarter...Continued from page 1

HN Daniel Dobrick

Life’s Lesson...I finally got my headtogether and my bodyfell apart!