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Making a High Reliability LEAP at NMRTC Bremerton

02 June 2023

From Douglas Stutz

An innovative idea, born out of necessity, implemented by hospital corpsmen under expert tutelage, has received LEAPS recognition from afar.The 2023 Rear Adm. Lewis E. Angelo Professional Symposium [LEAPS] High Reliability Organization poster competition winner in the non-clinical category was “Planning for Manning,” from Navy Medicine Readiness
An innovative idea, born out of necessity, implemented by hospital corpsmen under expert tutelage, has received LEAPS recognition from afar.

The 2023 Rear Adm. Lewis E. Angelo Professional Symposium [LEAPS] High Reliability Organization poster competition winner in the non-clinical category was “Planning for Manning,” from Navy Medicine Readiness Training Command Bremerton’s Main Operating Room.

“Across a competitive field of high impact entries, Lt. Jason Balazs’ process improvement submission is an exceptional accomplishment! Congratulations to him and his team for a job well done,” said Cmdr. Marc Silfies, Surgical Services director.

The poster competition provided contestants like the Main OR team with a congenial challenge, as well as visual means to promote the high reliability organization culture of learning, sharing, and continuous improvement.

“The significance of being chosen is evident in the foundation that we are forward thinking. High Reliability is a priority of Navy Medicine. I feel that the PI project contributes to the HRO through all three of the guiding principles of the competition; reliable processes, better outcomes, and improved quality of care, through having the manning to be able to provide all of the above,” stressed Balazs, certified registered nurse anesthetist who provided lead oversight to a trio of hospital corpsmen who made the project happen.

Accepting a LEAPS forward…Capt. Mark Lund, NMRTC Bremerton executive officer present Lt. Jason Balazs, certified registered nurse anesthetist, with the 2023 Rear Adm. Lewis E. Angelo Professional Symposium [LEAPS] High Reliability Organization poster competition winner in the non-clinical category was “Planning for Manning,” from Navy Medicine Readiness Training Command Bremerton’s Main Operating Room, May 19, 2023 (Official Navy photo by Douglas H Stutz, NHB/NMRTC Bremerton public affairs officer).
Accepting a LEAPS forward…Capt. Mark Lund, NMRTC Bremerton executive officer present Lt. Jason Balazs, certified registered nurse anesthetist, with the 2023 Rear Adm. Lewis E. Angelo Professional Symposium [LEAPS] High Reliability Organization poster competition winner in the non-clinical category was “Planning for Manning,” from Navy Medicine Readiness Training Command Bremerton’s Main Operating Room, May 19, 2023 (Official Navy photo by Douglas H Stutz, NHB/NMRTC Bremerton public affairs officer).
Accepting a LEAPS forward…Capt. Mark Lund, NMRTC Bremerton executive officer present Lt. Jason Balazs, certified registered nurse anesthetist, with the 2023 Rear Adm. Lewis E. Angelo Professional Symposium [LEAPS] High Reliability Organization poster competition winner in the non-clinical category was “Planning for Manning,” from Navy Medicine Readiness Training Command Bremerton’s Main Operating Room, May 19, 2023 (Official Navy photo by Douglas H Stutz, NHB/NMRTC Bremerton public affairs officer).
Making a High Reliability LEAP at NMRTC Bremerton
Accepting a LEAPS forward…Capt. Mark Lund, NMRTC Bremerton executive officer present Lt. Jason Balazs, certified registered nurse anesthetist, with the 2023 Rear Adm. Lewis E. Angelo Professional Symposium [LEAPS] High Reliability Organization poster competition winner in the non-clinical category was “Planning for Manning,” from Navy Medicine Readiness Training Command Bremerton’s Main Operating Room, May 19, 2023 (Official Navy photo by Douglas H Stutz, NHB/NMRTC Bremerton public affairs officer).
Photo By: Douglas Stutz
VIRIN: 230519-N-HU933-0332


For Hospital Corpsmen 3rd Class Julia Muro and Eric Huerta and Hospitalman Hunter Jeffers, decreased manning in the Anesthesia Department meant that something needed to be done to help mitigate the loss of personnel and augment their current shrinking numbers to provide support in the Main Operation Room.

They devised a plan to cross train other corpsmen with surgical technologist specialty skills to help with the daily workflow in the Main OR.

“Anesthesia is the best department in the hospital for someone to cross train in. Most corpsmen do not develop their hands on skills until they are deployed. Luckily, I get to practice them every day,” stated Muro.

The plan to train the others became acute when one of the two assigned anesthesia technicians transferred which limited the ability to provide assistance to the anesthesia provider. Anesthesia and Main OR department heads collaborated to come up with a viable, workable plan to ensure that day-to-day anesthesia needs would be met.

“The bottom line is that by training additional surgical technicians as anesthesia technicians, they were able to broaden their knowledge base. Plus, as providers, we are able to teach them about pharmacology, airway manipulation, and numerous items to assist them in understanding anatomy and physiology of the human body. This knowledge will not only make them a better corpsman but will assist them when they are taking their advancement exams,” Balazs noted.

Two surgical techs were selected to train for a month with their anesthesia tech counterpart and complete the necessary professional qualification standards. With those corpsmen already assigned in the Main OR, they gained added proficiency such as knowing the technique of intravenous placement which would help prevent any future roadblocks in providing patient care.

“Now our department has multiple backups in case of an emergency, ensuring the safety of our patients,” said Muro.

Balazs affirmed that staff also benefit as well as the patients.

“The turnaround time is decreased in the rooms as well as the placement of intravenous catheters, which in turn allows more time in the schedule to add more patients,” explained Balazs.

“The anesthesia technician is a vital assistant to the provider during the two most crucial steps in anesthesia,” Balazs continued. “They assist with induction through ventilations of starting of IV’s and are available to gather equipment in case of emergencies. They also assist us with emergence from anesthesia.”

The entire concept of a high reliability organization in Navy Medicine is anchored in patient safety, with leadership engagement, robust process improvement and (a) culture of safety as guiding tenants. Taking initiative, speaking up, and promoting safety are all part of the continuous discipline.

According to the Navy LEAPS 2023 website, the competition – which has steadily grown from a small gathering of Navy Medical Service Corps officers during a formative stage in the late 1970s - has strived to focus on highlighting both clinical and non-clinical initiatives designed to improve the Military Health System by fostering more reliable processes, better outcomes, and improved quality care, all geared towards patient safety.

The LEAPS theme for 2023 was “Bolder Leaders, Brighter Futures: Creating a Transformational Culture in Navy Medicine.”

Which was exactly what the Main Operating Room team accomplished at NMRTC Bremerton.

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