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David Grant U.S. Air Force Medical Center (DGMC)

The 60th Medical Group at David Grant U.S. Air Force Medical Center is at the forefront of military and regional healthcare facilities. Named after Maj. Gen. (Dr.) David Norvell Walker Grant, the first air surgeon of the U.S. Army Air Corps and U.S. Army Air Forces during World War II, DGMC is the flagship of 75 military treatment facilities in the Air Force Medical Service. It provides a full spectrum of care to a prime service area of more than 106,000 TRICARE-eligible patients in the immediate San Francisco-Sacramento vicinity and 370,000 Department of Veterans Affairs Northern California Health Care System patients, covering more than 40,000 square miles and 17 counties.

You can’t miss the modern four-level medical center, located off Air Base Parkway, one block east of the main gate. First opened in December 1988, the third-generation facility encompasses 808,475 net square feet with 3,662 rooms on a 55-acre campus. It is currently staffed to operate 298 acute care beds, which include 16 aeromedical staging facility beds and 52 dental treatment rooms in the adjacent Arthur J. Sachsel Dental Clinic.

With a “footprint” measuring greater than two football fields in width and almost four football fields in length, the horizontal nature of the medical center is very impressive. The facility has received five national awards for design and construction, is built to withstand major earthquakes and can operate for up to a week using integral utility capabilities. Additionally, integral structural components and foundations are sized for future vertical expansion.

DGMC is divided into three separate patient zones: inpatient nursing units, diagnostic and treatment areas, and outpatient clinics designed around five large courtyards. These provide a pleasing environment for staff and patients, as well as natural lighting and views for patient rooms.

DGMC currently operates with an annual budget of $310.5 million and is staffed by more than 2,500 active-duty officers, enlisted, Individual Mobilization Augmentee reservists, civil service civilians, contractors, Red Cross workers and highly dedicated military retiree volunteers.

Based on fiscal year 2012 data, DGMC saw more than 466,000 patients. An average day at DGMC consists of more than 1,500 outpatient visits, 67 emergency room visits, 13 ER admissions, 15 surgical operations, 160 dental appointments, nine hyperbaric chamber treatments, 1,650 meals served, 2,290 prescriptions filled, 500 diagnostic images (X-rays) studied, 1,650 lab tests and one baby delivered. DGMC manages one of only two inpatient mental health facilities in the Air Force and has a modern 12-bed medical/surgical intensive care unit.

Because it is a military medical center, DGMC personnel are “America’s First Choice” as the largest medical readiness platform in the Air Force. DGMC personnel have performed expeditionary medical missions for both combat support and humanitarian missions, ranging from Afghanistan and the Indonesian Tsunami to Hurricane Rita and California wildfire relief efforts stateside. DGMC also fulfills a key role in the National Response Plan as the Sacramento region Federal Coordinating Center for the National Disaster Medical System.

As one of the Air Force’s constant deployer model sites, DGMC personnel are currently providing the lead support to the Craig Joint Theater Hospital in Bagram, Afghanistan. DGMC fields more than 1,500 mobility positions with more than 700 personnel holding 150 different Air Force specialty codes, filling primary deployment roles on 114 different standard unit type codes. The current steady state has approximately 150 medical personnel deployed in support of Aerospace Expeditionary Force rotations and humanitarian missions “Anytime, Anywhere,” while ensuring world-class medical care and service to its customers at home.

VA/DoD Sharing – Joint
Incentive Fund
DGMC has become a specialty care referral hub for Northern California Veterans Health Administration patients with inpatient/outpatient care and facility sharing agreements.

VA/DoD Joint Venture programs 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 and a $5.7 million Joint Radiation Oncology Center were upgraded to state-of-the-art services in 2009.

A $56 million structural improvement and renovation program known as “Phase I” has also brought improved clinical services to DGMC. A consolidated Clinical Laboratory opened in Spring 2010, followed by an updated and expanded Hematology-Oncology Clinic, relocated back on the first floor near the north entrance.

The “crown jewel” however, is the opening of a new, robotically assisted, hybrid cardiovascular operating room — one of less than a dozen of its type in the nation. The CVOR officially opened in October 2010 as part of DGMC’s new $4.4 million Heart, Lung and Vascular Center. The CVOR is currently the only one in the DoD to feature the Artis Zeego multi-axial imaging system which uses robotic technology and 3-D imaging software to reconstruct images of the heart and vascular systems. The CVOR is a fully equipped surgical suite designed to handle the most complex of adult open heart and vascular surgeries, as well as minimally invasive procedures. The CVOR provides a technologically advanced environment for cardiac surgeons, vascular surgeons, interventional radiologists and cardiologists to work together as one efficient team.

A new Ophthalmology Clinic and Eye Surgery Center, located on Level 4 (fourth floor) with ophthalmologic and laser refractive services, is now consolidated under a “one stop” department opened in November 2010. A newly designed Customer Service Center, Inpatient Pharmacy and Clinical Laboratory opened in January 2011. A new Infusion Pharmacy opened in April 2011 and the expanded Outpatient Pharmacy debuted in September as part of the new area known as the “Patient Mall.”

Additionally, DGMC provides hyperbaric medicine support for VA San Francisco and VA Palo Alto Medical Centers. A multi-stage renovation of the hyperbaric chamber, the largest in DoD, was completed in Spring 2012.

“Phase II” projects, valued at $63 million and now underway for 2013 with scheduled completion in 2014, include a redesigned Emergency Department, Radiology and MRI, Teddy's Child Watch Service, comprehensive physical rehab center, alignment of additional outpatient functions, HVAC and power plant upgrades and the “Grant Central Station” café — a coffee bar and lounge, complete with fireplace and Wi-Fi Internet access. We ask you to mind any posted detour signs directing foot traffic away from areas currently under renovation.

For the latest details, visit DGMC’s website:www.travis.af.mil/units/dgmc.

Graduate Medical Education
DGMC operates the second-largest Graduate Medical Education program in the Air Force with 11 resident programs, consisting of five Medical, three dental, and three allied health sciences with more than 100 residents in training, averaging 40 graduates per year with a greater than 95 percent board pass rate at any given time. A certified registered nurse anesthetist class in conjunction with the U.S. Army’s graduate program in anesthesia nursing at Fort Sam Houston/Baylor College is ranked second out of 112 programs in the United States.

DGMC’s Family Medicine program with 42 residents in surgical, radiological and transitional courses is the largest in the Air Force. The general surgery and internal medicine residency programs treat civilian and military patients in partnership with the University of California at Davis. Diagnostic radiology, transitional year, advanced education in general dentistry, oral and maxillofacial surgery, pharmacy practice and social work residency programs round out the suite of GME programs.

Additionally, DGMC offers six Phase II training programs for enlisted medical technicians and a Nurse Transition Program for more than 300 students annually.

Accreditation and Health care
Partnerships
Fully accredited by the Joint Commission for Accreditation of Health Care Organizations, DGMC is a tertiary referral medical center for other military and federal hospital systems. The medical center also fulfills a key role in the National Response Framework as the Sacramento region Federal Coordinating Center for the National Disaster Medical System.
DGMC also interfaces with a network of civilian health care organizations and providers to augment our own extensive inpatient care, primary and specialty care, and emergency services. Our external partners include:

• Department of Veterans Affairs Northern California Health Care System (VANCHCS)
• VA Fairfield Outpatient Clinic
• VA Mare Island Outpatient Clinic
• VA Martinez Outpatient Clinic
• VA McClelland Outpatient Clinic
• VA Palo Alto Health Care System
• Kaiser Permanente
• KP Fairfield
• KP Vacaville
• NorthBay Medical Center - Fairfield
• NorthBay Healthcare - VacaValley Hospital
• Pacific Union College
• Sutter Medical Group
• Touro University College of Osteopathic Medicine (Marin Campus)
• TRICARE
• UC Davis Medical Center
• University of the Pacific

Travis Fisher House
Located on the grounds of the David Grant U.S. Air Force Medical Center within a short walking distance is the Travis Fisher House. This 5,000-square-foot house, donated by the late Zachary and Elizabeth Fisher, provides for families of patients receiving long-term care on an inpatient basis with the comfort and atmosphere of a home.

First opened in January 1994, it has served more than 2,700 guests since that time. The average occupancy rate is 98 percent on a first-come, first-served basis for those meeting the eligibility criteria. The Travis Fisher House features two single bedrooms, three double rooms, and two double-room suites, a large common room, dining room, fully stocked kitchen, laundry and office. It accommodates as many as seven families or 16 people at a time and provides a comfortable retreat for patient’s families.

A capital fundraising effort is underway to construct two smaller addtional Fisher Houses adjacent to the current house on the DGMC campus. Estimated date of completion is targeted for 2014.

Information Desk
DGMC offers two information desks within the main entrances of the facility. One is located on Level 1 at the North entrance on the flagpole side and the other can be found on Level 2 at the South entrance on the palm tree side.

Staffed by volunteers from the Military Retirees Activities Office and/or the American Red Cross, these information desks provide assistance for obtaining directions to various departments and clinics, telephone information and general information regarding DGMC.

Hours of operation for the north information desk are 7:30 a.m. to 4:30 p.m. and contact them at (707) 423-7300. Hours of operation for the south information desk are 8 a.m. to 4:30 p.m. and contact them at (707) 423-3687.

Appointments DGMC uses an automated attendant telephone system to provide patients a convenient and quick method for scheduling and canceling most outpatient appointments. This system automatically answers all incoming calls and also routes each call to the correct appointment service phone extension.

Patients should dial (707) 423-3000 to make or cancel an appointment in all outpatient clinics except the following:

Mental Health Clinic (707) 423-5174
Hematology/Oncology
Clinic (707) 423-5129
Arthur J. Sachsel Dental
Clinic (707) 423-7000
Flight Surgeon Office (707) 423-5446

All calls to (707) 423-3000 will be automatically answered by a voice message, and callers will be transferred by touch-tone responses through a series of voice messages to the correct appointment service. Patients can cancel an appointment 24/7 by leaving a recorded message at the appropriate cancellation service. Please listen to all the prompts before making your selection. Once the type of appointment selection is made, the patient will automatically be transferred to another voice message providing touch-tone instructions for the clinic in which the appointment is to be scheduled.

Acute appointments
DGMC’s Family Health Clinic has instituted an active duty acute appointments program, replacing what was formerly known as sick call. Acute appointments for active-duty personnel empanelled to DGMC’s Family Health Clinic are available starting at 7:45 a.m. on normal duty days by calling Central Appointments at (707) 423-3000 or (800) 264-3462 Monday through Friday, 7 a.m. to 4 p.m.

Patients may contact the on-call Primary Care Manager at (707) 423-5000 for urgent needs after duty hours or on holidays. If you are seeking advice on health care concerns, information is always available at the 24-hour Health Care Information Line by calling toll-free, (800) 611-2883. Additionally, several guides to medical self-care are available through the Family Health Clinic for patients’ home use.

Active-duty members are strongly encouraged to obtain routine appointments with their PCM for medical problems that do not affect their ability to perform duties that day. Continuity with your assigned PCM is an important factor in providing you the best possible care.

Local Calls (707) 423-3000
Long Distance Toll Free (800) 264-3462

Emergency Department
DGMC’s Emergency Department provides emergency care 24 hours a day, seven days a week. Dedicated to emergency care, the staff has received specialized training to treat any urgent medical problem with compassion and respect. The ED staff sees approximately 22,000 patients per year who are treated by providers and nurses that are board certified nationally in Emergency Medicine. Its medical technicians have also been trained in advanced cardiac life support.

Emergency services range from resuscitation and stabilization of the critically ill or injured to common fractures and illnesses. Services are provided with the full support of advanced technology, such as rapid helical computerized tomography, ultrasound and other diagnostic imaging services. There is also a dedicated X-ray room within the department. The Emergency Department staff utilizes advanced resuscitation equipment. They are supported by an array of on-call specialists to include Cardiology, General Surgery, Pediatrics, OB/GYN, Dental and Neurosurgery. The ED staff also keeps up with advances in medical information technology by utilizing an electronic medical record.

DGMC’s Emergency Department also houses an Admissions Call Center. Supported by administrative staff, this operation is one of a kind in Air Force hospitals. Its goal is to facilitate transfers of patients who would like (or their provider requests) DGMC’s outstanding care. To take advantage of this excellent service, contact the Admissions Call Center either locally at (707) 423-7790 or (707) 953-7790. Patients outside the local area can also call toll free at (877) 843-2457.

All patients are triaged and seen in order of the severity of their condition as determined by their triage category. All patients will be seen, but patients with non-emergent/urgent concerns may experience longer wait times.

Dialing “911,” or (707) 424-42911 on base, at the first sign of an emergency is important because it contacts the fastest and most beneficial mode of transportation to an emergency facility. An emergency is the sudden/unexpected onset of a medical condition that threatens life, limb, or sight and requires immediate care (i.e., loss of consciousness, chest pain, fractures, shortness of breath, uncontrolled bleeding, sudden/unexpected weakness, poisoning and suicide attempts/thoughts).

DGMC’s Emergency Department staff’s primary goal is to provide intensive care for the critically ill or injured patients. Patients seeking care for sore throats, ear aches, chronic pain, flu symptoms, cold symptoms and minor ailments and injuries should first seek care through their primary care clinic.

DGMC provides ambulance response to on-base emergencies only. Patients who live off-base may request local ambulance service to come to DGMC’s Emergency Department.

Pharmacy

DGMC’s Pharmacy Flight, part of the 60th Diagnostics and Therapeutic Squadron, is one of the largest in the Air Force, filling more than 50,000 prescriptions and ordering $2.5 million worth of medication every month. DGMC’s pharmacy fills 70 percent of all prescriptions internally and 30 percent from off-base providers. At most bases, the percentages are reversed with most prescriptions being filled by outside sources. On average, DGMC’s pharmacy serves 1,000 to 1,500 patients a day and 27,000 to 30,000 a month.

The pharmacy’s main goal is to make sure everyone receives the proper medicine they need in a timely manner. The pharmacy’s job is to process all prescriptions, fill them and counsel patients. The pharmacy wants everyone at Travis to keep healthy in order to continue to serve and keep the mission going. Pharmacy staff does this by reviewing and ordering prescriptions to make sure all information pertaining to the patient is correct.

The Outpatient Pharmacy, located on Level 2 (second floor) in the area known as “The Patient Mall,” provides daily prescription service Monday through Friday, 8 a.m. to 6 p.m. The Outpatient Pharmacy is closed Saturday, Sunday, federal holidays and Wing-designated down days.

This outpatient pharmacy location provides first-prescription-fills for those patients seen by providers in DGMC.
The Exchange pharmacy, located at Building 650 inside Exchange’s Mini-Mall, provides daily prescription service Monday through Friday, 8:30 a.m. to 5:30 p.m.; and Saturday, 9 a.m. to 4 p.m. The Exchange pharmacy is closed on Sunday, federal holidays and some Wing-designated down days. This pharmacy location provides first-prescription-fills for those patients seen by civilian physicians.

The Exchange pharmacy now accepts new prescriptions faxed directly from a physician’s office (some restrictions apply). Patients wanting prescriptions faxed directly to the Exchange pharmacy must have a physician’s office directly contact the Exchange pharmacy at (707) 423-5345 to make the required arrangements. Refill prescriptions are ordered 24 hours a day by calling (707) 423-7600 and are picked up at the Exchange pharmacy. Prescription refill requests called in by 1 p.m. Monday through Friday are ready for pick up the next duty day, while requests called in after 1 p.m. on Friday but by 1 p.m. Sunday are ready for pick up the next duty day, usually Monday.

To efficiently maximize DGMC Pharmacy’s limited financial and personnel resources, prescriptions activated at the Outpatient Pharmacy, new prescriptions submitted at the Exchange pharmacy, and called in prescription refills will be maintained for patient pick up for seven calendar days. If something unexpected arises preventing a patient from claiming a prescription within this period, contact the DGMC Pharmacy at (707) 423-7114 or (707) 423-5345 and select the respective pharmacy for an extension on the holding period.

Dental

Dental Clinic
The Arthur J. Sachsel Dental Clinic is located next to DGMC on the east side of the medical campus, across from the VA Fairfield Outpatient Clinic. General dentistry and all recognized specialties in dentistry to active-duty members, including activated National Guard and Reserve members through the dental services of the 60th Dental Squadron. Orthodontic treatment is only available as dictated by Air Force directives.

Acute dental care is available to all eligible beneficiaries. This emergency dental treatment is available during normal duty hours by calling the dental clinic at (701) 423-7001. For appointments other than true dental emergencies, non-active-duty patients are advised to seek off-base civilian dental care.

Limited care for retirees and their family members and dependents of active duty may be available to support the Oral and Maxillofacial Surgery and Advanced Education in General Dentistry residency training programs. Retirees and family members seeking care in general dentistry should call (707) 423-7001 and for oral and maxillofacial surgery, call (707) 423-7085.

TRICARE Dental Program is a voluntary, high-quality, cost-effective dental care plan for eligible family members of active duty, National Guard and Reserve members and their families. For complete benefits and cost-share percentages, please call (888) 622-2256. Retirees and their families are not eligible for the TDP; however, if you are a retiree, you and your eligible family members may enroll in the TRICARE Retiree Dental Program which is currently administered by Delta Dental. Please visit their website or call (888) 838-8737 Monday through Friday, 6 a.m. to 6 p.m. Brochures are also available at the TRICARE Service Center and the Beneficiary Counseling and Assistant Coordinators’ offices.

TRICARE

TRICARE is the health care program for active duty and retirees of the uniformed services, their families and survivors. TRICARE’s primary objectives are to optimize the delivery of health care services in the military’s direct care system for all Military Health System beneficiaries and attain the highest level of patient satisfaction through the delivery of a world-class health care benefit.

TRICARE brings together the health care resources of the Army, Navy, Air Force and Coast Guard and supplements them with networks of civilian health care professionals to provide access to high-quality health care services while maintaining the capability to support military operations.

We encourage you to contact your local Military Treatment Facility before you seek services elsewhere.
If you have questions about the TRICARE program or need TRICARE assistance, you may visit your local TRICARE Service Center. TSCs are walk-in centers only and are staffed with representatives who can help you with your health care needs and answer questions about the TRICARE program. TSCs are located at DGMC and within the VA Clinic at McClellan Park in Sacramento. Hours are Monday through Friday, 7:30 a.m. to 4:30 p.m. You may also receive assistance throughwww.tricare.mil.

Emergency Care
All TRICARE beneficiaries, in the event of a life, limb or eyesight-threatening emergency, should call 911 or go to the nearest emergency department for care. If enrolled in TRICARE Prime, in all emergency situations, you must notify your primary care manager or regional contractor within 24 hours of any emergency admission so that ongoing care and claims processing can be coordinated.

Urgent Care
In an urgent situation, contact your primary care manager’s office for a same-day appointment or advice on how to handle the immediate situation. You may also contact the regional contactor’s toll-free number for instructions on how and where to access urgent care. There are special rules on certain types of care.

TRICARE Online
TRICARE Online is a Department of Defense Internet portal to interactive health care services and information accessible by all TRICARE beneficiaries. Each MTF has its own page on TRICARE Online, and most MTF providers maintain an individual provider page on the MTF site. Providers are encouraged to include a picture and specific clinical information about themselves on the page. Many have provided educational links from their page to health care information that they want to share with their patients.

TRICARE Online provides national TRICARE information, including links to TRICARE regulatory guidance, policies and procedures; TRICARE program options and features; and the latest news and events. The TRICARE website, www.tricareonline.com, is the main resource for information about TRICARE.

TRICARE Dental Program is a voluntary, high-quality, cost-effective dental care plan for eligible family members of active duty, National Guard and Reserve members and their families. For complete benefits and cost-share percentages, please call (888) 622-2256. Retirees and their families are not eligible for the TDP; however, if you are a retiree, you and your eligible family members may enroll in the TRICARE Retiree Dental Program which is currently administered by Delta Dental. Please visit their website or call (888) 838-8737 Monday through Friday, 6 a.m. to 6 p.m. Brochures are also available at the TRICARE Service Center and the Beneficiary Counseling and Assistant Coordinators’ offices.

Defense Enrollment Eligibility (DEERS)

Reporting Systems (DEERS)
Proper registration in the Defense Enrollment Eligibility Reporting System is key to receiving timely and effective TRICARE benefits. DEERS is a worldwide, computerized database of uniformed services members (sponsors), their family members and others who are eligible for military benefits, including TRICARE. All sponsors (active duty, retired, National Guard or Reserve) are automatically registered in DEERS. However, the sponsor must register eligible family members.

After family members are registered, they can update personal information such as addresses and phone numbers.


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