‘The real work starts now’: BJACH leaders turn employee insight into action

FORT POLK, La. — More than 50 military and civilian leaders from across Bayne-Jones Army Community Hospital gathered at the Warrior Training Facility at the Joint Readiness Training Center and Fort Polk, Louisiana, Sept. 10-11 to examine how the organization’s structure, communication and processes support its workforce, patient care and readiness mission.

The BJACH Design Summit, facilitated by a team from the U.S. Army War College, built upon department-level assessments completed as part of the hospital’s Back-to-Basics Structure and Function campaign.

Participants worked across departmental boundaries to examine the organization from multiple perspectives, refine a shared problem statement and develop potential actions within four areas: processes and workflows, communication, training, and networks and partnerships.

BJACH Commander and Medical Treatment Facility Director Col. Patrick W. Miller opened the summit by emphasizing that meaningful organizational change requires participation from leaders and employees throughout the hospital.

“As the core leaders in this organization, we need to drive change,” Miller said. “That comes from everybody being bought in—feeling valued, feeling heard and seen, and bringing your ideas to the table.”

Miller encouraged participants to look beyond their individual departments, listen to different perspectives and consider how proposed changes could affect the entire organization.

“Ideas come from everyone,” he said. “This isn’t top down. Progress over perfection.”

Lt. Col. Sarah E. Hensley, chief of Clinical Operations and organizer of the summit, said BJACH needed an opportunity to step back from its daily demands and examine how the organization functions.

“BJACH did not need another meeting,” Hensley said. “We needed a deliberate pause to see ourselves more clearly.”

She said BJACH employees have continued accomplishing the mission through years of change across the Military Health System, implementation of new systems and workflows, leadership transitions, staff turnover, vacancies and reductions in funded positions.

“One of the clearest things we heard throughout this process was that the heart, expertise and sheer willpower of our people continue to hold this organization together,” Hensley said. “That is an incredible strength that serves us well during times of great change.”

The work began before the summit. Departments used a standardized Executive Decision Canvas to examine their missions, core functions, responsibilities, relationships, challenges and opportunities. Deputy leaders reviewed the information across their areas, while Miller also had access to the original department submissions.

The assessments were then combined into an enterprise-level view of recurring themes, risks, constraints and questions.

“The synthesis was never supposed to become the answer,” Hensley said. “It was supposed to help us see ourselves more clearly so we could have better conversations and make better decisions.”

Navy Cmdr. Michael M. “Quatto” Posey, a member of the U.S. Army War College facilitation team, said the team worked with BJACH leaders to design a process that moved participants from understanding the organization toward developing possible ways forward.

Participants began with an organization-wide review of internal strengths and weaknesses, along with external opportunities and threats. Cross-functional teams then identified friction points and recurring challenges, developed clearer problem statements and prioritized the most significant issues. From there, they began exploring organizational and process changes through lines of effort, tasks, timelines and potential quick wins.

“The goal was not to leave the offsite with a finished answer, but with a stronger shared understanding of the problems, trade-offs and credible options for moving forward,” Quatto said.

Quatto said he was impressed by the participants’ focus, teamwork and commitment to improving the organization.

“Different parts of a hospital naturally experience the organization in very different ways, so bringing those perspectives together was important,” he said. “Participants were candid about challenges, but they were also curious about why other departments saw things differently.”

As the discussions progressed, Quatto said participants began moving beyond the concerns of their individual departments and considering how processes, decisions and constraints affect the entire hospital.

“I saw a dedicated, intelligent group of professionals who want to provide the best care they can to Soldiers and their families,” Quatto said. “Many commanders say that they listen to their teams, but Col. Patrick Miller, the BJACH commander, brought his leaders together and gave them a meaningful role in wrestling with the best way forward.”

Maj. Brookes A. Warren, chief of the Resource Management Division, said the discussions demonstrated how differently departments can perceive the same organizational challenge.

“Different areas and departments can view similar problems through completely different lenses,” Warren said. “Seeing the issues from other angles allowed me to broaden how I viewed a particular problem.”

Warren said communication and training offer significant opportunities to strengthen hospital operations.

“A shared understanding of everyone’s roles can lead to better collaboration between departments and help the organization become more proactive instead of reactive,” she said.

Tracy Tidwell, a registered nurse and supervisory nurse supporting BJACH’s Fontaine Troop Medical Clinic and Soldier-Centered Medical Home, said the discussions also revealed how frequently departments experience similar challenges.

“I learned that solutions to problems can affect many different areas, both positively and negatively, and those effects must be considered before decisions are made,” Tidwell said. “I was also able to interact with leaders from several departments and realized that many of our struggles and challenges are the same.”

Tidwell said structure, communication, training and partnerships are interconnected elements of health care delivery.

“We cannot have partnerships without communication, and we cannot provide excellent patient care without proper training,” she said. “The right structures, processes and workflows help connect those areas and improve how care is delivered.”

The summit also brought together longtime employees who provide institutional knowledge and newer teammates who could view the organization with fresh eyes.

Kaili Eatherly, supervisory health system specialist and Patient-Centered Medical Home practice manager, said the offsite gave her an opportunity as a newer employee to contribute while learning from military and civilian teammates with different career experiences.

“Bringing those different viewpoints together led to thoughtful conversations, innovative ideas and actionable next steps that can help shape BJACH’s future direction,” Eatherly said.

She said sustainable improvement requires systems that preserve institutional knowledge through military leadership transitions while allowing incoming leaders to bring fresh perspectives and build upon what is already working.

“Ultimately, employees will be looking for evidence that their voices were not only heard, but that their input resulted in action,” Eatherly said. “Even when change takes time, continued communication, visible progress and opportunities for employees to remain involved demonstrate that the offsite was more than a conversation—it was the beginning of meaningful, sustained work.”

Catherine “Katey” Husband, who works in process improvement with BJACH Quality Management, said broad participation was essential because changes within one area can affect departments across the hospital.

“At a smaller treatment facility such as BJACH, our responsibilities overlap, and even small changes can ripple into other departments, processes and mission delivery at the ground level,” Husband said.

She said participants combined their perspectives into practical ideas for command consideration. Sustaining progress, she added, will require measurable goals, consistent tracking and continued communication.

“The changes and quick wins need to be measurable and tracked,” Husband said. “The results also need to be communicated clearly and often so employees understand what is changing and whether those changes are working.”

The summit produced a clearer organizational problem statement, four lines of effort, key tasks, possible quick wins and organizational design options requiring further review.

Leaders will continue refining recommendations, evaluating risks and effects, identifying responsible owners, establishing timelines and determining how progress will be measured. Some actions may move forward quickly, while proposed changes affecting personnel, workflows or patient care will require additional analysis.

“The summit was not the finish line,” Hensley said. “What it gave us was something we did not have before: a much clearer starting point.”

Quatto said BJACH must now establish priorities, assign responsibility and translate promising ideas into specific actions. Early successes can build momentum, but lasting improvement will require continued attention and assessment.

“Six months to a year from now, BJACH should revisit those decisions and assess whether the changes are actually improving how the organization functions,” Quatto said. “Sustainable improvement requires continued attention, clear ownership, and a willingness to learn and adjust as changes are implemented.”

Miller is expected to discuss the work, actions moving forward and issues requiring further study during the BJACH town hall Sept. 25.

For Hensley, progress means improving employees’ daily experiences—not simply creating a new organizational chart.

“My measure of success is whether our people feel the difference—whether roles are clearer, communication is better, workflows are more efficient and our people have the space to bring all of that passion and talent to the mission,” she said.

Miller closed the summit by thanking participants for engaging in difficult conversations, considering perspectives outside their usual areas and helping develop a plan for continued improvement.

“The real work starts now,” Miller said. “We’ve got the plan. We’re going to continue to refine it, and we’re going to see it through.”

The effort supports BJACH’s commitment to strengthen its workforce, improve health care delivery and contribute to medical readiness at Fort Polk.

Miller challenged participants to continue looking for practical ways to improve the organization incrementally and collectively.

For BJACH, progress will depend upon continued communication, shared ownership and a willingness to turn the work of the summit into sustained action.

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