In a recent development, the DoD invested $2.9 million in the renovation of its unit for the same day`s operation, which was completed in 2011. At the end of February 2012, the director of the joint venture stated that the associated sharing agreement was still under review and approved by the Air Force Medical Support Agency, And the reopening was scheduled for March 2012.2 The allocation agreement will be concluded between the 377th MDG and the NMVAHCS for the VA in order to occupy DoD`s outpatient rooms in exchange for 30 free operations per month for DoD beneficiaries (VA/DoD, 2011b). The William Beaumont Army Medical Center (WBAMC) and el Paso Veterans Affairs Health Care System (EPVAHCS) have been sharing resources since the early 1970s. At that time, will cancel plans to build a hospital in El Paso, when the army agreed to accommodate VA beneficiaries in the WBAMC then under construction. The El Paso DoD/VA joint venture was founded in 1987, when VA had to replace its dispensary. A working group between the two organizations agreed to an agreement in which the VA was building its new, larger VA Eastside El Paso Clinic (VA Clinic) next to the WBAMC. The clinic was opened in 1995 and each floor is physically connected and has free access to the WBAMC. The Army provides VA receivers in El Paso, which provide 26 percent of the stationary WBAMC`s stationary services. VA employees share an 8-bedroom outpatient suite and a 16-bed recreation area on the fourth floor of the WBAMC with army personnel. Va Clinic staff provides veterans with primary and behavioural health care, specialized services, dental services and outpatient surgery and has two outpatient suites that can be used by the WBAMC. In 2008, will open an additional 29,000 square meters to the physiotherapy clinic, behavioral health and podiatry programs. While the WBAMC was renovating its post-anaesthetist care center (completed in 2009), the VA allowed army officers to use the outpatient suite of the clinic. Texas Tech University School of Medicine has entered into a consortium agreement with EPVAHCS and WBATM to train residents in internal medicine and psychiatry.
The WBAMC Postgraduate Medical Training Program (GME) is open to VA physicians (AMEDD, 2012; DoD/VA, 2002, 2008b; GAO, 2007; Hite, 2011; U.S. Senate, 1980; VA, 2012b; VA/DoD, 2002, 2006). One of the lessons learned from El Paso is that open communication and information exchange are of the utmost importance for the success of a joint venture and that trust and cooperation are key elements of cooperation. There must be strong and engaged leadership and a strong governance structure, including interim management, subcommittees and working groups, that are sufficient to address important issues together. Members of the DoD/VA team (in collaboration with management when needed) should work together in brainstorming to solve the most important issues and work creatively on plans and documentation. This type of communication implies that it specifically addresses situations that arise in order to promote more targeted discussions and practical solutions and to create a paper channel. In this way, employees of both organizations will understand each other better and identify with the positive community efforts they are making. Staff should also gather as much as possible to strengthen their community identification. Unions should be involved in discussions early and as often as possible (Perdue and Ancker, 2007, 2011; VA/DoD, 2006; Wirtemburg and Ancker, 2008).