Landstuhl Regional Medical Center Strengthens Medical Partnership with Czech Military Hospital
to the Czech Republic Sept. 23-25 for a bilateral engagement with the Military University Hospital
Prague, or UVN, focused on trauma systems, surgical care and long-term medical collaboration between the two nations.
UVN is a premier teaching hospital that integrates military and civilian medicine, while providing comprehensive adult health care. Originally established to support the Czech armed forces, the hospital opened its doors to the general public in 1994.
Today, UVN employs approximately 7,000 people and operates 700 patient beds, including more than 2,700 active military personnel working alongside civilian staff.
"We are incredibly proud to be the very first hospital in Central and Eastern Europe to earn the prestigious Joint Commission International accreditation, said Czech army Col. (Dr.) Radek Pohnan, head of the Department of Surgery. "Building on that commitment to excellence, we were formally designated as a university hospital in 2012.
Pohnan said clinical capabilities span a broad range of specialties.
"We recently marked a decade of utilizing surgical robotics," Pohnan said. "Across the spectrum, our core strengths center on trauma and emergency care, neurosurgery and neuro-oncology, cardiology, and comprehensive cancer treatment."
For Col. Claude Burnett, director of LRMC Global Health Engagement team, seeing those capabilities firsthand underscored the value of the growing partnership.
"This was a reciprocal visit," Burnett said, referring to a November visit by a Prague delegation to LRMC. That initial exchange offered an in-depth look at LRMC clinical footprint, laying the groundwork for both sides to improve interoperability, exchange best practices, and identify opportunities for reciprocal professional exchange.”
The engagement included introductions between medical professionals from both institutions, as well as two U.S. Army officers representing the United States Embassy
Prague.
On behalf of the LRMC leadership, U.S. Army Col. Charles Douglas, deputy commanding officer, extended greetings from LRMC Commander Col. Warren Stewart and emphasized the importance of developing relationships and professional exchanges before a crisis occurs.
The United States has long history of working with multinational surgical teams during military operations, he said. For those teams to succeed when lives are at stake, preparation and integration must begin well before deployment.
"Knowledge exchange and integration are the absolute keys to our success," Douglas said. "What we are looking to establish right now are robust observer programs and collaborative initiatives. Understanding each other's clinical practices and specialized skills, especially in trauma, the operating room, and other critical specialties, is something we must actively pursue today, well before we are faced with a large-scale conflict."
Douglas said the changing operational environment has prompted LRMC to reassess its medical capabilities and consider how the medical center can adapt to increased demands.
"The traditional U.S military medical model has emphasized stabilization at the point of injury followed by movement through established roles of care towards definitive treatment. In a large-scale conflict, however, disrupted evacuation timelines could require patients to remain much longer within allied and partner medical systems," Douglas said. "As our mission expands, we need to adapt and keep this shifting operational reality in mind as we evaluate how we structure clinical observer programs moving forward."
Czech army Col. Veronika Sedivcova, deputy director of the Military Medicine Division of the Czech Ministry of Defense, said the Czech military and UVN face many of the same challenges.
"Implementing these changes will take time because we aren't just working within our Ministry of Defense; we also have to coordinate across our nation public health care system," Sedivcova said. "Fortunately, our civilian partners are incredibly eager to collaborate with us."
She also highlighted joint readiness exercises conducted with allied nations as an example of existing cooperation.
Sedivcova said aligning clinical procedures, medical infrastructure, and support networks will be critical to improving interoperability among allied medical systems.
Burnett agreed, saying the challenge extends beyond clinical care to systems that support patient
movement and sustainment.
"Across our Allies and partners, we frequently discuss the need to improve standardization and interoperability,” Burnett said. “Our medical systems do not always communicate or integrate as effectively as they need to during exercises, and those gaps could become significantly more consequential in a crisis or conflict."
Burnett said medical interoperability must encompass more than treatment at a hospital.
"It's everything that surrounds the movement like blood problems," Burnett said. "It's an entire myriad of things that we need to ensure we are aligned with. I will be looking at areas in the hospital for opportunities to develop some of those capabilities, like patient crisis care, mass casualty, blood management."
Sedivcova said patient evacuation and medical stabilization remain significant challenges among NATO allies because of differences in national laws and medical systems.
"The number one thing is how you evacuate your patients," Sedivcova said. "Medical is a priority, and to get all nations within NATO to implement this, especially with all the different national laws, is not easy."
The delegations also discussed differences in medical education and professional staff credentialing among nations.
Burnett said those differences must be reconciled in a manner that facilitates clinical interoperability to meet the demands of modern warfare.
"In our past operations, our training and immediate interventions were heavily focused on penetrating trauma, severe burns, and combat amputations," Douglas said. "However, what we are seeing in current conflicts is a stark shift. The use of the advanced weapon systems and heavy artillery is resulting in an unprecedented volume of traumatic brain injuries that require entirely different clinical approaches."
Douglas said allied medical facilities must also prepare for the logistical challenges associated with a large-scale, high-intensity conflict.
"We have to anticipate that once casualties begin flowing through the evacuation chain, we will be forced to manage a heavy, unregulated flow of patients," Douglas said. "This means handling high volumes of casualties arriving at our facilities without prior coordination or electronic tracking."
He said traditional evacuation timelines could also be disrupted, potentially requiring patients to remain in local medical facilities for extended periods.
"In a large-scale scenario, we may not see patients evacuated back to Landstuhl for weeks or even months" Douglas said. "Because of this delay, we have to critically examine the gaps we are not currently addressing in our systems, and we must plan for a reality where the vast majority of our patients will need to be sustained and treated in local partner hospitals near the front lines."
Burnett said improving medical interoperability does not require allied health systems to become identical. Instead, the immediate objective is to better understand how each system operates, identify differences that could affect patient care or movement during combined operations, and determine where greater alignment is both necessary and achievable.
“Every nation operates within its own legal, regulatory and clinical framework,” Burnett said. “Those differences cannot simply be standardized away. What we can do is understand one another systems, identify where those differences create operational friction, and work together
on practical solutions.”
He said reciprocal observer ships provide a realistic starting point.
“We can build trust, exchange clinical knowledge and become more familiar with how our respective systems function now, before we are asked to work together during a crisis,” Burnett said. “That is a practical step toward greater interoperability.”
Pohnan emphasized the importance of sharing clinical experience among NATO allies and partners.
"We believe wholeheartedly in the power of sharing hard-won clinical experience," Pohnan said. "It is absolutely vital to our mission, especially when it comes to maintaining seamless combat interoperability alongside our NATO allies."
U.S. Army Master Sgt. Crystal Pulido, senior enlisted leader to the chief of nursing officers and deputy commander for patient caring services at LRMC, highlighted that the three-day engagement with the UVN delegates was, especially the way they have integration state-of-the-art technology and realistic training models,
"Seeing the UVN team's clinical excellence firsthand from high-fidelity tactical stress simulations to advanced robotic surgeries completely redefined what allied integration looks like in practice," Pulido said. "It is very comforting to know that we have world-class medical partners standing shoulder to shoulder with us, ready to provide top-notch care under all circumstances along with their commitment, creativity, and professionalism is absolutely amazing."
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