, 2002). U.S. Army Hospital Mission.

Impact. Today, U.S. Army hospitals may be situated in the middle of the homeland or in close proximity to the battle front (Hegadoren & Lasuik, 2006). While the need for timely and quality medical care is equally important in either venue, in the latter case, there are some important distinctions that affect the need and timing for procurement procedures. In this regard, the old adage, "There's a war on!," has been used time and again to justify emergency procurement techniques for the military that might appear exorbitant or inappropriate from a civilian perspective, but the military occupies a special niche in American society and human lives are constantly at stake as a result of the supply chain management process. According to Bondanella and his associates, "Financial considerations are only one factor affecting the decisions of logistics customers. Customers may also care about the speed with which an item is delivered or repaired and the quality of the service, for example. Taking all these factors into account, customers make decisions that are cost-effective from the local perspective" (2002, p. 18). This approach is congruent with existing U.S. Army procurement policies that use a best value concept to award many contracts.

According to USACCE Pamphlet 715-5 (2002), "Obtaining the 'best value' means that the Army will consider award of a contract to other than the lowest price offer, or other than the highest technically rated proposal. A tradeoff process is used to balance the decision of paying a higher cost against the perceived benefits to the Army of the technical proposal. The U.S. Army may include in the evaluation the past performance of potential contractors. The solicitation will specify the relative importance of price and other factors, such as past performance, in the award decision" (p. 4).

Effect on patient care. It is one thing entirely to have the delivery of a pizza oven or milkshake machine delayed; while the impact on morale might be significant, it is unlikely that there will be any substantive physical harm involved. This is not the case, of course, with vital materiel such as medical imaging equipment and delays in delivery could well translate into fatalities or adverse clinical outcomes where they could have been avoided by timely delivery of equipment. To ensure that a company is able to "deliver the goods" on time every time, the Army retains the right to survey a provider to ensure...

Army has extensive experience in the procurement of sophisticated medical equipment, including x-ray machinery, that dates back almost seven decades. The research also showed that there remains a paucity of accountability by contract specialists and purchasing agents who are responsible for negotiating and administering such contracts, but there are some indications that improvements in the form of assurances that a company is financially and technologically capable of fulfilling its commitments have improved the supply chain management processes that support these services. The research was consistent in emphasizing that in emergency situations, the Army is authorized to do what is necessary to ensure that its personnel have the equipment and training needed to accomplish their respective missions, but these same factors tend to adversely affect the effective administration of such contracts. In the final analysis, it is reasonable to assume that hospital commanders in war zones will continue to receive priority treatment for their materiel requests, but the safeguards outlined above will go a long way in ensuring that what is received is what was actually ordered.