Operational Support Teams work inside “beating heart” of USAF Published Sept. 10, 2018 By Peter Holstein Air Force Surgeon General Public Affairs FALLS CHURCH, Va. -- Each squadron in the Air Force faces different stressors and health challenges that require unique solutions. General David Goldfein, Chief of Staff of the Air Force, is leading an effort to revitalize Air Force squadrons. “The squadron is the beating heart of the United States Air Force; our most essential team,” Goldfein wrote in a letter to Airmen. “Our vision demands that squadrons be highly capable, expeditionary teams who can successfully defend our nation’s interests in both today’s and tomorrow’s complex operating environments.” The Air Force Medical Service is supporting that effort by rolling out a new health care model at the squadron level, called Operational Support Teams. OSTs rotate through squadrons at a base, seeking to improve individual health and squadron performance. By focusing on each squadron’s unique job, needs and environment, the OST can address the root causes of illness and injuries, and ensure readiness. Joint Base Elmendorf-Richardson stood up its OST June 4, 2018. The OST has a physical therapist, a psychologist, two nutritionists, an exercise physiologist, and a human performance integrator technician, and embeds with units around the base on a rotating basis. “OSTs lower barriers to care and head off potential injuries and illnesses by being embedded into the unit,” said Dr. Alyssa Wu, a physical therapist on the JBER OST. “We take what we learn and combine it with our expertise to make recommendations and implement policies that support the squadron.” Most health providers on base work in the clinic and treat patients that come to them, while OST members are out in squadrons, engaging Airmen in their daily routines. Rather than focusing on individual health on a reactive basis, the OSTs work to systemically reduce risky health behaviors and improve human performance across the entire unit. “Our number one priority as OST providers is unit readiness and performance,” said Dr. Natasha Swan, a psychologist on the JBER OST. “We are not in the clinic doing individual treatment. Our focus is to evaluate the squadron or unit as a whole. We look at how it is working, what the conditions are that cause certain injuries, and what strategies can be implemented to address or prevent health issues.” As Wu explains, embedding into the unit gives a better idea on the specific challenges a specific unit faces. JBER’s OST worked to understand the Airmen’s daily tasks while on duty. “The first step when we embed with a unit is to get fitted for gear and accompany them on duty,” said Wu. “We learn their routines and their challenges. From there, we implemented different policies and programs that would best benefit that unit.” “Being embedded in a unit gives us a ground-up perspective to tailor our efforts,” said Swan. “Each squadron experiences different stressors. Not only are we looking at the unique environment, but also the different dynamics within the squadron.” Viewing each squadron as a discrete system helps OST members assess what policies are in place and make recommendations to improve the health of the unit. One policy already recommended by the JBER OST and put in place for the base guard squadron, is a new vitamin D policy. OST Nutritionists tested the unit’s vitamin D levels, and found that 78 percent were deficient. “Low vitamin D is linked to many healthy issues, like sleep disorders, increased risk of respiratory problems, a weaker immune system, and a higher prevalence of musculoskeletal injuries,” said Staff Sgt. Travis McAdams, a nutritionist on the JBER OST. “When considering the Alaskan environment and long periods of darkness in the winter, low vitamin D levels can have a real effect on Airman performance. Monitoring vitamin D levels and providing supplements should improve individual health and overall unit performance.” This policy highlights the systems-level, multidisciplinary approach the OST takes to address the underlying health issues at the source. “If a squadron is having sleep issues, it most likely touches several health specialties: physical, mental, nutritional and others,” said Swan. “We can prevent the core negative health behavior by addressing what causes those unhealthy sleep habits.” As the Air Force refocuses on the value of squadrons as the engines that drive the force, the embedded OST model optimizes health and performance. Specialized care and policies helps squadrons reach their peak effectiveness. “The goal is to improve the human weapon system’s capability,” said Wu. “Having that embedded medical team to improve the overall readiness and maintain squadrons at that constant level of superior physical, mental and nutritional health makes an OST a really special and unique asset.”