AF Operational Support Teams continue to show success, support squadron readiness

FALLS CHURCH, Va. — The Air Force’s Operational Support Team concept has shown its success since it stood up in 2019. Since then, teams have grown across the Department of the Air Force to improve operational readiness and overall Airman and Guardian availability.

An Operational Support Team, or OST, features a multidisciplinary medical team of active duty and civilian personnel that includes a physical therapist, a psychologist, social worker, strength and conditioning specialist and team specialist. OSTs temporarily embed in an occupational setting within operational units to address musculoskeletal and mental health injuries and identify the underlying causes of injuries to the unit members. OSTs embed within units from four to six months, depending on the needs of the unit.

“We have taken lessons learned from various embedded initiatives to develop an enhanced program called [OSTs] to optimize performance and readiness, using evidence-based physical and mental health risk mitigation strategies,” said Lt. Gen. Robert Miller, Air Force Surgeon General in his 2022 written statement on Defense Health Programs to the Senate Appropriations Subcommittee on Defense.

Right, Senior Airman Katelyn Day, 388th Munitions Squadron, along with other Airman hold a plank pose during a timed assessment at Hill Air Force Base, Utah, June 2, 2022. The Operation Support Team is a multidisciplinary medical team of muscular-skeletal and mental health professionals who use risk data to identify high-risk units on base. The team embeds with units between 3-6 months to observe for broader, longer-term symptoms causing muscular-skeletal and mental health issues so the unit can make adjustments to prevent future injury or mental health issues. (U.S. Air Force photo by R. Nial Bradshaw)

The Air Force Medical Service developed the concept of embedding medical personnel within high-risk units on a rotational basis in 2016 and first beta tested it at Joint Base Elmendorf-Richardson, Alaska and Whiteman Air Force Base, Missouri, in 2018. Due to their initial successes in addressing musculoskeletal and mental health injuries, two major reasons for a member not to deploy, OSTs have been programmed for 72 installations – currently 26 teams are operating across the Air Force and Space Force.

“My data analytics team analyzes high-risk squadrons 12 months before an OST embedment and 12 months after, looking at 63 units with more than 16,000 personnel across the Department of the Air Force,” said Lindsay Buckalew, OST chief, 711th Human Performance Wing, Air Force Research Laboratory. “What we found was a 20% decrease in mobility and duty restricting profiles that prevent a member to be on duty or deploy.”

Buckalew explained that while OST embedment helped to reduce profiles for individuals, the team’s efforts had a wider impact on the unit, including returning time and manpower back to the units to support the mission. Also, the military treatment facility saw a decrease in appointments by 5%, which equated to over 7,000 appointments since OST interventions and programs addressed many of the health and injury concerns.

“Put simply, Air Force leadership wants this capability,” said Buckalew. “They have seen the incredible impact OSTs have and they are requesting it.”

Buckalew said the most notable success has been among security forces units where OST-shared education programs on preventative health care, like sleep hygiene and nutrition, had significant impacts on unit readiness. OSTs have embedded within 12 security forces units, which covered more than 3,600 personnel.

“Through our embedments, we have been able to significantly decrease musculoskeletal and mental health profiles by 25%,” said Buckalew. “We have allowed for more members to get back to the mission. For example, at Whiteman Air Force Base, because we were able to return more members back to duty, the unit was able to go from 12-hour shifts to eight-hour shifts, improving overall well-being for the unit members.”

There are several reasons for OST’s success, including a data-driven approach to identify high-risk units to develop targeted interventions and programs to address specific units’ challenges and needs. OST members also develop an important relationship with unit leadership to sustain interventions after their initial embedment ends.

“When I was part of an OST, we were able to bring in leadership into the conversation about what health issues we were seeing,” said Dr. Andrea Matthes Berg, Air Force Integrated Operational Support program manager. “By gaining their involvement to build programs and initiatives, we are able to ensure those interventions and positive outcomes are sustained long after we leave the unit.”

To achieve sustained success, OSTs follow up with unit leaders monthly to ensure the programs and interventions they have tailored continue to be implemented and unit readiness continues to improve.

“What we have found is that OSTs rotational versus permanent embedment model, has had a better return on investment,” said Buckalew. “Based on our current data, we should continue to see good numbers and improvements in unit health through rotational embedments.”

Since OST’s initial launch in 2019, a formal program office stood up at the 711th Human Performance Wing, part of the Air Force Research Laboratory, which has helped formalize support to the field. In addition, the program office has established training for providers preparing to be part of an OST.

“Our training capabilities have definitely grown and expanded to allow for enhanced execution of the OST mission,” said Maj. Samantha Warren, OST director of operations, 711th Human Performance Wing. “We offer a five-day, in-person training course at the [U.S. Air Force School of Aerospace Medicine], which provides the knowledge and background our teams need to fully understand the different culture in an operational unit and how to operate outside a military treatment facility. Many of our providers are not used to delivering care outside of the military treatment facility, so our training provides them with the necessary guidance. No other embedded medical program has this level of formal training.”

As Warren explained, sustained overall health and readiness of Air Force and Space Force units will become increasingly important to ensure all members remain ready and deployable. OSTs have proven to deliver the necessary support and have shown to significantly impact their operational units.

“We teach the Airmen and Guardians in a unit how to fish,” said Warren. “Through OSTs, we are able to bring stronger relationships with unit leadership and with our military treatment facilities. We are able to get ‘left of the bang’ by addressing issues sooner. OSTs provide a lot of education and preventative care, teaching them good practices that keep them healthy and mitigate the need for potential profiles. Throughout their embedment, the OSTs provide the units with the tools necessary to sustain their unit health long after our OSTs have left. That is the key to our success.”