Page 118 - 2020 JSOM Winter

• How should we measure HPT “operational” return on common barriers to cross-boundary teaming and propose
investment to validate service impact? strategies to optimize HPT potential within the SOF commu-
• How should we integrate HPT with existing health sus- nity. A summary of the barriers and solution strategies are pre-
tainment and medical services? sented in Table 2.
• How should we standardize HPT service delivery, while
maintaining flexibility to adapt to population needs? TABLE 2 Summary of Common Barriers to Effective HP
• How should we improve Operator and leadership un- Teamwork and Proposed Strategies to Enhance Teamwork and
derstanding and utilization of HPT services? Team-Effectiveness
• How do we improve cross-agency collaborations and Barrier Strategy
reduce redundancies? Narrow perspective on human Develop a broadened shared
• How do we ensure military and civilian professionals performance optimization by mental model of full-spectrum
are prepared for their HPT roles? focusing only on restoring health readiness that includes both
OR enhancing performance
aspects of restorative health
• What are the structures, policies, and resources needed AND performance optimization
to sustain HPT programming? Resourcing and staffing support Prioritize staffing of HPT
broad applications of health to address most significant
The future success of health and performance efforts depends sustainment and performance warfighter career field needs
on the ability for integrative, multidisciplinary HPTs to inno- efforts that do not account based on performance demands
vate quickly and adapt to the changing landscape of combat for career field diversity or and vulnerabilities
warfighter core tasks
and national security needs. Much of the research on team
dynamics has been derived from studying the military: military Diverse and multidisciplinary Develop a shared lexicon and
professionals deliver their skills
practice model that considers
teams have long informed what we know about the drivers through uncoordinated and intersections of total force
and antecedents of team effectiveness, high-quality leader- siloed services that occur mostly fitness domains, coordinated
ship, best practices for staffing and team composition, and independently of each other and collaborative care, and an
evidence-based approaches to training teams. The science of understanding of how individual
4
training and competencies
teamwork can be applied to HPTs with the goal of maximizing contribute to group-level goals
their effectiveness and enabling them to help the SOF commu-
nity better meet operational goals for readiness. We offer practical approaches for organizing practitioners to
maximize their potential, fostering successful integration and
Many competencies can be targeted to enhance teamwork: alignment within the existing Military Health System (MHS)
(1) attitude-based competencies, like cohesion and trust; (2) network, and improving coordination with existing installa-
skill-based competencies, like coordination and communica- tion health assets. We also propose innovative ways to bet-
tion; and (3) knowledge-based competencies like situational ter target services and maximize the investment made by SOF
awareness and shared mental models, to name a few. Table 1 communities in these efforts. Anchored to existing research,
5
presents the subset of evidence-based competencies described we present strategies to build effective multidisciplinary teams
by Lacerenza and colleagues, which depict attitude-, skill-, and propose recommendations that can be applied to individ-
5
and knowledge-based proficiencies that can be applied to bol- ual, interpersonal, and systemic changes in hopes of advancing
ster teamwork. These proficiencies offer solution strategies for service delivery to better meet the needs of SOF community
strengthening team-based competencies. members.

TABLE 1 Attitude-, Skill-, and Knowledge-Based Competencies Broadening Perspectives Through a
Derived From the Evidence for Optimizing Teamwork
Attitude-Based Skill-Based Knowledge-Based Shared Mental Model of Full-Spectrum Readiness
Competencies Competencies Competencies Historically, the service delivery model for supporting warf-
Cohesion Coordination Situation awareness ighter readiness has been siloed and focused primarily on re-
Commitment to Communication Transactive memory ducing or treating injury and illness. The absence of pathology
teamwork systems became synonymous with mission readiness and the primary
Trust Conflict resolution Shared mental models basis for medically oriented service delivery, professional com-
Psychological safety Shared leadership petencies, best practices, research, education and training,
Collective efficacy Backup behavior and policy. Warfighter “mission readiness” is now defined by
7
These competencies were described by Lacerenza et al. 5 more than just the absence of pathology and centers on a war-
fighter’s ability to optimally perform their mission essential
These competencies reflect attitudes, behaviors, and cogni- tasks. Consequently, the aperture for service delivery has been
tions and pave the way for individual team members to be broadened and adjusted to be inclusive of a performance-ori-
able to interact interdependently with each other, to cultivate entation for a warfighter’s mission capabilities.
expertise in teamwork in addition to individual-level exper-
tise, and to work effectively toward a common task or goal. The DoD embraced the need for a paradigm shift to close the
5
In health care, strengthening the capacity for team-based work gap between “medical” and “mission” readiness and realized
is essential for enabling positive outcomes for patients, central that merely embracing the concept was not enough. The shift
to health care delivery reform, and improving the job perfor- would require a shared understanding and integrated efforts
mance of practitioners. 6 across organizational agencies and stakeholders. As a result,
the DoD adopted a shared model to execute its strategic pol-
This article draws on existing research and best practices on icy and structural realignments. 2,8,9 Similarly, within the SOF
how to develop team-based competencies related to enhanc- community, HPO plays a critical role in this paradigm shift by
ing multidisciplinary team effectiveness. We identify three offering an additional way of looking at a warfighter’s needs,

116 | JSOM Volume 20, Edition 4 / Winter 2020