Page 119 - 2020 JSOM Winter

through a performance-oriented “lens.” First introduced in focus on supporting warfighters’ diverse talents and adding
2007, to the DoD and operationalized for warfighter commu- a performance emphasis to existing health sustainment and
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nities in 2019, HPO provides HPTs a capability-based lens medical readiness models. The HPO spectrum operational-
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through which health and performance needs are contextual- izes the paradigm shift and requires practitioners to consider
ized by a warfighter’s primary duties, also known as core tasks a full- spectrum model of care more aligned to a warfighter’s
(CT) and contributions to their unit’s mission essential task list “mission readiness.” It requires engaging all available HPT re-
(METL). HPO addresses full-spectrum “mission readiness” by sources in support of warfighters at every stage of their careers
expanding, broadening, and reorganizing the traditional spec- and demands that HPT practitioners value the whole spectrum
trum of care to move beyond simply health (e.g., weight man- and interface across boundaries more effectively. Functional
agement), and toward including mission-focused capabilities boundary crossing, in turn, facilitates a deeper commitment to
(e.g., strength needed to lift a round of ammunition). teamwork and interdependency.

The HPO spectrum (Figure 1) is a visual representation of the Attitude-based competencies like cohesion, trust, commitment
HPO approach and acts as a framework and tool that can as- to teamwork, and collective efficacy can be cultivated through
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sist with optimizing HPT service delivery. It illustrates the full a shared understanding of the HPO spectrum as well. Effective
spectrum of a Warfighter’s mission readiness and correspond- teams begin with effective team members, and in healthcare
ing HPT health and performance services organized across a teams, effective teams feel a commitment to the organization
capability-based continuum. A Warfighter’s state and match- and not just themselves or their specific role. HPT practi-
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ing HPT service delivery is organized using colors, which serve tioners across the HPO spectrum need to understand that a
as boundaries that represent specific types of service delivery, team-oriented approach is necessary since the success of the
professions, and competencies. organization cannot be achieved by just one person working
in isolation. Teams may have to reconcile competing interests
FIGURE 1 HPO Spectrum. or agendas and instead work toward a clearly articulated com-
mon goal.

Prioritizing HPT Staffing Through Understanding
Warfighter Diversity
A significant value of HPTs is their diversity of professional
backgrounds, disciplines, roles, and experiences, etc. as this
diversity provides a variety of embedded and readily accessible
resources to warfighters. It also poses a considerable challenge
to effective and sustainable boundary crossing, especially when
professionals have different priorities, lexicons, methods, and
styles of engagement. To effectively support mission readiness
The Performance Sustainment Phase (Figure 1; green) rep- as a cohesive team with mutually intelligible and synergistic
resents warfighters who first join the SOF community or who goals and priorities across the entire team, HPTs require a
have fully recovered from a previous injury/illness, and meet bridging tool or boundary object 13,14 to foster systematic and
all of the milestones of health sustainment: they possess the productive collaboration between HPT members, leadership,
minimum to moderate abilities to perform their CT within and other key warfighter community stakeholders. Identified
their units. In this stage, the goal of HPT services would be as a gap, the DoD recommended the following strategic bridg-
to reduce occupational exposures related to the performance ing solution: “Conduct a review of relevant DoD and Service
of their CT, which could push them back towards the right of Doctrine for each operational community, in collaboration
the spectrum or further degrade their performance and health. with SMEs, to conduct an analysis of their METL and identify
In the Performance Enhancement Phase (purple), warfighters key areas of strengths and weaknesses. Identify opportunities
have a foundation of health. HPT service delivery in this phase to develop COAs for optimizing HPO and minimizing iden-
should be directed to building capabilities to exceed their tified risks. Incorporate elements of the TFF framework for
CT-specific demands. Finally, in the Health Sustainment Phase achieving SMs fitness and mission readiness” (Item 2) .
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(yellow/red), HPT services would focus on restoration and re-
covery from injuries (physical, mental, emotional, or moral) The Capability Based Blueprinting (CBB) process supports
sustained as a result of their job, and which impact their abil- the 2019 JROCM within warfighter communities to improve
ity to perform basic CT functions. Unlike traditional “medical HPT service engagement. The CBB process is the systematic
readiness” standards, however, return to duty (RTD) determi- application of HPO and TFF—an operationalization of a
nation and “mission readiness” within the HPO model would shared mental model—and its ensuing blueprint is designed
be measured by a warfighter’s ability to perform their CT. to function as a boundary object or bridging tool to support
collaboration amongst leadership, HPT and medical person-
To intentionally and effectively cooperate across the profes- nel, as well as key military career field stakeholders. CBB is a
sional boundaries and phases captured in the HPO spectrum, community tool that enables evaluation of key strengths and
health and performance personnel need to ground their efforts vulnerabilities and was designed to support HPT by identify-
in a shared mental model. Enhancing teamwork begins with ing key pressure points within their communities: the goal is to
adopting a shared mental and integrative mental model. positively affect the health and performance of warfighters.
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The HPO spectrum was created specifically for HPTs to im- Using a career field’s critical CT as a foundation, the CBB pro-
prove teaming across boundaries and overall service engage- cess identifies the health and performance demands of a career
ment and impact. HPTs accomplish this through a primary field, occupational exposures associated with the critical CT,
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