Water Reed Army Medical Center

Walter Reed at War

Wednesday, Oct. 6, 2010

Walter Reed supports the Department of Defense in wartime, both by caring for ill or injured servicemembers who are evacuated to the medical center for specialty treatment and by sending its own staff members into harm's way.

More than 1,000 Walter Reed Soldiers have deployed to Operations Iraqi and Enduring Freedom, staffing a variety of combat support hospitals in Iraq, Afghanistan and Kuwait. To fill vacancies Walter Reed staff members created at the medical center when they deploy, the Army mobilizes Army Reservists onto active duty and assigns them to work at the medical center.

Meanwhile, the hospital staff began caring for servicemembers from both theaters of war operations shortly after combat began in March 2003. Walter Reed has treated more than 10,000 wounded, ill or injured patients from both operations.

A major portion of Walter Reed's resources in treating battlefield casualties in the 21st century has been devoted to caring for amputees. In 2002, Congress appropriated funds specifically for an amputee care center at Walter Reed because of a high number of such casualties expected from Operation Enduring Freedom.

Planning began in September 2003 for a separate building on the Walter Reed campus to bring together all amputee care capabilities, including occupational and physical therapy, social work, psychiatry, nursing, Department of Veterans Affairs counseling and other specialties. Four years later, the Military Advanced Training Center, a state-of-the-art facilityin the treatment and rehabilitation, opened its doors in September 2007.

This facility offers comprehensive treatment incorporating some of the most advanced therapeutic and prosthetic techniques in the world. The center's goal is to return amputee patients to the highest functional levels possible. Walter Reed has treated 774 servicemembers who lost one or more limbs during Operations Iraqi Freedom or Enduring Freedom, or 90 percent of all amputee patients from both theaters.

Warrior Transition Brigade

The Warrior Transition Brigade (WTB) was activated April 25, 2007. The WTB was the first Warrior Transition Unit established by the Army to provide command and control, primary care, and case management support for severely wounded, ill, or injured Soldiers. The WTB consists of three Warrior Transition Companies - Able Troop, Battle Company, and Chosen Battery.

The mission of the Warrior Transition Brigade is to provide command and control, primary care, and case management for Warriors in Transition to establish the conditions for their healing and to promote their timely return to the force or transition to a productive civilian life.

The Warrior Transition Brigade is dedicated to assisting Warriors in Transition accomplish their mission, which is to heal. Warriors are assigned a Triad of Warrior Care, which includes a primary care manager (a doctor), a registered nurse case manager, and a squad leader. The Triad works together to develop a Comprehensive Transition Plan for each Warrior, which includes a plan for their medical care as well as participation in a work, education, or other cognitive development program.

The Triad coordinates with medical specialties as well as other agencies (such as social workers, Army Wounded Warrior Program, federal recovery coordinators, Veterans Affairs, and others) to provide Warriors with support and education in the medical transition process.

The primary care manager, a licensed independent provider (physician, nurse practitioner, or physician assistant) is the sole provider for the Warrior in Transition. The primary care manager develops an individual comprehensive treatment plan for the Warrior, diagnoses and treats a range of health concerns and coordinates care for preventive, primary and specialty health care services.

The nurse case manager is a registered nurse who facilitates all medical care for the Warrior. The case manager promotes communication, collaboration and coordination in order to provide focused care by working with the Warrior, Family members, providers (primary care and specialists), the Physical Evaluation Board Liaison Officer (PEBLO), social worker, and the chain of command. The nurse case manager coordinates all appointments and consults for the Warrior in Transition. The nurse case manager is also a key link to other systems such as Veterans Affairs and the Physical Disability Evaluation System.

The squad leader is an experienced noncommissioned officer who serves as the first line supervisor for the Warrior in Transition. The squad leader facilitates all administrative matters for the Warrior and the Warrior's Family. The squad leader ensures accountability for each Warrior in Transition, enforces military standards, ensures appropriate living conditions, and ensures Warrior compliance with the Comprehensive Transition Plan.

Upon transition from inpatient to outpatient, Warriors in-process to their individual company with the assistance of their squad leader. Warriors are individually counseled by their squad leader and others at various stages in their transition to ensure they understand their plan of care and their status in the process. Warriors participate in a series of briefings and classes that will, along with their counseling sessions and appointments, ensure they have as much information as possible about the transition process, their medical care, and their benefits.

Some Warriors can expect to be referred to the Army Physical Disability Evaluation System to go before a Medical Evaluation Board (MEB) and⁄or a Physical Evaluation Board (PEB) at some point during their transition process. Whether or not they go through an MEB or PEB, their Triad will assist them in the transition process back to active duty or on to a productive civilian life.

Warrior Clinic

The Warrior Clinic, located in Heaton Pavilion, Bldg. 2, provides primary care services, for acute care, minor illnesses, pain management, physical exams, wellness exams, and medication education for Warriors in Transition assigned to the Warrior Transition Brigade.

Each company in the Warrior Transition Brigade has one primary care manager in the Warrior Clinic dedicated to providing a comprehensive treatment plan for each Warrior in Transition. The primary care managers, with the support of the other clinic staff, coordinate for all the medical care needs of all Warriors in Transition who are assigned or attached to the Warrior Transition Brigade.