Army Activates New Warrior Transition Brigade at Walter Reed

By Fred W. Baker III
American Forces Press Service

April 25, 2007 – The Army stood up a new brigade today at Walter Reed Army Medical Center to improve outpatient care for wounded soldiers. Dubbed the Warrior Transition Brigade, the unit's leaders will take control of its first company of wounded warriors April 27. Two more companies will be added when the full complement of 166 soldiers is on the ground in June. About 600 wounded soldiers will eventually be assigned to the brigade.

Officials called the activation historic and precedent-setting, as it signals a fundamental shift in the way the Army manages those thrust into its sometimes confusing and bureaucratic medical system.

The unit is called the Warrior Transition Brigade, because the soldiers assigned there are "in a very difficult transitional period in their lives and in the lives of their families," said Army Maj. Gen. Eric B. Schoomaker, commanding general of North Atlantic Regional Medical Command and Walter Reed Army Medical Center.

Army Vice Chief of Staff Gen. Richard A. Cody and Sgt. Maj. of the Army Kenneth O. Preston both attended the event, flanked by a host of other VIPs and congressional representatives.

The structure of the brigade is based on a triad of support for the soldier, the unit's commander, Army Col. Terrence McKenrick, said. It will become the model for all medical treatment facilities across the Army.

Under the new formation, each company boasts a staff of 50, including 18 squad leaders, 12 case managers and headquarters staff. Squad leaders, case managers and primary care managers will all be integrated into the patient care plan and, for the first time, all three will be working within the same brigade.

The three companies were given armor, infantry and artillery nicknames: Able Troop for armor, Battle Company for infantry, and Chosen Battery for field artillery.

"Those three separate organizations represent the heart of our organization, which is the squad leader. Most of our squad leaders were chosen from the armor, infantry and field artillery units," McKenrick said. Many are combat veterans, he said.

The squad leaders are the first line leaders for the command and will have only nine to 12 patient-soldiers in their care.

The unit's top NCO, Command Sgt. Maj. Jeffery Hartless, said the squad leaders will provide hands-on, eyes-on leadership that was absent when the center came under fire for poor outpatient soldier care.

"That squad leader is your mother. He's your father. He's your brother. He's your best friend. He's someone you can talk to," Hartless said. "He's someone who fixes your problems."

Also under the new structure, 28 new case managers have been added, totaling 36 for the brigade. Each company will have 12. In addition, three senior case managers will oversee the staff. All of the case managers are Army registered nurses, allowing a better understanding of the patient care plan, Brigade Surgeon Army Lt. Col. Mike Bell said.

The additional managers allow for a caseload of one-to-17; before it was about one-to-50, Bell said.

Each company will have a physician and staff who work with specialists in the hospital to develop a patient care plan for each patient-soldier. Before, the military medical system assigned primary care managers from a pool of managers scattered within Walter Reed. Now a 25-member cell of physicians, nurses and support staff will focus only the primary care needs of those in the brigade, Bell said. The goal is to develop a seamless program that improves access and continuity of care, he said.

The brigade has been receiving cadre for the past seven weeks. Most of the company-level leaders are in place, and all should be here by the end of May. Hartless said the first task for the brigade leaders will be earning the trust of the patient-soldiers.

"We have to gain their trust. They're scared," he said. "Things are changing again for them. Some are getting new case managers. They are getting new platoon sergeants. They are going to have a squad leader. It's unknown for them. They already trust the medical part."

Each staff member will undergo a cadre training plan that includes 55 briefings on topics ranging from an overview of the medical command, the duties of squad leaders and platoon sergeants, and the medical and physical board process.

Still, Hartless said, he will be keeping a close eye on how the new cadre and patient-soldiers interact.

"I have no problem pulling a cadre member aside and saying, 'Hey, remember who you are talking to. This guy's had a traumatic brain injury,'" Hartless said. "He has an appointment at 10 at physical therapy tomorrow. You need to make sure he gets there. You may have to take him. You have to know where your people are. Go check up on them."

The first company to stand up April 27 is made up of the National Guard and Reserve soldiers receiving care at the center. After June 8, when the other two companies are staffed, those soldiers will be integrated into the other companies down to the squad leaders.

"They shouldn't be separate. A soldier is a soldier is a soldier," Hartless said. "It's one fight, one team. That's what we are going to do here."

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