The 509th Medical Group at Whiteman Air Force Base, Mo., has launched a “Five in Four” initiative that expands clinic hours to better benefit patients working nights, swing shifts or irregular hours, according to a Defense Health Network press release.

The initiative extended hours to operate from 6 a.m. to 8 p.m., four days a week, increasing appointment availability and better aligning with shift worker schedules. Early morning and evening appointments make it easier for patients to receive care without sacrificing sleep or duty time, the press release said.

“At its core, the Five in Four initiative is mission-driven to deliver patient-centered care in a non-rigid format that supports shift workers, enhances military readiness and addresses the unique challenges faced by the military healthcare team,” said Maj. Shawn Miranda, Aerospace Operations Flight commander and Five in Four architect, per the release.

Ancillary services such as laboratory, pharmacy and radiology have also adapted alongside the new schedule to maintain continuity and support expanded access.

“Patients don’t have to wait until 7:30 a.m. to be seen if they just got off work at 4 a.m.,” said Staff Sgt. Kaitlin Lavares, a warrior operational medical technician, according to the release. “It’s a game changer for shift workers, and ultimately, for readiness.”

The initiative allows for greater provider engagement with high-risk patients and offers more time for professional development and deployment preparation.

“This change has improved readiness and administrative efficiency, enhanced patient care and access, provided higher provider sustainability and reduced interruptions,” said Capt. Djoanna Boyd, a nuclear operations physician assistant.

With coordinated efforts from healthcare operations teammates performing readiness-based appointments and support from leadership, Whiteman’s medical group is now ranked first in Individual Medical Readiness across Air Force Global Strike Command.

“This isn’t just a change in hours — it’s a cultural shift,” added Capt. Skye Couvrette, a flight doctor. “We’re creating space for people to thrive, not just survive.”