Some learnings from Role Change Theory

Role Change Theory is a way of looking at what it takes to successfully make a new role work in practice. This applies quite well to care management, as care managers are often a new role in practice.
Their inclusion also means that other roles in the practice, or at least some tasks or duties, change as well. Commonly, the care manager has no peer in the practice. Consider the table below in how you and your practice members are viewing the role of care manager. Making sure you address all the five elements of Role Change Theory, along with role clarity, can make the difference between successful and not successful care management.

Does your care management effort successfully address all these areas?

DomainDefinition Questions for your practices Tips on Success
Structural
Autonomy
The freedom to make choices
about how, when, and where
role and responsibilities are fulfilled.
What degree of autonomy
do care managers have,
in what areas, and how?
Successful care managers do
Client demand
and trust
The extent to which clients desire
and demand what the person in the
new role is doing and trust the
person in
the role to deliver this service.
Do the patients feel the care
manager is sufficiently
qualified to help them?
Do they trust him or her as a
member of the health care team?
Care managers and those
performing care management
tasks need to be adequately
qualified to do what they are
doing. Patients must have a
sense of trust in care managers
that their knowledge is accurate
and that they are acting in the
patients’ best interests with their
behaviors and words.
Cultural
credibility
for new role
Trustworthiness and
acceptance of the
role within the
culture of the
organization.
Do the providers and staff
trust the care manager to
do the specified tasks in
that role? To work with
patients independently?
To extend the work of the
provider?
Lack of trust on the part of
providers and other staff is a
key reason for failure of care
management. Providers need
to develop a new “mental
model” of providing care in a
team setting to make this work.
Resources
and
mobilization
of new role
occupants
Time and
appropriate
expertise needed by
role occupants to
carry out the
demands of a new
task.
What training, background,
and expertise are needed
from the care manager?
Is the care manager role
adequately resourced in
terms of time to achieve goals?
Care managers and those
performing care management
tasks need the appropriate
training and expertise to do
this work. Care managers need
adequate time to address patient concerns.
By Complete Care Management, Inc.