Learning and performing care management: experiences of a newly formed interdisciplinary, assessment and rehabilitation team

Abstract

Developments in primary and intermediate care services have enhanced interest in the notion of care management, the processes that it encompasses and the challenges that it poses to practitioners who are more used to working in a uni‐ or multidisciplinary manner. This article explores the way that a set of practitioners, new to care management, coped with the challenges of working within a newly created care‐managed assessment and rehabilitation service for older people in one UK county. Data were gathered via non‐participant observation, and group and individual interviews, as part of a wider action‐research evaluation study. Three themes emerged from the data: the processes of ‘learning’ to become a care manager; ‘doing’ care management; and ‘experiences’ of the role. In order to ‘learn’ care management, staff needed to develop a range of new skills, establish supportive care‐management processes, develop a new identity and work in an interdisciplinary way. ‘Doing’ care management involved working with a small group of patients with complex needs and precarious levels of homeostasis. Problem solving and crisis management were key activities and often required a creative approach to practice. Although care managers derived great satisfaction from their role, their ‘experiences’ were characterized by stress and anxiety. The practitioners from healthcare backgrounds needed more preparation to adapt to their new levels of responsibility and client risk. Successful management of the transition to care manager requires support from the key stakeholders and strong leadership within care manager teams. In‐house competency‐based training and induction programmes, and mentorship, can also play an important role, together with innovative forms of postqualifying education and training, for example, via job exchanges or an apprenticeship model.

Interdisciplinary teamwork: is the influence of emotional intelligence fully appreciated?

“…Interdisciplinary teamwork raises questions about partnership working (Leathard 2003) and role understanding including transition and flexibility (Griffiths et al. 2004, Kneafsey et al. 2004, McLellan et al.…”

“…The interdisciplinary team is defined as a group of health professionals from different disciplines, who work together sharing responsibility for collaborative decision-making and the outcomes of client-focused care (Liedrtka & Whitten 1998). Interdisciplinary teamwork raises questions about partnership working (Leathard 2003) and role understanding including transition and flexibility (Griffiths et al 2004, Kneafsey et al 2004, McLellan et al 2005. Discussions of team types and efficiency (Thylefors et al 2005) and the characteristics of effective health care teams (Mickan & Rodger 2005) go some way to identifying specific indicators that promote interdisciplinary teamworking that supposedly improves the quality of care (Irvine Doran et al 2002).…”

Editorial

“…(2006) and Adams et al . (2006) are concerned with learning to be a team member; but only Kneafsey et al . (2004) address the problems facing managers of newly formed interdisciplinary teams, in this case for assessment and rehabilitation.…”

Change and transformation: the impact of an action‐research evaluation on the development of a new service

“…In response to these anticipated demands, national policy initiatives (Department of Health 1989; Department of Health 1997; Department of Health 1998; Audit Commission 2000), local consultations, evidence on the potential role of rehabilitation targeted at those in need (Nocon & Baldwin 1998; Sinclair & Dickinson 1998) and the value of a care‐management approach, the county decided to review its rehabilitation service for older people. It was acknowledged that the health and social care work‐force needed to be able to work more effectively and efficiently to deliver assessment and rehabilitation services to meet the needs of older people living in South Cheshire (Kneafsey et al . 2004).…”

“…The RLTs linked together multi‐agency services and adopted interdisciplinary working using a care management model (Ovretveit 1993; Kneafsey et al . 2004), in preference to the traditional multi‐disciplinary team working (Marriott & Wright 2002).…”