Community Aged Care Case Managers Transitioning to Consumer Directed Care: More Than Procedural Change Required

Abstract

Consumer directed care (CDC) is increasing in community aged care. However, limited information is available to successfully transition social workers and other case managers to their new role. This paper reports on a case study of six senior case managers who supervised staff in three Australian community-aged care agencies as they transitioned from agency directed care to consumer directed care. A change management framework was used to analyse the qualitative data collected in 12 semistructured interviews. A key finding is that changes in values, attitudes, and organisational culture are needed before staff can fully implement CDC principles of service user self-determination, empowerment, and choice. Process changes needed to assist staff transition to CDC are: using a change management strategy that maximises certainty; monitoring and responding to feelings of anxiety through ongoing consultations; and providing ongoing education and support in group sessions.

消费者导向的看护在社区老人看护中方兴未艾。不过，社会工作者和其他个案管理者如何顺利过渡到新角色，则这方面的信息非常有限。本文是对澳大利亚三处社区老人看护机构六位员工经理的个案研究，他们经历了机构导向看护向客户导向看护的过渡。作者使用了变化处理框架来分析收集到的12份半固定访谈。本文的一个重要发现是，工作人员要想充分施行消费者导向所主张的服务使用者自决、赋权及选择的原则，他们首先需要价值观、态度以及的组织文化上的变化。有助于工作人员向消费者导向看护转变的程序变化包括：使用一种变化处理策略尽量强化确定性；监视焦急的情绪并通过不断的咨询对之做出反应；在小组会上提供教育和支持。

Keywords:

• Consumer Directed Care
• Community Aged Care
• Workforce
• Case Managers
• Cultural Change
• Change Management

Acknowledgements

We thank the interviewees who generously participated in this study, our colleague Dr Goetz Ottmann, and acknowledge that the study was undertaken with Australian Research Council (ARC) funding.