Since this was a new role and a new type of individual filling this role, a formal orientation program was important.  In addition, TVHS found that it was important to provide education to other staff about the role of the Unit-Based Care Manager.

Change management is difficult for the staff.  And there have been so many approaches to coordinating care over the years.  VA TVHS found that to really get the staff nurses and other providers on board they had to implement the model and show the staff how beneficial having this new could be.

Communication about the new role, its merits and outcomes was essential to a successful implementation of the role.  TVHS also clearly delineated what the Unit-Based Care Manager should not do, specifically assume administrative duties or cover for the nurse manager.

One challenge of implementing new roles with CNLsSM is determining an appropriate and effective supervisory structure for the role.  TVHS leaders thought it was important to have a senior nursing leader maintain leadership of the introduction and management of new roles using CNLsSM until those programs are firmly established.

A business case and plan for the introduction of a new role or development of a new care delivery model should be developed at the beginning of the process.  And that business plan should have the support of key executives including the CFO, COO, and nurse executive.