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Information management for a rehabilitation client assistance program.

Information Management for a rehabilitation client assistance program

Managing information in a client assistance program (CAP) follows the same general principles used in managing rehabilitation case records. These principles include accountability, documentation of needs and services, chronological case narratives, and support data for decisionmaking. In other respects, however, information management within a CAP differs because a CAP's mission in the rehabilitation services community is different. As it affects the rehabilitation client's life, CAP has the task of providing information about services, of helping to resolve conflicts as experienced by the client and, finally, of serving as an advocate for the client when conflicts cannot be resolved by the client without assistance.

CAP information management techniques are aimed at achieving these mission goals in a timely fashion so that rehabilitation efforts may continue with minimum disruption. Case information, as the basis for the CAP intervention decisions, is used to resolve issues to the client's satisfaction within the context of available rehabilitation resources, community resources, legal mandates, and agency policy. This context naturally includes consideration for the client's abilities, limitations, past history, and future goals during and beyond the rehabilitation program.

Gathering Information

Information management within the CAP, then, becomes a collection of methods and techniques that can be used to enhance the rehabilitation process by averting or solving problems arising within the service system. The proper management of such information does not require duplicating the case file, but instead requires the gathering of only that information related to the problem at hand. That is, managing information begin here with gathering data that clarifies the problem or conflict. That information usually includes: * the client's perception of the problem or the conflict; * the service provider's perception of the problem or conflict (usually from the counselor); * relevant policies, regulations and laws that might determine the outcome or resolution; * similar past CAP cases that might suggest the most appropriate intervention strategy; and * ways to help minimize other problems in the conflict aftermath period.

Quality and quantity of information influence management decisions and outcomes. This information helps the CAP accurately identify or define the issues central to the problem or conflict. From the moment a client requests assistance from the CAP, the management goal becomes one of gathering pertinent information in a form that can be used for intermediate decisions which collectively aid in solving the immediate problem or conflict. Information, if it is to be managed, must be in a form that can be used by the CAP in resolving the conflict. Otherwise, it is merely raw data, not information. So the gathering process includes an element of communication strategy as well. Information from the client needs to be as clear and concise as possible. This often has the added benefit of helping the client better understand the problem because he or she is asked to verbalize it or to write about it as a concrete concept.

This plain explanation of the problem from each client helps minimize needless information that, in time, could overwhelm the CAP's filing capacity. Only the essential information is of immediate value to the CAP in that it serves as the basis for time management decisions and for case strategy decisions. The client's perception of the problem, as expressed by the client, helps the CAP predict informational needs that must be collected from other sources. These subsequent needs, too, are shaped by both quality and quantity appropriate for CAP intervention decisions.

Time and Resources Decisions

When clear or essential information from any source arrives at the CAP in useable form, it makes initial conflict assessment easier. Physical management of the information typically involves or generates the following steps:

* Intake, recording and storage (opening CAP case file).

* Summarization and evaluation (CAP case notations; including previous client attempts at resolution).

* Conflict assessment notations (CAP service predictions).

* Identification of other informational needs (initial CAP actions).

* Strategy planning for resolution (for client and CAP).

* Information dissemination planning (to engage external resources for client and CAP; other agencies that might assist in resolving conflict).

These steps help the CAP to establish case and management priorities and to budget its time or resources according to case demands. Once the CAP identifies and acquires the exact information needed to assist the client, case planning becomes a matter of management by objective; the overall goal is achieved by satisfying intermediate objectives geared toward conflict resolution and client needs.

Information and Communication

Most CAP activities are characterized brief interventions, discussions of the problem and suggestions for alternative solutions to the parties involved in the conflict. This is so for several reasons, one of which is that CAP strives to find timely solutions that will neither hamper the rehabilitation process for the client nor erode the rapport between client and rehabilitation counselor or other service provider. As in the generalization that "form follows function," the information used by the CAP needs to be clear, accurate and as value-free as possible. This helps those involved in the conflict to see the problem from a mutual perspective arising from the sharing of objective information

Another reason for brief interventions is that most client assistance programs do not have the mission or the resources to conduct rehabilitation programs. CAPs are not intended to compete with existing rehabilitation programs. Assistance to the client is brief and oriented toward problem solving, not toward long-term clinical intervention.

This functional role has a direct impact on the flow of information in and out of the CAP as well as upon the management of that information. In general, most clients seek assistance because they do not understand the rehabilitation system or because they have misunderstood the rehabilitation counselor. However, sometimes the counselor has failed to understand the client's needs and desires. Such misunderstanding usually emerge from problems common to human communication, problems that are most easily corrected through the introduction of precise and clear information.

The possibility that the conflict can be settled easily and quickly is related to the degree that the CAP can interject such information into the client-counselor relationship. Information managed to this end serves to bring the parties together. So the client assistance program offers information useful to both sides but does not make decisions for the client or for the counselor. By focusing its management attention upon information essential to the understanding and resolution of the problem, the CAP does not encourage an environment in which the client feels dependent upon CAP or in which the counselor views CAP as the "point of contact" with the client. Once the problem is resolved, the CAP can more easily withdraw from the client's case to assist in restoration of the client-counselor relationship, if its informational involvement has been limited to and focused upon the conflict and its issues.

From the perspective of information management, these outcomes are facilitated by prudent use of information during the period of conflict. Any CAP information about the client which does not violate rules of confidentiality should, with the client's permission, be shared with the rehabilitation counselor or other service provider involved in the conflict. The opposite is also true: information from the counselor should be shared wiht the client, as long as it does not jeopardize the counselor's role or bring harm to the client. If such information is concise and value-free, it may be received by either party as "new information" that can help resolve conflicts that much sooner. So what the CAP does to manage information can also be considered as an attempt to reframe the communication strategies of the conflicting parties by offering proactive input. In this way, the CAP may help provide solutions merely by opening channels of communication between the parties again.

Information and Resource Conservation

By limiting its case information gathering activities only to that which is needed to understand and resolve conflicts, the CAP accomplishes several other tasks. The problem-specific information encourages CAP to resolve conflicts at the lowest possible level, a practice which is beneficial to the client and to the service delivery system because it save client time and agency money.

Additionally, this limitation reduces the effort and resources which the CAP must commit to the physical handling of information on paper. The savings in resources helps assure that CAP energies are available when needed for unexpected conflicts. This flexibility, as a goal of information management, also helps preclude the likelihood that an unexpected conflict will interrupt the CAP's daily planning and daily flow of information.

Most client assistance programs do other things, of course, besides conflict resolution. For example, a CAP may provide general information and referral services, technical assistance to rehabilitation providers and outreach projects for service consumers or communities. The streamlining of the informatio flow contributes to these other efforts by keeping enough CAP resources available. For example, consumer information that has helped clients in the past might be maintained as a resource file; information on support groups, community facilities, and so forth, can be kept on hand for immediate use. Because these data would then be readily available, client questions would require less research time to answer.

System Feedback

In addition to information on specific cases, the CAP also acquires information over time that can be of value to the entire service delivery system. Again, by limiting the type and volume of information that comes into the CAP, resource managers may find it less difficult to analyze that information. Patterns and trends in client problems may be more quickly recognized or defined. For instance, if numerous clients have trouble understanding eligibility requirements or case closure procedures, this information, once identified by the CAP, can be put to good use by service managers and planners interested in improving communication between the clients and service providers. This also helps the CAP fulfill its mandate to provide system input about agency policy for evaluation and analysis.

The same sort of information on developing patterns among CAP clients can greatly assist individual counselors who want to function as effectively as possbile. Individualized feedback can help the counselor recognize his or her own strengths and weaknesses and can contribute to the betterment of the rehabilitation process. Not surprisingly, the reverse is also true; feedback from counselors and other service providers can improve the CAP's own effectiveness. Once the CAP has intervened to resolve a conflict, client-counselor rapport has been re-established or strengthened, and the rehabilitation process has resumed at its normal level, the counselor may gain important information about CAP services from client statements of satisfaction or dissatisfaction. In either instance, the information can be valuable to CAP managers interested in improving services. Similarly, the CAP can conduct followup activities that allow for client input into service evaluation.

Although low-level intervention for conflict resolution remains an important axiom, a better one is that of conflict prevention. The CAP activities which emphasize consumer education, communication strategies, technical assistance to providers, and system feedback represent a collective policy of information management aimed at conflict prevention. As most problem arise from communication failures of one kind or another, most solutions are to be found within improved communication. Thus, the information which is disseminated through these activities provide knowledge from which can come better understanding. So in this way, potential conflicts and problems may be averted through improved communication of useful information about the delivery system.

Conclusion

This brief discussion has centered upon the notion that information management within a client assistance program remains a matter of collecting and using only that information which is directly related to problem or conflict resolution. When a client asks for help from a client assistance program, he or she usually has some particular problem in mind that needs resolving. Toward that end, the CAP identifies and gathers information which will be valuable in helping the client solve the immediate conflict, not information that more correctly belongs in the rehabilitation case folder. This practice helps guarantee that CAP resources will be available for a quick response to all client inquiries.

There is much more to be learned about information management within this context. People who work in client assistance programs should not hesitate to borrow other techniques and concepts from related fields such as communication theory, information theory, psychology of information, sociotechnical systems, and, most important, other human services delivery systems. Adaptation of such ideas depends in large part upon the information management system extant in the prevailing rehabilitation service sector encountered by the CAP. The management systems should be compatible so that effort is not lost trying to mesh two different kinds of systems. Management system evaluation by the CAP can help conserve human resources so that they are more readily available to work on behalf of the rehabilitation client, the person for whom the system exists.

Mr. Holmes is Rehabilitation Counselor and Ms. Tabor is Director for the Client Assistance Program, Kansas Rehabilitation Services.
COPYRIGHT 1989 U.S. Rehabilitation Services Administration
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Copyright 1989, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Author:Tabor,Susan E.
Publication:American Rehabilitation
Date:Mar 22, 1989
Words:2137
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