Role Clarity and Work Alignment (RCWA) is a dynamic process used to determine both the intricacies of work activities of all nursing care providers for a specific population of patients and to identify the complexity of the interventions routinely performed.

Role Clarity and Work Alignment is neither a patient classification nor scheduling system, but it provides data essential to both.  Using Nursing Interventions Classification (NIC) language, representatives from a nursing unit analyze the complexity and volume of work, what work is appropriate for delegation, the structural relationships that support delegation, and professional practice concepts.

Unit staff develop a deep appreciation for the complexity of clinical nursing care and what is unique about their individual unit. Staffing and work flow decisions become knowledge based and client centered rather than task based.

Jayne Felgen, consultant and President Emeritus of Creative Health Care Management, explains how Role Clarity and Work Alignment (RCWA), improves the quality of patient care, increases efficiency, and gives staff nurses the confidence to work interdependently with physicians and clinicians in other disciplines. For two decades, nurses have used Role Clarity and Work Alignment (RCWA) to analyze their work and make decisions about skill mix.

Who Should Attend

  • Unit Practice Council members
  • Staff members (licensed nurses and others) who regularly provide patient care

The process requires careful concentration on the part of the direct caregivers and their cooperation with the facilitator who leads them through the discovery technique.

What You Will Learn

As caregiver roles are clarified, staff gains new insight about ways to lift up the role and extend the knowledge of professional nurses while optimizing the contributions and work satisfaction of all caregivers in caring for patients as a unified team.

As work and roles are explored, group members develop a more extensive awareness of the complexity, scope, and value of their work and develop new ways of approaching old problems and dilemmas.  Clarity of roles is essential to trust and thus to effective delegation.

RCWA gives a clear, comprehensive picture of how each unit functions so that changes in roles, policies, processes, and procedures can be aligned and enhanced to actively advance care delivery and professional practice initiatives.

Outcomes of this Program

The consultant facilitating Role Clarity and Work Alignment integrates the findings of the RCWA for each individual unit in order to create a comprehensive plan for transformational change that is customized for the organization. Specific outcomes include the following:

  • Creation of a knowledge-based, patient-centered approach to care delivery.
  • Improved documentation and interdisciplinary communication.
  • Sharpened critical thinking skills including new understandings of organizing and accomplishing work activities.
  • Establishment of a rational framework for delegation decisions that maximizes skill mix.
  • Maximized use of resources through awareness of time spent in value-added and non value-added work.
  • Increased appreciation for the complexity of clinical care.
  • Development of efficient, effective interdisciplinary relationships.
  • Preparation of organization for comprehensive electronic clinical/resource information system.
  • Creation of platform to engage the staff in implementing unit-specific responses to organizational initiatives.

The Role Clarity and Work Alignment process is not simply about identifying current realities, but about moving people forward toward greater care for those they serve.