Case Managers for High-Risk, High-Cost Patients as Agents and Street-Level Bureaucrats

2017 ◽  
Vol 75 (5) ◽  
pp. 527-561 ◽  
Author(s):  
Jeffrey Swanson ◽  
William G. Weissert
Keyword(s):  
Resource Allocation ◽  
Case Management ◽  
Case Managers ◽  
Green Tape ◽  
Specific Process ◽  
Street Level ◽  
Outcome Goals ◽  
Process And Outcome ◽  
Street Level Bureaucrats ◽  
The Relationship

Case management programs often designate a nurse or social worker to take responsibility for guiding care when patients are expected to be expensive or risk a major decline. We hypothesized that though an intuitively appealing idea, careful program design and faithful implementation are essential if case management programs are to succeed. We employed two theory perspectives, principal–agent framework and street-level bureaucratic theory to describe the relationship between program designers (principals) and case managers (agents/street-level bureaucrats) to review 65 case management studies. Most programs were successful in limited program-specific process and outcome goals. But there was much less success in cost-saving or cost-effectiveness—the original and overarching goal of case management. Cost results might be improved if additional ideas of agency and street-level theory were adopted, specifically, incentives, as well as “green tape,” clear rules, guidelines, and algorithms relating to resource allocation among patients.

scholarly journals An Examination of Street-Level Bureaucrats’ Discretion and the Moderating Role of Supervisory Support: Evidence from the Field

2021 ◽  
Vol 11 (3) ◽  
pp. 65
Author(s):  
Mohammed Salah Hassan ◽  
Raja Noriza Raja Ariffin ◽  
Norma Mansor ◽  
Hussam Al Halbusi
Keyword(s):  
Human Resources ◽  
Positive Impact ◽  
Supervisory Support ◽  
Street Level ◽  
Perceived Supervisory Support ◽  
Street Level Bureaucrats ◽  
The Relationship ◽  
Moderating Role ◽  
Support Evidence

This study aims to provide a deeper understanding of the relationship between the discretion of street-level bureaucrats and their willingness to implement as well as between discretion and client meaningfulness by testing street-level bureaucrat theory in a different context. The effect of discretion on willingness to implement and client meaningfulness may differ due to perceived supervisory support. Data from 241 bureaucrats (labor inspectors) in the Malaysian Ministry of Human Resources indicated that discretion significantly influences bureaucrats’ willingness to implement and client meaningfulness. Critically, the moderating role of perceived supervisory support augmented only the positive impact of discretion on client meaningfulness; for example, this relationship is more significant among bureaucrats who perceive high supervisory support. This study sheds new light on the notable role of supervisory support in ensuring that discretion enhances client meaningfulness and willingness to implement.

scholarly journals An Exploratory Examination of the Relationship Between Trust and Street-Level Bureaucrats’ Willingness to Risk Their Lives for Others

2021 ◽  
pp. 027507402110554
Author(s):  
Nissim Cohen
Keyword(s):  
Police Officers ◽  
Exploratory Study ◽  
Future Directions ◽  
The Public ◽  
Street Level ◽  
Behavioral Theories ◽  
Street Level Bureaucrats ◽  
The Relationship ◽  
Do So

This article presents the findings of an exploratory study examining the relationships between street-level bureaucrats’ (SLBs) trust in their peers, managers, and the institution they belong to, and their willingness to endanger their own lives for the public. We build on previous administrative and behavioral theories to present a model of these relationships. Using a survey of 211 police officers in Israel, our findings demonstrate the important role of trust in understanding the willingness of civil servants to risk their lives for citizens. We also identify additional factors that may be related to their willingness to take this risk and the types of clients for whom they are less or more willing to do so. We discuss the normative elements related to these findings and suggest fruitful future directions for study.

Family Firms, Social Responsibility, and Non-Family Member Employees Identification

Think India ◽  
2013 ◽  
Vol 16 (3) ◽  
pp. 10-19
Author(s):  
Ang Bao
Keyword(s):  
Resource Allocation ◽  
Social Responsibility ◽  
Family Member ◽  
Program Implementation ◽  
Social Identity Theory ◽  
Family Firms ◽  
The Family ◽  
Corporate Social ◽  
The Relationship ◽  
Csr Engagement

The objective of this paper is to find the relationship between family firms’ CSR engagement and their non-family member employees’ organisational identification. Drawing upon the existing literature on social identity theory, corporate social responsibility and family firms, the author proposes that family firms engage actively in CSR programs in a balanced manner to increase non-family member employees’ organisational identification. The findings of the research suggest that by developing and implementing balanced CSR programs, and actively getting engaged in CSR activities, family firms may help their non-family member employees better identify themselves with the firms. The article points out that due to unbalanced CSR resource allocation, family firms face the problem of inefficient CSR program implementation, and are suggested to switch alternatively to an improved scheme. Family firms may be advised to take corresponding steps to select right employees, communicate better with non-family member employees, use resources better and handle firms’ succession problems efficiently. The paper extends employees’ identification and CSR research into the family firm research domain and points out some drawbacks in family firms’ CSR resource allocation while formerly were seldom noticed.

The Working Sheep Dog as a Model of the Street- Level Public Servant

Public Voices ◽  
2017 ◽  
Vol 6 (1) ◽  
pp. 51
Author(s):  
Anne J. Hacker
Keyword(s):  
Organizational Structures ◽  
Servant Leader ◽  
Street Level ◽  
Public Servant ◽  
The Relationship

There are examples all around us of natural, simple, yet amazingly complex organizational structures that demonstrate models of leadership that are of use today. The working sheep dog is one such example. It is a vision of grace, ability, stamina and integrity. The relationship that exists between theses canine and human partners mirrors that of the street-level public servant and servant leader.

Policy Refiners and Street-Level Lesson Learners

2018 ◽  
Author(s):  
Alastair Stark
Keyword(s):  
Policy Evaluation ◽  
Central Government ◽  
Street Level ◽  
Street Level Bureaucrats ◽  
Central Level ◽  
Government Level ◽  
Inquiry Lesson

This chapter explores agents who are influential in terms of inquiry lesson-learning but have not been examined before in inquiry literature. The key argument is that two types of agent—policy refiners and street-level bureaucrats—are important when it comes to the effectiveness of post-crisis lesson-learning. As they travel down from the central government level, street-level actors champion, reinterpret, and reject inquiry lessons, often because those lessons do not consider local capacities. Policy refiners, however, operate at the central level in the form of taskforces, implementation reviews, and policy evaluation processes. These refiners examine potentially problematic inquiry lessons in greater detail in order to determine whether and how they should be implemented. In doing so, these ‘mini-inquiries’ can reformulate or even abandon inquiry recommendations.

A case study of bureaucratic discretion: heterogeneous application of market entry regulation in Germany

2021 ◽  
pp. 1-20
Author(s):  
Petrik Runst
Keyword(s):  
Market Entry ◽  
Case Managers ◽  
Science Literature ◽  
Entry Regulation ◽  
Quantitative Evidence ◽  
Bureaucratic Discretion ◽  
Street Level ◽  
Actual Application ◽  
Uniform Manner

Abstract All law is relatively coarse after its initial implementation as the legislature cannot foresee all contingencies that can arise in the actual application of the law. Therefore, decisions need to be made by street-level administrators as novel and particular circumstances arise. Economists have largely ignored the political science literature on street-level bureaucrats, such as policemen, welfare case managers, or regulatory agents. I present a case study in the context of market entry regulation in Germany. Qualitative and quantitative evidence suggests that bureaucratic discretion exists, that is, administrative actions can be found on different ends of a decision space, and that its effects are potentially large. Administrators do not apply legislation in a uniform manner and we observe a systematically different application of rules across subnational jurisdictions.

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