1. Perla, Lisa Y. PhD, MSN, CFNP
  2. Barry, Erin S. MS
  3. Grunberg, Neil E. PhD


Purpose/Objectives: Veterans Affairs (VA) case managers assist and advocate for veterans navigating VA and civilian health care systems. However, government reports indicate repeated dissatisfaction with veteran care coordination. Several case management publications suggest that VA case managers lead, as well as manage, but do not indicate exactly what this means. Few published articles address leadership, specifically, among VA case managers.


The VA All Employee Survey (AES) is an annual survey of VA employees, including case managers, to gather information about their attitudes toward workplace characteristics, relationships, and leadership. The present study utilized a conceptual Leader-Follower Framework (LF2) to assess questions on the annual VA AES to determine which leadership elements are addressed, which leadership elements are not addressed, and whether there are any leadership elements that do not fit within the LF2.


Primary Practice Setting: Case managers work in a variety of clinical settings including more than1,400 facilities throughout the United States. VA case managers advocate for safe, effective, and equitable patient care according to their scope of practice.


Findings/Conclusions: All eight leadership elements from the LF2-Character, Competence, Context, Communication, Personal, Interpersonal, Team, and Organizational-were represented among the AES questions, and no leadership elements outside of the framework were identified. However, the leadership elements were unevenly represented within the AES questions, with communication and personal elements occurring frequently whereas context and team were underrepresented.


Implications for Case Management Practice: These results indicate the LF2 can be used to evaluate the responses of VA employees, including those providing case management, and to address questions of interest related to leadership and may be considered in the development of future case management surveys.