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The theoretical framework known as R+A+A has appeared in nearly every book Creative Health Care Management (CHCM), the originators or RBC, has published (Felgen, 2007; Guanci & Medeiros, 2018; Koloroutis, 2004; Koloroutis & Abelson, 2017; Koloroutis, Felgen, Person, & Wessel, 2007; Manthey, 1980, 2007).

Any individual or group, whether council, task force, or committee, needs a clear scope of responsibility and a defined level of authority for decision making. R+A+A can also provide a mutually agreed upon system to assure reflection and review of the impact of everyone's efforts. Clarity around all three elements is necessary for success. They are defined as follows: