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PubMedDate not supplied

Making policy and procedure systems work effectively.

Policy and procedure manuals can be cumbersome to keep current and updated. One approach to meet this challenge is by implementing a decentralized system to develop, review, revise and approve policies and procedures. Mechanisms to operationalize such a system involve sharing of responsibility and accountability of specified policies and procedures by various existing committees and development of coordinating systems and support mechanisms. Other key attributes of a decentralized system included collaboration and extensive communication strategies.

Humans↗
PubMed2001

Political strategy 101: how to make health policy and influence political people.

Many health policy decisions that affect how health care professionals care for their patients are made by the federal government or state and local governments. For most health care professionals, the policy-making process is a mystery. Health policy decisions made by elected and appointed officials in various branches of government are influenced by political factors often unfamiliar to the decision-making process of health care professionals. With some guidance on how to think critically about politics, health care professionals can influence the development, passage, and implementation of government-sponsored health policies that affect their patients. Based on insights gleaned from experience, accounts of the policy-making process, and political science literature, this article describes a process of gathering and analyzing political information that can aid physicians in developing a strategy that will help them influence the political agenda and their patients' care.

Child↗
PubMed2005

Who makes alcohol policy? Science and policy networks 1950-2000.

This chapter examines the interaction between alcohol policy networks, ideological "frames" of understanding of the alcohol problem and the production and use of research evidence. The emergence and growth of policy networks and the production of research based "evidence" as the rationale for change is traced from the mid-nineteenth century over major shifts in understanding of the problem, from a "moral" model to a "disease" model to a "public health" approach and, finally, to an approach which brings together health and criminal justice perspectives. The chapter challenges policy discourse which presents a rational model of policy making supported by "scientific" research.

Alcohol Drinking↗
PubMed1993

Demography, nursing and community care: a review of the evidence.

Demography is a most powerful influence upon social policy making. Policy making cannot be divorced from the constitution and the characteristics of the population for which it is intended. This paper commences by identifying and reviewing the most potent of those trends, and then examines the implications, first for the capacity of the community to cope with its dependents and then for the supply of nurses, before illustrating the importance of community nursing to government policies on community care.

Adult↗
PubMed1978

Who should make moral policy decisions in health care?

Physical therapists are not always involved in the formulation of moral policy that significantly affects their professional practice as clinicians, researchers, and educators. This paper analyzes five major positions being taken regarding what the physical therapist's role ought to be, and suggests possibilities for increased involvement in the policy-making process.

Decision Making↗
PubMedDate not supplied

The inside story: a simulation game on ethical, legal, and political decision making in health policy for nurse practitioners.

This game can be conducted with as many as 50 and as few as 15 players. The optimum size includes 4-5 Board members and 4-6 participants in each of the four small-group scenarios. The game takes about 11/2-2 hours to play. This includes a break between Part I and Part II. Existing state and national laws and policies are used in the game so that participants may understand their effects and limitations. The game has no winners or losers. Everyone gains if the decision markers are able to consider the needs of the individuals and the needs of the public, though some individuals may or may not benefit as much as others. This, however, is reality and is inherent in the policy-making process. In primary care, nurse practitioners (NPs) have a crucial responsibility to weigh the impact of their decisions on their clients and the community. The "Inside Story" integrates recommended NP curriculum content such as ethical decision making and health policy into a creative and powerful educational experience. This simulation game could be adapted for other topics with ethical, legal, and political implications such as issues regarding allocation of scarce resources. It could be played among students or professionals from many disciplines as part of their curriculum or in a continuing education offering.

Decision Making↗
PubMed2006

The limitations of 'evidence-based' public health.

This paper examines how the concept of the 'evidence-based' approach has transferred from clinical medicine to public health and has been applied to health promotion and policy making. In policy making evidence has always been interpreted broadly to cover all types of reasoned enquiry and after some debate the same is now true for health promotion. Taking communities rather than individuals as the unit of intervention and the importance of context means that frequently randomized controlled trials are not appropriate for study of public health interventions. Further, the notion of a 'best solution' ignores the complexity of the decision making process. Evidence 'enlightens' policy makers shaping how policy problems are framed rather than providing the answer to any particular problem. There are lessons from the way that evidence-based policy is being applied in public health that could usefully be taken back into medicine.

Decision Making↗
PubMed1991

Assessment of health policy in Costa Rica--some preliminary remarks.

Costa Rica is one of the world's success stories in primary health care. During the past 20 years the country has experienced a demographic and epidemiological transition. However, during the 80's the economic recession severely affected the country. The social, economic, political and geographic contexts are important for the assessment of health policy. The longstanding democracy, investments in public education and health all contribute to the peace and stability. Assessment of health policy needs both a quantitative and qualitative approach. The policy-making process--how policies are made, translated into action and evaluated--is a research challenge. The national health policy 1986-1990 includes commitment to Health for All strategy; development of the National Health Care System; strengthening of the health care infrastructure; consolidation of health achievements and undertaking of new problems and approaches on integral care for the population; community participation in all health care system activities; and health care priorities. Important research issues are the relationship between the needs of the population and health policy development and the impacts of health policy on the health of the population. A comprehensive study of policy-making includes studies of policy content, process, output and evaluation of impacts (including economy of health policy), and analysis for policy, i.e. information for policy making, process and policy advocacy. Recent successful health policy issues are child health and HIV/AIDS, while water pollution and traffic accidents have been more problematic policy issues.

Cause of Death↗
PubMed1994

The impact of social science research on health policy.

The relationship between research and health policy is discussed from a policy process perspective, describing communication problems in the course of policy formulation, implementation and evaluation. Policy process is often expected by researchers to be rational, having logical sequence of steps and the objective evaluation of alternatives based on scientific knowledge. In fact, policies are often formulated without clear problem identification or based on wrong assumption. The timing of research and policy-making differs. Policy-makers need to respond quickly. Evaluations may be regarded by politicians as embarrassing if they point to a need for significant change. It is not satisfactory to consider only research and policy-making: their relationship is influenced by the media, different interest groups and by the general public. Health policy formulation is embedded in the general policy environment of particular societies. Some countries have a long tradition of consensus-building, while in others health reforms have been formulated and introduced in a centralized way. Traditional bio-medical thinking influences health policy-makers. The importance of social and political acceptability tends to be overlooked. The paper emphasizes that we are experiencing an era of scarcity of resources and growing tension concerning allocation decisions. Existing institutions provide insufficient incentives for policy-makers and researchers to promote public dialogue about such issues. The paper concludes that there is a need for new approaches to policy development and implementation, new structures in policy-making, changes in research financing and co-operation between disciplines and new structures for public participation in policy-making. Research should facilitate more open and democratic dialogue about policy options and the consequences of alternative choices.

Communication↗