Developing & Implementing Health Policy

Instructor: Maya Shapland

Maya has worked in the clinical, education, and management sections of healthcare for over 25 years and holds bachelor's degree in Speech and associate degree in Nursing.

Health policy lays the foundation for care of patients in the US. This lesson uncovers the methods for developing and implementing health policies as well as examples of the process and finished product.

Health Policy Development

Where there are healthcare needs, there are opportunities for meeting those needs. John is a registered nurse working in an environment of incredible opportunities to shape the care of patients in his region. He has developed a team to work on health policies addressing rural trauma care in his state. Health policy is the development of actions that address certain health-related issues in an area either locally, nationally, or internationally. It is a complex process that broken down into steps, assist the policymakers in addressing challenges and bring improvements.

Building the team

John developed a team from the stakeholders or those who have an impact in the decision-making process either directly or indirectly. Here are a few stakeholders on John's team:

  • Governmental influencers such as Emergency Services and Public Health
  • Hospitals in the area and urgent care leadership
  • Political influencers such as the Mayor or City Council-members
  • Patient representatives
  • Private business owners
  • Legal representatives

Developing health policy requires a clear direction, evidence-based research, and a full assessment of the need. Successful policy development moves through these phases: situational analysis, planning, implementation, and evaluation. Here is a snapshot of possibilities for your team.

Health Policy Process

Analysis

John has used the trauma data for his state to gather the number of patients coming from rural communities. Location of rural hospitals and urgent cares have been mapped. Distances from the trauma center to each rural community or helipad have been noted. This is just a beginning. Analysis of the region will provide the risks for the need of trauma care such as: waterfall, lakes, rivers, mountains, highways, and weather to name a few. Asking the hard questions early in the process can bring clarity to the project. Looking at past data can help formulate the questions to be answered before moving forward. This is the who, what, when, where, how, and why of policy formation. Counting the cost of the health policy will determine the ability to proceed.

Planning

John and his team have used all the evidence gathered to create a plan for this policy to care for trauma patients including: What role each stakeholder will perform and how they will perform it. John had to help the team decide the steps in the process of rural trauma care in a clear concise manner, how to get the policy to those it affects, and what type of measurement would be used to determine effectiveness. Planning requires a full scope of the possible solutions and the consequences of each action. The risk vs. benefits list is a valuable tool to clarify the best course of action. Troubleshooting should problems occur is essential.

Implementation

The trauma policy team has visited each stakeholder with the written form of the policy and time for questions and answers. Rolling out health policy takes a commitment to communication in multiple ways for the success of the project. Discussion and education are part of this phase as each team will need support. Constant monitoring is imperative for making sure problems are quickly managed. Making sure each group (hospital, emergency services, and governing bodies) know what to do and when to do it will prevent disastrous consequences. Successful implementation requires proper timing, education, management support, community engagement, and prompt response to questions or problems.

Evaluation

After 10 medical flights, John's team has met for evaluation of the policy. There are issues with when to notify flight services that have already been addressed as well as a clear channel for communication on the radio between the flight crew and the destination. This phase is critical for supporting those who are implementing the policy and for those who are directly impacted by the policy. Listening to those who are implementing and using the rural trauma policy will go a long way for John's team. The answer to what is going well and what is not going well is a great place to start. John must investigate the details to determine the next steps and is sharing the data with his stakeholders for their feedback and ideas.

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