3. Health policy

Problem Identification

*A health-related issue is identified, usually as a problem.* Nurses can be especially effective in this stage *by helping to frame the issue*. Framing the issue means creating a particular perspective for the issue—for example, that assisted suicide is ethically justified because patients have a right to make their own health care decisions.

why does politics exist

*Politics exist because resources can be limited and some people control more resources than others.* Control of health care resources is spread among a number of vested interest groups, *called stakeholders*—Stakeholders tend to exert *political pressure* on health policy makers in an effort to make the health care system work to their economic advantage (at the municipal, provincial, or federal level).

Health care will be defined and controlled by those with ___ and ___

*political influence and power.*

****What responsible actions can nurses and the nursing profession take toward eliminating avoidable disparities? * (8)

-*Pursue roles in advocacy, partnering and policy change* -Act to create enabling environments and reduce poverty -Advocate for change and human rights -Create partnerships for change -Est equitable hiring practices that are supported by a just system -Align with social responsiveness, gender-equality fairness and equity -Protect civil rights and build supporting institutional resources -Conduct research to determine which changes in the provision of nursing care are most effective (CNA, 2010)

What is Health Policy (4)

-*decisions, plans, and actions that are undertaken to achieve specific health care goals within a society* -*comprises the choices that a society makes regarding its health goals and priorities, and the ways it allocates resources or policies to attain those goals.* -formulated, enacted, and enforced through political processes at the local, regional, provincial, territorial, and federal levels. -defined and controlled *by those with political influence and power.*

priorities of the office of nursing policy overview (3)

-HC access: through workforce stability -HC quality: through workforce dev - HC sustainability: through sys transformation

How Can Nurses Become Politically Active?

-Join/maintain membership w/in RNAO to bc aware of current issues and participate in the assoc political action events -talk to neighbours/co-workers about health policy -join an organizational commitee/council/qual improvement initiative -resp to RNAO action alert - lend your expertise/voice to a community issue through various forums -run for office

CNA's objectives (4)

-advance nursing excellence and +ve health outcomes in public intrest -promo profession-led regulation in pub intreest -act in pub interest for CND nursing and nurses, providing ntnl and intnl leadership in nursing and health - advocate in the public interest for pub funded, not-for-profit health sys

Politically-Active Nurses

-articulate *what nurses do and why.* -*Have a clear political strategy before taking political action, voicing concerns, making demands, or advocating for others. A political strategy helps nurses* persuade the people supporting an issue, formulating a policy, or taking action. -*Are aware of the position of other involved groups* regarding any relevant political issue. -Listen *to other policy perspectives* and understand as many facets of the issue as possible when making health policy proposals (have a clear rationale) -*Lobby at the individual and federal levels*

Attributes of social justice (defn by CNA) (10)

-equity, incl health equity -human rights and the right to health -democracy and civil rights -capacity building -just institutions -enabling enviros -poverty reduction -ethical practice -advocacy -partnerships

function of the office of nursing policy overview

-issue ID and syn -enhancing evidence-base for policy dev -brokering knowledge -creating oppportunities

CNA's goals

-promo/enhance role of RN to strengthen nursing/CAN health sys -shape and advocate for healthy pub policy prov/terr/ntnl/intnl -advance nursing leadership for nursing and for health -broadly engage nurses in advn nursing and health

What Nurses Need to Know in politics? (5)

-the *relevance of policy and politics* to health care outcomes and nursing practice -that control and distribution issues will have an *impact on their incomes, workloads, work environments, and clients.* -they play a valuable role in policy making because of *their knowledge and expertise with determinants of health*—they are key informants for health and health care. -*Nurses have an ethical & moral obligation* to be aware of and act upon ethical endeavors related to broad societal issues -need to be partners in change to *compete, negotiate, and collaborate with stakeholders for effective political change, i.e. Nurses need to develop strong political and advocacy skills.*

Advocacy

Engaging others, exercising your voice and mobilizing evidence to influence policy and practice. Speaking out against inequity and inequality Participating directly and indirectly in political processes and acknowledge the importance of evidence, power and politics in advancing policy options (CNA, 2019)

Agenda Setting

Once defined and framed, an issue is refined through a political process that involves negotiation and debate as well as the mobilization of support from interested politicians and interest groups.

An operating budget accounts for which of the following?  a. the purchase of minor and major equipment b. construction and renovation c. income and expenses associated with daily activity within an organization d. applications for new technology

c

what is the role of a stakeholder in politics

Stakeholders tend to exert *political pressure* on health policy makers in an effort to make the health care system work to their economic advantage (at the municipal, provincial, or federal level).

Why does politics exist? a. It is required by law. b. Resources cannot be limited by political process. c. Some people control more resources than others. d. Resources must be equally distributed among stakeholders.

c

what is politics

Using power to influence, persuade, or change—it is the activity in which conflicting interests struggle for advantage or dominance in the making and execution of public policies.

The Canada Health Act embraces which of the following five principles? a. Public administration, comprehensiveness, universality, portability, accessibility b. Social justice, equity, acceptability, efficiency, effectiveness c. Accountability, equality, economy, collaboration, coordination d. Insured health services, provider compensation, hospital services, community care, pharmaceuticals

a

A nurse manager appropriately behaves as an autocrat in which situation? a. Planning vacation time for staff. b. Directing staff activities if a client has a cardiac arrest. c. Evaluation a new medication administration process. d. Identifying the strengths and weaknesses of a client education video.

b

Which of the following best defines leadership?  a. being in a leadership position with authority to exert control and power over subordinates b. a process of interaction in which the leader influences others toward goal achievement c. managing complexity d. being self- confident and democratic

b

nurses need to know how a policy ____ ___ ____, what bodies perpetuate it, and where the opportunity for ____ ___ rests

came into existence, policy change

Policy implementation

carrying out the proposed intervention

A process used today by nurses or nurse managers in health care organizations, which of the following best describes management? a. scientific management b. decision making c. commanding and controlling others, using hierarchical authority d. planning, organizing, coordinating, and controlling

d

Economics is the study of which of the following? a. the cost: quality interface b. cost accounting c. the cost of doing business d. how to manage scarce resources

d

Policy evaluation

determining if the policy achieved the desired policy goals

health inequities

diff in health *that could be avoided if reasonable action were taken* (therefore, these diffs are considered to be *ubfair and socially unjust*) -diffs mostly d/t *unequal distrib of social and economic factors that influence health, SDH,*

Social Justice

fair distrib of society benefits and resps and their conseqs

advocacy

invl engaging others, exercising your voice and mobilizing evidence to influence policy/practice. -speaking out against inequity and inequality -participating directly/indir in political processes and acknowledging the imp of evidence, power, and politics in adv policy opitons

who defines and controls health care?

ppl w political influence and power

health inequalities

the diff in health status among pop gorups defined by specific characs. these diffs can be d/t bio factors and indiv choices

Effective Advocacy Skills (9)

understand the enviro know the desired outcome have a strategy be reg and consistent know your audience make it personal focus on soln, not probs be certain of the facts use many approaches be persistent

Policy adoption

—a proposed intervention is selected.

Policy formulation

—different policy interventions are proposed and considered.