Health Policy 8/29

health policy definition

goal-directed decision making about health the is the result of an authorized and public decision-making process ( includes laws, rules, and regulations intended to accomplish certain goals)

public policy

means to protect the public and is goal orientated (set), public, and authoritative nature.

difference between health law and health policy

they are different in the way they are enforced and and the consequences of noncompliance law- governs whether you go to jail policy- governs how much the fine is

Professional Nursing Practice

*Scope and standards of professional nursing practice *Negligence and malpractice *Engagement and advocacy

Dynamic Tension (Cost, Quality, Access)

-A dynamic tension exists with access to health care, health care cost, and health care quality. -Changing one of these variables can improve or lessen the effectiveness of another.

Interrelated Concepts to Health Policy

-Evidence -Ethics -Safety -Health Care Quality -Health Care Economics -Health Disparities -Health care Law Health policy is not an autonomous concept. Several additional concepts discussed in this book are closely related to health policy (Figure 57-3). Data and research are used to generate support and 530interest for a specific health policy agenda. This use of Evidence supports advocacy. Distribution of scarce resources and policy development to enhance the greater good while minimizing harm require use of ethical decision making. Negotiation of diverse values in the context of balancing the competing values of fairness (Ethics) and efficiency (Health Care Economics) epitomizes the challenge of designing and implementing successful health policy, particularly addressing Health Disparities.

Participative Governance

-Federal, state, and local governmental power is gained through elected representation. -Citizens have indirect power to develop or change policy through the election process. -Involved citizenry leads to healthy, participative governance. **VOTE**

Intergovernmental relationships

-Health policy can be made at the federal level, state level, or local level. -Many policy initiatives require collaboration between the federal government and the state government. -These relationships result in complex shared responsibilities and, at times, challenges in establishing authority.

Values

-National and state health policy reflect societal values. -Fairness and efficiency are two competing values often at the heart of health policy decision making.

Health Care Delivery

1. Social Policy-relates to decisions that promote the welfare of the public. The goal of these policies may not be primarily about health but the outcome may impact health. ..Example- government policies that address obesity may result in regulation that governs the sale of high-fat/high-sugar content in public schools. 2. Institutional Policy-govern the workplace. Example-policy and procedure manuals of nursing units or clinic or home health agency 3. Markets-function to ensure efficient distribution of resources to the goods and services that are the most desirable among many options.

process of policy development and how nurses can be involved

1. agenda setting--Nurses can identify health issues that are problems and create a perspective from the point of view of a health care professional who is focused on holistic patient care. Nurses can do this by speaking at public meetings, writing to legislators, and writing letters to the editors of local papers. 2. policy formulation--Nurses can both propose policy interventions and offer constructive feedback on those under discussion by speaking at public meetings, writing to legislators, and writing letters to the editors of local papers. 3. policy adoption--Nurses can act in a manner to influence the individuals ultimately responsible for adopting or not adopting the policy by speaking at public meetings, writing to legislators, and writing letters to the editors of local papers.

how attributes are applied or addressed

1. decision made by government institution-- Patient Protection Affordable Care Act- passed by senate and House of Representatives and signed by President 2. public reaction and input--senators and representatives hold meetings to explain the bill and receive public response (reaction)..public attends the meetings or make contact through written statements (input) 3. ongoing review of policy-- Policy goal was to furnish health care services to all Americans by providing affordable health insurance and improving access to primary care. 4. changes in the policy-- depending on the election result changes will be made and voted on

major government institutions that decide, implement(enforce), and regulate the policy

1. legislature- creates laws and determine appropriate funding 2. judiciary and courts- determine rights in health policy disputes through judicial review 3. executive branch- executes and implements laws 4. regulatory agencies- enforce the laws through a rule- making process

process of policy development and how nurses can be involved (continued)

4. policy implementation--Depending on the particular policy, intervention may require changes in local health care agencies. In this case, nurses can be involved by serving on institutional planning committees and on supporting implementation in interactions with staff from their own units. 5. policy evaluation--Depending on the particular policy, intervention may require changes in local health care agencies. In this case, nurses can be involved by serving on institutional evaluation committees and engaging in evaluation activities in their own units.

attributes to making health policies

Major - authorized governmental institutions make the decisions - the decision making process is subject to public review and input - health policies address public policy goals Minor - health policies are subject to ongoing review - health policy goals change

Interrelated Concepts to Health Policy (continued)

The tension described previously among cost, quality, and access highlights these competing values. Nurses are in a unique position to combine their advocacy role of ensuring patient Safety and Health Care Quality with the ethics and health economics values of fairness, access, and cost efficiency. In some contexts, it may be difficult to distinguish health policy from Health Care Law. Health professionals often respond to the laws and regulations that have been promulgated as a result of health policies.

what are the primary elements regulated by the state regulatory board, and how are these activities linked to health policies?

primary-nursing license related- scope of practice, disciplinary action the board of nursing through its administrative rule-making authority sets health policy. Thus, regulations related to licensure, scope of practice, and discipline, among others, are examples of health policy.