Health Policy Quiz
Advocacy for social justice
This theory includes the role of nurse as patient advocate not only at the bedside but within health care facilities and throughout society.
Insurance program that provides low-cost health coverage to children and families that earn too much money to qualify for another policy but cant afford private insurance
chip
Explain what "the state" refers to
"the state" refers to a particular kind of social group
unified theory of advocacy
(a) safeguarding patients' autonomy, (b) acting on behalf of patients, and (c) championing social justice in provision of health care"
Discuss the evolution of the role of the nurse advocate
-Florence Nightingale's advocacy is the foundation to modern nursing practice -Dorothea Dix- advocated for dignity for psychiatric patients and human treatment of the mentally ill -Loretta ford recognized the need for children to have primary care and is responsible for developing the role of the nurse practitioner and advocating that nurses practice to the full extent to their education and licenses -The role of the nurse as advocate has evolved over the years, from performing nursing functions adequately and safely to advocating for issues of social justice. It is a central tenet of nursing practice throughout the world
explain socialism
-Government should protect workers for negative situations and conditions • Equality regardless of role or status • Economy supports the good of all • Concept of a common good • Lack of individual ownership • Lack of privatization • Centralized government in control
explain conservatism
-Historically: Those in power have responsibility to help those not in power • Contemporary form: Opposes rapid and fundamental change but advocates for decreased federal involvement in all matters, reduced tax burden, traditional social values, and transfer of authority to the geographic states • Preference for tradition, stability, and structure • Patterns of power that are predictable
Outline the evolution of health policy in nursing
-Modern nursing movement began with Florence nightingale -late 1800s and early 1900s, Wald and colleagues set out to address getting best health care to vulnerable individuals, families, communities, and populations
what are the political analysis steps
-identification of the isse -context of the issue -politcal feasibility -stakeholders -econmics and resources -value assessment -networks and or coalitions -power -goals and proposed solutions
describe the sources of power
-legitimate power -reward power -expert power -referent power -coercive power -information power -connection power -persuasion power -empowerment
What are the social determinants of health?
-neighborhood and physical environment -health and health care -social and community context -education -economic stability -food
Steps of Negotiation
-prepare -identifying the interests -identifiying suitable options -establish standards -identify alternatives
Explain the types of advocacy
-professional advoacy -issues advocacy -political advocacy
what are the two models of policy-making process
1) Kingdon's policy streams model 2) longest policy framework
Understand the origins of conflict to effectively maneuver through policy issues
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Evaluate how the health of individuals, families, communities, and nations is promoted by advancing policy and political context.??????
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Discuss a framework for shaping health policy in the United States
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federal healthcare insurance for 65+ and those with disabilites like ESRD
medicare
most signinficant piece of social legislation passed in the U.S. since Medicare/Medicaid enacted in 1965
ACA
the ability to punish others and is rooted in real or perceived fear of one person by another. For example, the supervisor who threatens to fire those nurses who speak out is relying on coercive power, as is a state commissioner of health who threatens to develop regulations requiring physician supervision of nurse practitioners.
Coercive power
Describe policymaking in the USA
Federalism- intended to create and sustain a highly decentralized locus of authority Incrementalism- often restricted to familiar policy options related to the status quo, and the analysis may focus more on the problems than on the solutions. Proceeds slowly by degrees
Describe the meaning of healthcare access
Having the ability to receive the right type of care, when needed, at an affordable price
the authoritative decisions made in the legislative, judicial, and executive branches of government that are intended to direct or influence the actions, behaviors, and decisions of others
Health policy
Describe three educational opportunities for nurses to learn policy and political skills.
Internships and fellowships, volunteering, professional association activities
Describe professional advocacy
Involves nurses championing issues that support the professional (ex: safe staffing, nurses' health, healthy work environments)
existential advocacy model
Refers to human beings as authentic, the nurse works with the patient to determine the personal meaning of the experience
Discuss the components of political skill
Social astuteness, interpersonal influence, networking ability, and apparent sincerity,
federal insurance program that provides benfits for retired people and disabled
Social security
Explain how mentoring is a vehicle for developing political skills.
The characteristics of successful mentors include being trustworthy, an active listener, accessible, and able to support the protégé's professional development; A study among nurses who either possessed a doctoral degree (PhD or DNP) or were a candidate for the degree revealed that the mentoring functions of advocacy, career development, learning facilitation, and friendship correlated with political skill development in the protégé. Compared with non-mentored individuals, productive mentoring relationships result in the protégé gaining increased visibility, self-efficacy, access to new social networks, and greater career mobility
explain political strategies
The development and implementation of a political strategy to solve an issue requires that there is a tightly framed message, an aligned common purpose or goal, and a well-defined target audience. Messaging is critical to the development of a political strategy. Nurses need to be able to communicate with policymakers, other health care leaders, and the public and may sometimes use social media for messaging to advise on institutional and public policy. -look at the bigger picture and know what you are advocating about and do the research
Explain the steps in the policy process
The first step is: defining and framing the problem, which Involves assessing its history, patterns of impact, resource allocation, and community needs The second step is: bring the problem to the attention of those who have power to implement a solution; Other key factors to consider include generating public interest, the availability of viable policy solutions, the likelihood that the policy will serve most of the people at risk in a fair and equitable fashion, and consideration of the organizational, community, societal, and political viability of the policy solution.
Analyze the elements of the Affordable Care Act.
There are four elements of the Affordable Care Act 1) Create value- increase patient health outcomes and satisfaction; decrease medical errors, costs, and waste 2) Coordinate care- across people, functions, activities, locations, and time; ensure active patient participation 3) Payment reform- change the way providers are paid to reward care that improves health ad minimizes waste 4) Expand access- affordable portable, transparent health insurance for all individuals to have choice, control, and peace of mind
Compare and contrast how upstream factors can undermine or promote health.
Upstream factors promoting health include safe environments, adequate housing, economically thriving communities with employment opportunities, access to affordable and healthful foods, and models for addressing conflict through dialogue rather than violence. The key to reducing and eliminating health disparities, which disproportionately affect racial and ethnic minorities, is to provide effective interventions that address upstream factors both from within and outside of healthcare systems.
What is the Affordable Care Act?
a major federal policy, aimed to improve access to health care through health coverage
The role of working to protect or promote individual rights, values, access, interests and equity in health care
advocacy
granted to those perceived to have important and sometimes extensive connections with individuals or organizations that can be mobilized. For example, the nurse who attends the same church or synagogue as the president of the home health care agency, knows the appointments secretary for the mayor, or is a member of the hospital credentialing committee will be accorded power by those who want access to these individuals or groups.
connection power
what are the cornerstones of reform in ACA
create value, coordinate care, expand access, payment reform
all of these types of power, shared among the group. Nurses need to share power and recognize that they can build the power of colleagues or others by sharing authority and decision making. Empowerment can happen when the nurse manager on a unit uses consensus building when possible instead of issuing authoritative directives to staff or when a coalition is formed and adopts consensus building and shared decision making to guide its process.
empowerment
based on knowledge, skills, or special abilities, in contrast to positional power. Benner (1984) argues that nurses can tap this power source as they move from novice to expert practitioner. It is a power source that nurses must recognize is available to them. Policymakers are seldom experts in health care; nurses are.
expert power
functional model of advocacy
focus on patient choice; In this model of advocacy, the nurse provides the patient with important information, determines that the patient understands that information, and then supports the patient's right to make the best decision for himself/herself even if the nurse disagrees with it.
Human advocacy model
for patient's humanity; Nursing advocating for mankind to prevent loss of humanity
what does health care access means
having the ability to receive the right care, when warranted, and affordable
Describe the preparatory steps of strategic communication
how to prepare for strategic communcation 1) analyze the strategic situation and context 2) define the ends 3)determine the means 4) formulate the ways 5) assess
results when one individual has (or is perceived to have) special information that another individual needs or desires. For example, this source of power can come from having access to data or other information that would be necessary to push a political agenda forward. This power source underscores the need for nurses to stay abreast of information on a variety of levels: in one's personal and professional networks, immediate work situation, community, and the public sector, as well as in society. Use of information power requires strategic consideration of how and with whom to share the information.
information power
describe issues advocacy
involves the role of the professional in championing social, economic, legal, and environmental factors that influence the health of the population.
that one has the right to power to make decisions and to expect others to follow them. It is power obtained by virtue of an organizational position rather than personal qualities, whether from a person's role as the chief nurse officer or the state's governor.
legitimate power
Discuss 2 models for policy formulation and guidelines for strategic conversations and dialogue
one model is the tretler cloud model which assess Ways, Ends, Means, Risk, and Cost for proposed solution. Identifes areas to be considered when advocating for or against a particular policy or action. Useful for assessing the arena policymakers are working in.
based in the ability to influence or convince others to agree with your opinion or agenda. It involves leading others to your viewpoint with data, facts, and presentation skills. For example, a nurse is able to persuade the nursing organization to sponsor legislation or regulation that would benefit the health care needs of her specialty population. It may be the right thing to do, but the nurse uses her skills of persuasion for her own personal or professional agenda.
persuasion power
set of regulations (public policy), practice standards (workplace), governance mandates (organizations), ethical behavior (research), and ordinances (communities) that direct individuals, groups, organizations, and systems toward the desired behaviors and goal
policy
includes all the activities that are involved in policymaking, including those activities that inform the legislators.
policy formulation
the rule-making phase of policy development.
policy implementation
allows all previous decisions to be revisited and modified
policy modification
describes policy goals and the ideas of those in policy subsystems, such as researchers, congressional committee members and staff, agency officials, and interest groups; The solution proposed must be hitched to an identifiable, timely, and urgent problem.
policy stream
the investigation of an issue including the background, purpose, content, and effects of various options within a policy context and their relevant social, economic, and political factors
political analysis
Discuss what political philosophy encompasses
political philosophy encompasses the goals, rules, or behaviors that citizens, states, and societies ought to pursue ....
describes factors in the political environment that influence the policy agenda, such as an economic recession, special interest media, or pivotal political power shifts.
political stream
describes the complexities in focusing policymakers on one specific problem out of many.
problem stream
based in identification or association with a leader or someone in a position of power who is able to influence others and commands a high level of respect and admiration. Referent power is used when a nurse selects a mentor who is a powerful person, such as the chief nurse officer of the organization or the head of the state's dominant political party. It can also emerge when a nursing organization enlists a highly regarded public personality as an advocate for an issue it is championing.
referent power
ability to compensate another and is the perception of the potential for rewards or favors as a result of honoring the wishes of a powerful person. A clear example is the supervisor who has the power to determine promotions and pay increases.
reward power
Those directly impacted by specific policy decisions and who may be involved in the policy making process
skakeholders
describe political advocacy
the active engagement in the political process through activities such as voting, campaigning for candidates running for office, donating to a political action committee (PAC), and lobbying and educating elected officials about important issues.
Describe what policy entails
the authoritative decisions made in the legislative, executive, or judicial branches of government intended to influence the actions, behaviors, or decisions of citizens.
Upstream factors of health
the broad range of issues, other than health care, that can undermine or promote health AKA social determinates of health
Describe what the policy process entails
the policy process is like a circle: problem identification, agenda setting, alternatives, policy choice, implementation, evaluation.
define political anaylsis
the process of examining an issue and understadning the key factors and people that might potentially influence
Describe forces that shape health policy in the United States
values, policy analysis, and analysts, advocacy and activism, presidential power, policies, science and research, the media, and interest groups
explain liberalism
• Individuals should be able to develop fully as individuals • Emphasizes individual rights and freedom of thought and expression (but not without limits) • Individuals have control over own bodies and minds, but not to extent of harming others • Democracy as ideal form of government, allowing everyone to participate and express views freely • Government protections against abuse of power
