The role of health services research in developing practice policy: development of practice guidelines.
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Clinical Protocols↗
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Results for “Policy Development”
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Policy development for compensating workers exposed to crystalline silica in Ontario, Canada.
The Ontario Workers' Compensation Board develops policy for diseases by considering scientific information within legal, political, and social contexts. The purpose of this paper is to describe the process used to develop a policy for lung cancer among gold miners and to examine the extent to which this process assists the development of similar guidelines for workers with silica dust exposure. The scientific and policy questions are similar, both requiring consultation with stakeholders. To improve the development process for the gold miner policy, consultation for silica and lung cancer needs to be more inclusive. The resulting procedures would also need to be precise enough to assist adjudicators to make decisions without limiting their ability to decide each claim on the merits of the case. The major challenge is to ensure that the final policy is scientifically and legally supportable and acceptable to both workers and employers.
Canada↗
A population policy and a development policy are one and the same thing. An introduction to World Population Year.
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Demography↗
Developing policies for runaways: insights from the literature.
This article examines the literature on runaways from an historical perspective. It argues that societal responses to runaways have been structured by the prevailing assumptions about the nature and meaning of runaway behaviour. The recurring theme of detachment and connection is highlighted and its implication for policy development is examined.
Adolescent↗
ASHP policy-development process: opportunities for improvement. ASHP Ad Hoc Committee on Policy Development.
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Decision Making, Organizational↗
The role of health education in public policy development.
Health educators should view policy development as a unit of professional practice analogous to the individual, the small group, the community, and the organization. The impact of policy on other units of practice and on people served by health educators is too great and the competition for scarce resources for health and human services is too keen to be disregarded. An increasingly active role in the policy process is, therefore, vital to the profession. Unfortunately, many health educators find an active role strange and lack guidelines for effective policy intervention. This paper attempts to mediate that situation. First a conceptual framework is offered. Operational definitions of important terms are given, including policy, public policy, social policy, health policy, and health education policy. A model of the policy development process is presented, detailing the purpose and dynamics of several steps: establishing problem awareness, setting goals and objectives, selecting a course of action, designing alternative courses of action, analyzing policy, assigning implementation responsibility, implementing, and evaluating. Then five categories of intervention strategies encompassing 16 individual suggested roles ranging from indirect influence to direct political involvement are presented. The categories are: acting as a source of policy information, providing technical assistance, organizing, influencing policymakers, and taking direct political action.
Consultants↗
A method for employee participation in the policy development process.
A method for policy development is described that permits employee participation at all levels within a mental health agency. This method is adaptable to a variety of organizational structures and does not require major administrative changes. It does require a commitment to participatory management and the belief that employees should be involved in the organizational change process. A step-by-step procedure is related, and guidelines for developing draft policies are offered.
Community Mental Health Centers↗
Health policy development in Lithuania.
The process of formulating a national health policy in Lithuania, a country in transition, has undergone several stages. Despite the existence of a national critical mass of professionals who understand the major principles of health policy development and who have a solid database to scientifically back the suggested decisions, and despite general acceptance by the public of the broader dimensions of health, the actual process of developing health policy is still facing considerable difficulty. Many factors obstruct this process, such as the inflexibility and resistance of the medical profession, traditions from the previous health service model and an extremely difficult economic situation. Nevertheless, one of the most important factors is the frequent change of government and, subsequently, of ministers of health, which makes continuity difficult. Fortunately, however, in contrast to the political level, the health professionals involved in health policy development and implementation assure at least one level of this necessary continuity. As a result of continuous efforts by the Health Reform Management Group and research and education institutions, and with the constant support of WHO, a policy and strategy for health for all continues to be developed, and the groundwork is being laid for improved dialogue and participation.
Cooperative Behavior↗
A survey of tuberculosis control programs in seventeen Minnesota hospitals: implications for policy development.
BACKGROUND: Generation of proposed policies directed at interrupting the transmission of Mycobacterium tuberculosis resulted in a need for data establishing health care worker (HCW) tuberculosis (TB) transmission risk and control programs that were in place before 1992. METHODS: A voluntary sample of 18 Minnesota health care facilities was surveyed retrospectively for the years 1989 to 1991. The survey was designed to establish the frequency of positive tuberculin skin test (TST) results, the rate of positive results during routine screening, the incidence of positive TST results identified through exposure follow-up, the type of respiratory protection (mask) used, and ventilation patterns of TB isolation rooms. The TST testing program, including name of product used, method of application, and reading/documentation behaviors, was requested. RESULTS: Data were analyzed from 17 hospitals (one long-term facility was deleted). Three hospitals screened all HCWs annually; the remaining hospitals screened HCWs at varying intervals. Forty-eight positive TST results were identified in routine screening. The rate per 10,000 HCWs screened was 5.8 in 1989; 15.9 in 1990; and 14.8 in 1991. An upward trend was noted in positive TST results only in metropolitan teaching/public hospitals. Intercomparisons of TST screening data demonstrated that employees located in Greater Minnesota were more likely to have positive TST results than employees at facilities in the metropolitan area. Hospitals in Greater Minnesota were more likely than metropolitan area hospitals to use tuberculin skin test material. HCWs screened with tuberculin purified protein derivative were more likely to have positive test results than HCWs screened with tuberculin purified protein derivative. Unisolated patients with communicable TB accounted for 445 patient days of probable risk of exposure for HCWs, without demonstration of a trend by calendar year. There were a total of 33 exposure events. Ten of 1031 HCWs screened after an exposure event were declared to be TST positive, for an overall conversion rate of 9.7 per 1000 employees screened. All hospitals used surgical masks for respiratory protection. Seventy-six percent of the hospitals had isolation rooms with negative ventilation; 12% reported isolation rooms with neutral pressure. CONCLUSION: The practice in Minnesota hospitals surveyed was reasonably consistent with the critical elements defined in the 1990 CDC guidelines for an effective TB control program. The rate of positive TST results was low, with programs in place before 1992. Unified TST programs permitting evaluation of programs are endorsed. Respiratory protection should be protective, not excessive. Engineering controls of isolation rooms should be ensured. Policy development should be driven by the prevalence and incidence of disease in the HCW's place of employment.
Adult↗
An activist looks at nursing's role in health policy development.
Health care delivery systems are evolving and transforming rapidly. Nurses will need new leadership and policy skills to meet the challenge of ensuring patient care safety and quality health care delivery. Nurses bring a unique perspective to health care policy development because of their educational training, professional values and ethics, advocacy skills, and experiential background. Significant progress has occurred over the years toward advancing nursing's presence, role, and influence in the development of health care policy. However, more nurses need to learn how to identify issues strategically; work with decision makers; understand who holds the power in the workplace, communities, state and federal level organizations; and understand who controls the resources for health care services. In health care policy development, nurses are essential in ensuring quality health care that is accessible and affordable for all women and their infants. More nurses need to actively work as leaders in the health policy arena.
Health Policy↗
The abnormal distribution of development: policies for southern women and children.
This paper offers a feminist critique of the relationships between gender and development by exploring the intersections between three sets of debates: firstly, the relations between interventions for women and for children through the anomalous position accorded to 'the girl child' in aid and development policies; secondly, the relations between psychological and economic models of development; and thirdly, the gendered and geographical allocation of attributes and opportunities. Drawing on analyses of the 'psychological complex' the author suggests that the cultural resources that inform developmental psychological models are highly cultural and class-specific (white, middle class, of the northern hemisphere), giving rise to a globalization of development that is reinscribed within international aid and development policies. In homogenizing difference to its norms, this globalization paradoxically reproduces the north-south opposition as an expression of cultural and political imperialism. While northern children 'develop', dominant discourses of children of the South are preoccupied with 'survival'. By such means the cultural hegemony of a unitary psychology remains intact. This paper discusses the 'abnormal distribution' of development to draw attention to the ways cultural and gender inequalities flow from the norms and generalized descriptions central to the current practice of developmental psychology and to urge that this is an important site of intervention for feminists addressing gender and development issues.
Adolescent↗
The analysis of policy: understanding the process of policy development.
A key question in addiction studies is why do governments not readily adopt policies that research shows to be effective in reducing harm? In this paper, it is argued that policy development can best be understood as a political activity, which is not necessarily scientific. A descriptive model of policy analysis is illustrated by case examples from alcohol and tobacco policy arenas. By understanding policy development as a process, it is suggested that policy advocates can match their strategies to the stages of the process, and thus raise the probability that the advocated policy will be adopted.
Alcohol Drinking↗
The necessity for a collection development policy statement.
The heart of the library lies in its collections, and collections have to be built continuously. Budgetary constraints perforce stress the need for better defined collection development policy, although the ultimate goal should be an improvement of library service rather than any reduction of library cost. A written collection development policy facilitates a consistent and balanced growth of library resources, and a dynamic policy is one that evolves as the institution grows. Such a policy is based on the understanding of the needs of the community it serves and seeks to define and delimit the goals and objectives of the institution. A collection development statement is not a substitute for book selection; it charts the forest but does not plant the trees. It should be used as a guidepost, not a crutch. Book selection requires judgment and the courage to choose. A sound collection development policy, on the other hand, provides the necessary rational without which a collection may grow amoebalike, by means of pseudopodia.
Book Selection↗
Collection development policies and practices in medical school rare book libraries.
A survey of collection development policies and practices in medical school rare book libraries indicated that only 20% had documented criteria for collection development. The advantages of preparing and maintaining a formal written collection development policy are presented with guidelines for formulating such a policy.
Book Collecting↗
Developing a conscious sedation program: from policy development through quality improvement.
Conscious sedation (CS) has rapidly become a popular method of anesthesia, administered to decrease the pain and anxiety associated with operative or invasive procedures while avoiding the potential complications of general anesthesia. Intravenous conscious sedation (IVCS) is most frequently administered, but the patient can also receive CS by oral, intramuscular, or rectal routes. Although the level of sedation using CS is not as deep as general anesthesia, the patient is potentially at risk for respiratory depression. CS provides many benefits. It also places an increased burden on healthcare providers to ensure safe and competent care when this form of anesthesia is used.
Certification↗
Primary health care: a framework for policy development.
Primary health care has utility for policy development at all levels of organization in any nation, including policies influencing the health of persons living with severe and persistent mental illnesses. Using the primary health care framework, policies to improve health and housing for this population evolve from intersectoral collaboration. Active participation by those persons whose essential health is compromised by housing that is not acceptable, adequate, suitable, and affordable is required. Appropriate and affordable methods that address health challenges are identified. Access to services meeting essential health care needs of citizens has potential for healthy outcomes.
Canada↗
Metropolitan health policy development: barriers to implementation.
The complex health issues facing urban areas require effective public policy responses. Consistent with the call by the Institute of Medicine for local health policy development, a variety of groups within metropolitan areas have engaged in these efforts. This paper provides an exploratory analysis of a cross section of 25 health policy initiatives undertaken in Chicago from 1987 through 1994. Characteristics of these initiatives, their recommendations, and factors which served as barriers to implementation are identified. The barriers include: deficiencies in policy design, inadequate political support, organizational barriers, and resource constraints. Our findings are compared to other policy implementation research. Suggestions for improving the effectiveness of local policy development include: involving key individuals from the public and private sectors, maintaining a strategic perspective on achieving priority recommendations, including financial analysis and planning, developing an initial implementation plan, and securing political support.
Chicago↗
Policy process framework: a systems approach to policy development.
This paper discusses a framework for understanding policy analysis and development. The framework presented can be used in the policy development process or post facto in policy analysis. The usefulness of the framework is that it provides a means to think about a policy and its development. It is not prescriptive, nor is it predictive about any particular policy. Policy analysis has tended to rely too heavily on technical analysis, with insufficient attention to other dimensions. This framework offers a basis for people to talk across organizations and cultures.
Decision Making↗