Health Policy and Politics Overview

Health Policy and Politics

• Nurses advocate for health care delivery
• Health policy is a set of actions by the government or health care organizations to achieve positive outcomes
• Private health policies are made by health care organizations (e.g., hospitals, managed care)
• Public health policies are created by judicial or legislative branches of government (local, state, or federal)
• Health policy issues include cost, access barriers, quality and safety, and disparities
• Policy-making involves the legislative, executive, and judicial branches
• Legislative branch originates major initiatives
• Executive branch supports or vetoes initiatives, and can return them for revision
• Judicial branch ensures laws/bills are constitutional
• Key stakeholders include elected officials, governmental agencies, experts, corporate representatives, and special interest groups
• Health policy involves translating public problems into viable issues and processes
• Introduction, committee, house/senate, and presidential action are steps in a bill's journey to becoming law
• Implementation of new legislation often differs from intentions
• Regulations are rules issued by government agencies enforcing new laws
• Regulations take effect between interim and final rules
• Health policy are guidelines to achieve a goal
• Regulations are created after policy/legislation is passed

Regulation Connection VS Health Policy

• Regulations are written rules for new laws
• Regulations carry the force of law
• Intervals between interim and final rules are crucial for assessing policy effects
• Health policy comprises broad guidelines for achieving specific goals

Federal Health Policy Examples

• Sheppard-Towner Act (1921)
• Hill-Burton Act (1950)
• Medicare program (1965)
• Renal disease program (1972)
• Diagnosis-related groups (DRGs) (1983)
• Patient Protection and Affordable Care Act (2010)

State and Local Health Policy Examples

• Local health policies: free/reduced-rate immunizations, tobacco-free public buildings, emergency medical systems
• State health policies: nursing practice acts, healthcare facilities, and Medicaid

AHCA (Agency for Healthcare Administration)

• Approves healthcare facility licensing
• Conducts facility medicine practice inspections

National Regulatory Bodies

• Joint Commission (TJC): nonprofit organization accrediting health care organizations and programs
• OSHA: ensures worker safety in workplaces
• Nursing education accreditation bodies (e.g., ACEN, CCNE, CNEA)

Professional Nursing Organizations

• Help unite the profession, influence policy, and represent nurses

ANA (American Nursing Association)

• Major national nursing organization, representing nurses at a federal level
• Focus on practice issues, standards, employment, ethics, and benefits

Florida Nursing Association (FNA)

• State nursing organization
• Fosters high nursing standards
• Promotes professional and educational advancement of nurses
• Part of the ANA

Politics

• Process of influencing decisions and controlling events
• Political influence involves money, knowledge, relationships, information, talent, and control over large voting groups
• Grassroots political strategies include joining organizations, working in campaigns, attending meetings, and communicating with policymakers.

Institute of Medicine (IOM)

• Nonprofit, nongovernmental organization providing national advice on biomedical science, medicine, and health

Health Care Reform

• General term for policies changing how health is promoted, accessed, delivered, and paid for

Nursing Involvement

• Nurses influence policy decisions directly or indirectly (political action committees)
• Aides handle feedback via emails

Workforce Advocacy Nursing Responsibility

• Preventing hospital readmissions (ex: if a patient comes into a hospital with a condition and is discharged and readmitted within 30 days)

Nursing Shortage

• Nursing school enrollment, recruitment, and faculty shortages
• Efforts to recruit more nursing students have been successful, yet shortages persist in nursing faculty.

Nursing Retention

• Creating a supportive, professional environment
• Providing opportunities for continuing education and professional autonomy
• Offering compensation, growth, stability, and work flexibility

Safe Staffing

• Federal regulations mandate appropriate nurse-to-patient ratios and staffing committees
• States create different staffing models.

Overtime & Decision Making

• Nurse concerns about mandated overtime.
• Clarifying the expectations of staff in terms of working conditions, patient care needs, and their own limitations.

Patient Advocacy

• Promotes patient safety, preventing medical mistakes, and fostering patient health.
• Monitoring, reporting unsafe practice, and implementing solutions.

Workplace Safety

• Hazards include exposure to bloodborne pathogens, ergonomic issues, workplace violence, and fatigue
• Policies protect nurses from retaliation when reporting workplace issues
• Safe workplace practices are crucial to nurse well-being and patient care.

Conclusion

• Participation in healthcare policy helps nurses advocate for their patients and the nursing profession.