Discussion: Policy Analysis Frameworks
Discussion: Policy Analysis Frameworks
Consider the social contract between the nursing profession and consumers of health care. This social contract has long been demonstrated by nurses. For example, recall the nursing pioneer Lillian Wald who in the late 1800s worked to improve the health and welfare of the immigrant population in New York. How does engaging in the policy process assist nurses with fulfilling this social contract today? To better influence health and nursing policy, which seeks to improve health and quality outcomes, nurses need to develop their policy acumen. Utilizing a policy analysis framework can assist in this process.
This week continues the examination of the policy process addressed in Week 3. You will examine how frameworks from nursing and other disciplines can work together to inform policy analysis.
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Learning Objectives
Students will:
Propose a policy analysis framework for a specific policy issue
Conduct a comprehensive policy analysis critically analyzing a health policy from multiple contexts
Learning Resources
Required Readings
Blackman, V. S. (2005). Putting policy theory to work: Tobacco control in California. Policy, Politics, & Nursing Practice, 6(2), 148-155. doi: 10.1177/1527154405276289
In this article, the author applies Kingdon’s multiple streams theory to agenda setting and the public policy issue of tobacco use. In addition, the author points out two limitations of Kingdon’s model—the need to build alliances and the varying power levels among stakeholders.
Craig, R. L., Felix, H. C., Walker, J. F., & Philips, M. M. (2010). Public health professionals as policy entrepreneurs: Arkansas’s childhood obesity policy experience.American Journal of Public Health, 100(11), 2047-2052.
Fawcett, J., & Russell, G. (2001). A conceptual model of nursing and health policy. Policy, Politics, & Nursing, 2(2), 108-116. doi: 10.1177/152715440100200205
Fawcett and Russell provide a five-level conceptual model of nursing and health policy, and diagram the relationship between the model and new health policies. Guidelines for health policy analysis and evaluation are also provided.
Hewison, A. (2007). Policy analysis: A framework for nurse managers. Journal of Nursing Management, 15(7), 693-699. doi: 10.1111/j.1365-2934.2006.00731.x
Initially, this article presents a broad analysis of policy making and then provides a specific framework of policy analysis for nurse managers. The author focuses on the necessity for nurses to become involved in health care policy making
Policy analysis: A framework for nurse managers. Journal of Nursing Management, 15(7) by Hewison, A. Copyright 2007 by BLACKWELL PUBLISHING – JOURNALS. Reprinted by permission of BLACKWELL PUBLISHING – JOURNALS via the Copyright Clearance Center.
Howie, W. O. (2009). Mandatory reporting of medical errors: Crafting policy and integrating it into practice. Journal for Nurse Practitioners, 5(9), 649-654. doi:10.1016/j.nurpra.2009.07.012
John, P. (2003). Is there life after policy streams, advocacy coalitions, and punctuations: Using evolutionary theory to explain policy change? Policy Studies Journal, 31(4), 481-498. doi: 10.1111/1541-0072.00039
This article advances the use of evolutionary theory as policy theory. The author proposes that aspects of evolutionary theory such as randomness, competition, and selection be applied to policy theory but cautions that more research regarding its applicability is needed.
Rawat, P., & Morris, J. C. (2016). Kingdon’s “Streams” model at thirty: Still relevant in the 21st century? Politics & Policy, 44(4), 608-638. doi: 10.1111/polp.1216
Russell, G. & Fawcett, J. (2005). The conceptual model for nursing and health policy revisited. Policy, Politics, & Nursing, 6(4), 108-116. doi: 10.1177/1527154405283304
In this article, Russell and Fawcett revise their 2001 conceptual model of nursing and health policy and provide guidelines for nursing-specific research.
Optional Resources
Bardach, E. (2004). Presidential address—The extrapolation problem: How can we learn from the experience of others? Journal of Policy Analysis and Management, 23(2), 205. doi: 613545361
Discussion: Selecting a Policy Analysis Framework
The goal of policy analysis is to provide in-depth, relevant, and evaluative information about a policy. Using a framework as a guideline for the analysis provides scaffolding for logically and carefully considering the policy issue. To select a framework, one should consider the focus of the policy being analyzed and whether the policy is intended to be predictive or prescriptive. For this Discussion, you will choose a policy issue that is important to you and after evaluating the frameworks described in the Learning Resources, select the framework most appropriate for analyzing the issue.
To prepare:
Reflect on your understanding of the policy process: how policy is formulated, adopted, implemented, and evaluated.
Review the various frameworks presented in this week’s Learning Resources and consider how they are applied to nursing and health policies. How do they assist you in understanding and shaping policy?
Brainstorm a list of the issues that are most important to your practice (these can be issues at the institutional, local, state, national, or international level). Then identify a specific nursing or health care policy related to one key issue, and consider which of the frameworks you would use to examine the issue.
Note: You may not select the Patient Protection and Affordable Care Act for this analysis.
By Day 3
Post a cohesive response that addresses the following:
Identify the policy you have selected.
Describe the framework that you would use for this particular issue, and provide your rationale.
At what other stages in the policy process might an analysis framework provide guidance?
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues selecting postings for which you have an alternative framework suggestion and explain how that framework might affect the analysis.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 4 Discussion Rubric
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 4 Discussion
Assignment 1: Issues in Health Care Reform (Interview)
Continue to work on this Assignment, assigned in Week 2 and due in Week 9.
By Day 7 of Week 9
Submit this Assignment.
Assignment 2: Health Policy Proposal Analysis (Policy Brief)
Continue to work on this Assignment, assigned in Week 3 and due in Week 7.
By Day 7 of Week 7
Submit this Assignment.
Assignment 3: Policy Analysis Paper [Major Assessment]
In previous Discussions and Assignments, you have examined various aspects of the policy process: exploring the unintended consequences of policies, agenda setting, and analyzing policy recommendations. In this Assignment, you will have the opportunity to further develop your analysis skills by working through the policy analysis process. To be an effective agent for social change, you must be able to logically and critically analyze policy from multiple perspectives and contexts and then present your insights in a succinct and professional manner. This exercise will afford such an experience.
For this Assignment, you will examine a particular policy of interest to you (perhaps the one you selected for this week’s Discussion), and apply a policy analysis framework to understand the impact associated with the implementation of the policy. You will then develop a policy analysis paper, which is due the end of Week 11. This paper will also serve as your Major Assessment for this course.
To prepare:
Select a health care policy and a policy analysis framework to utilize for this Assignment. You may use the policy and framework you identified in this week’s Discussion or change your selection.
To complete:
Write an 8- to 10-page analysis paper (including references) in which you succinctly address the following:
Part 1: Define the policy issue.
How is the issue affecting the policy arena?
What are the current politics of the issue?
At what level in the policy making process is the issue?
Part 2: Apply a policy analysis framework to explore the issue using the following contexts:
Social
Ethical
Legal
Historical
Financial/economic
Theoretical underpinnings of the policy
Include in this section:
Who are the stakeholders of interest?
Is there a nursing policy/position statement on this health care issue? If so, who developed it?
Part 3: Policy options/solutions
What are the policy options/solutions for addressing the issue? Include at least three levels of options/solutions: no change; partial change; radical change or maximum change.
What are the theoretical underpinnings of the policy options/solutions?
What are the health advocacy aspects and leadership requirements of each option?
How does each option/solution provide an opportunity or need for inter-professional collaboration?
What are the pros and cons of each suggested change? Include the cost benefits, effectiveness, and efficiency of each option along with the utility and feasibility of each option.
Part 4: Building Consensus
Outline a plan for building consensus around your recommended option/solution for solving the policy issue.
Part 5: References
Limit your references so this section is no more than 2 pages.
Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from appropriate Learning Resources and additional scholarly sources as appropriate. Refer to the Publication Manual of the American Psychological Association to ensure that your in- text citations and reference list are correct.
By Day 7 of Week 11
This Assignment is due.
Week in Review
This week, you proposed a policy analysis framework for a specific policy issue and conducted a comprehensive policy analysis that analyzed a health policy from multiple contexts.
Next week, you will review the four principles of medical ethics and examine these principles in the light of current health care policy.
To go to the next week:
Week 5
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Discussion: Policy Analysis Frameworks
A major element of a reliable policy analysis entails utilizing an analytical framework founded on one or more policy-making theories and models. The frameworks assist in identifying and interpreting the connection between crucial variables pertinent to the policy issue of interest (Sheldon, 2018). Medicaid is an example 0f a health policy in the US that led to establishing a health insurance program that covers low-income individuals and families (Maddox et al., 2020). The policy directs that the insurance program be funded jointly by the federal and individual state governments. Besides, the policy mandates that the eligibility to the program be determined by an individual relative to the federal poverty level.
Lowry’s Dimensions of Federalism framework would be used for this issue. I would use this framework since it offers a relevant analytical lens to examine the influences of state policy responses. The framework hypothesizes that there is a direct connection between the severity of a problem and state policy response (Sheldon, 2018). Besides, the framework proposes that the strength of this connection is influenced by some variables, the most noteworthy of which are the extent of federal involvement (extent of regulatory policy-making) and degree of interstate competition for business (Sheldon, 2018). Based on the framework, we can conclude that a high level of federal involvement improves communication and coordination of policy implementation across states since the federal government uses the state exemplars to cause change across states.
An analysis framework can be used to provide guidance when establishing a policy’s status, that is, whether it is a consultation document or parliamentary bill. The framework can also be used to establish a policy’s relationship with other previous and more recent policy initiatives (Hewison, 2007). In addition, it can be used to identify the themes that the policy addresses.
References
Hewison, A. (2007). Policy analysis: a framework for nurse managers. Journal of Nursing Management, 15(7), 693–699. https://doi.org/10.1111/j.1365-2934.2006.00731.x
Maddox, K. E. J., Bauchner, H., & Fontanarosa, P. B. (2019). US health policy—2020 and beyond: introducing a new JAMA series. JAMA, 321(17), 1670-1672. https://doi.org/10.1001/jama.2019.3451
Sheldon, M. R. (2018). Policy-making theory as an analytical framework in policy analysis: implications for research design and professional advocacy. Physical Therapy, 96(1), 101-110. https://doi.org/10.2522/ptj.20150032
