Instructions

Review the lesson and readings about Bardach’s eightfold steps to policy analysis, especially in the Chapter 4 Policy Analysis section of the Patton text. Then, select a healthcare policy that impacts, or has the potential to impact, the practice problem and population selected in previous weeks of this course.

The following links will assist in your search for policies and/or bills.

• Current Legislative ActivitiesLinks to an external site. (Congress.gov)
• NursingLinks to an external site. (Gov info)
• NursingLinks to an external site. (Govtrack)

You can select a broad, national health policy (i.e., Accountable Care Act) or one that is specified for a specific health issue (i.e., Minority Diabetes Initiative Act). 

Critically appraise the healthcare policy using Bardach’s eightfold steps to policy analysis:

1. Define the problem
2. Assemble evidence
3. Develop alternatives
4. Select criteria to evaluate the alternatives
5. Project outcomes
6. Analyze trade-offs
7. Make decisions
8. Communicate results

Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:

• Link (webpage): DNP Discussion GuidelinesLinks to an external site.

Program Competencies

This discussion enables the student to meet the following program competencies:

1. Analyzes health care policies to advocate for equitable health care and social justice to all populations and those at risk due to social determinants of health. (POs 2, 9)
2. Translates a synthesis of research and population data to support preventative care and improve the nation’s health. (PO 1)
3. Leads others in professional identity, advanced clinical judgment, systems thinking, resilience, and accountability in selecting, implementing, and evaluating clinical care. (PO 1)

Course Outcomes

This discussion enables the student to meet the following course outcomes:

1. Critically analyze the history, formation, and implementation of local, state and national health policies from the perspectives of stakeholders and the profession of nursing. (PC 5; PO 2)
2. Synthesize ethical and legal principles to advocate for value-based, equitable, and ethical health policies at the micro, meso, and macrosystem levels. (PC 5; PO 9)
3. Assimilate epidemiology principles and interventions to impact the social determinants of health, Global Burden of Disease, and population health outcomes. (PCs 7, 8; PO 1)
4. Demonstrate collaborative interprofessional leadership and political competency to develop and implement healthcare policy to improve healthcare delivery and population health outcomes. (PC 5; PO 2)

Lesson 

Rodgers and Bardach and Pataschnik

According to Rodgers (1989), the definitions of health policy that appear in healthcare literature are not relevant for nursing practice, education, research, or theory. In fact, the definitions found in the literature are more applicable to public and social policy and are inconsistently used among healthcare authors. Certainly, an emerging definition of health policy is necessary to best influence the legislative process.

Bardach and Pataschnik’s model of policy analysis (2016) provides a well-constructed framework for which an aspiring political advocate could develop a platform for policy support or rejection. The role of the DNP-prepared nurse is centered on the use of translational science to provide valid, applicable, and evidence-based data to support policy initiatives to improve health outcomes for populations (Patton et al., 2019). Failure to utilize this skill leaves the policy initiative vulnerable to those who seek to provide faulty or inaccurate information. This model has been used often by nurses to analyze health policy, including legislation about breastfeeding policies (Skiff et al., 2020).

View the following video to explore how the work of Rodgers and Bardach and Pataschnik underpins policy platform development and analysis.

Policy Development & Analysis (2:21)

Rogers suggested four specific measures of the concept of health policy: Attitude, which refers to the demonstrated values regarding specific health issues. Direction, which refers to one’s level of support regarding specific health concerns. Practice, which refers to one’s action regarding specific health concerns. And domain, which refers to one’s focus application of the concept among the areas of expenditures, services, and personnel. Bardach and Patashnik 2016 developed a phenomenal method to analyze a health policy. Their method of policy analysis is intended for any public policy. Health policy fits into their method well and can be used to assess the potential impact of health policy on populations. (Patton et al., 2019). 1. Define the problem. What is the problem? 2. Assemble some evidence, Is the evidence up to date, scholarly, reliable, and valid? 3. Construct the alternatives. What are the different paths? 4. Select the criteria. What does the evaluative plotline? Is it efficient, equal, fair, equitable, and just? 5. Project the outcomes. What do you expect from the policy? Be realistic. 6. Confront the trade-offs. What are the pros versus cons? Is there a clear-cut benefit? 7, Decide. What pathway will you choose? 8. Tell your story. Be prepared. Have a well thought out story ready. This model of health policy analysis provides a well-constructed framework for which an aspiring political advocate could develop a platform for policy support or rejection. For the DNP-prepared nurse, steps 2 and 3 become significantly important as they are framed with evidence which can be used to support the initiative or to provide empirical evidence in which the initiative can be rejected. It is all in the perspective of the political analyst and the established outcome goals of the legislation.