Healthcare Policy and Patient Advocacy. Angela Mund CRNA DNP. Objectives. Discuss the history of nursing and policy Compare and contrast policy and politics Describe the policy process and areas for personal involvement Discuss the current literature as related to health policy.
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Angela Mund CRNA DNP
Advent of Advanced Practice Nursing
AANA continuing to follow and advocate for changes to outdated, inefficient TEFRA requirements for payment
Cost and Efficiency
Impact of policy on nursing practice
Impact of policy on patient care
Impact of policy on national and global health
Impact of policy on politics (legislative and regulatory)
Never doubt that a small group of thoughtful committed citizens can change the world. Indeed, it is the only thing that ever has.” Margaret Mead
Ham, et al 1992
Just take a look at attempts for Health Care Reform!
Title: A bill to amend title 38, United States Code, to enhance the capacity of the Department of Veterans Affairs to recruit and retain nurses and other critical health-care professionals, to improve the provision of health care veterans, and for other purposes.
WRITE, CALL, VISIT, WRITE, CALL VISIT…
5. Talk to strangers
6. Give early and often
7. Take credit and control
(What is the role
of the PAC?)
8. Politics has a chit economy
9. Reputations are permanent
10. Don’t take it personal
BEST OFFENSE IS A GOOD DEFENSE
American Association of Nurse Anesthetists came in 18th
44,000 members (including students)
The ANA came in 17th
Represents over 3 million nurses
Only other nursing PAC to make top 100
American College of Nurse Midwifes
What are some challenges you experienced in your practice that could be impacted by changes in legislation or regulation?
How can you use the some/all of the political strategies to create influence?
Lack of leadership/mentoring
Power is an inevitable part of human interaction, and those persons, including nurses, who deny this fact will be at a serious disadvantage when trying to make changeKalisch &Kalisch, 1982
As patient advocates we cannot be spectators or sideline shoutersWe mustaffect change through discussion, debate, analysis, and research in a positive proactive mannerC. Bettin, AANA Senior Director of Commincations
Robert Wood Johnson Foundation Survey (2010)
Question Wording: Please tell me if you think each of the following is a major barrier, a minor barrier, or not a barrier to nurses’ ability to contribute to improvements in planning policy development, and management of health systems and services?
Not Important Decision Makers
Doctors as Revenue Generators
Question Wording: What, if anything, do you think could be done to ensure that nurses take on more leadership in improving health status and delivering healthcare services in the United States today? (Open-end question; Percent shown)
Educators will need to demonstrate the relevancy of policy to practice
Maynard (1990) Political Influence: a Model for Advanced Nursing Education
“The DNP graduate integrates practice experiences with two additional skill sets: the ability to analyze the policy process and the ability to engage in politically competent action” (AACN)
“Nurses will not be effective in politics and policy making until they value their voices, develop policy agendas that embrace their core values, and learn the skills of policy making and influencing”
What kind of degree would be required/needed?
Health Affairs, 29, no.8 (2010):1469-1475
NURSING ECONOMIC$/May-June 2010/Vol. 28/No. 3
Influence of Supervision Ratios by Anesthesiologists onFirst-case Starts and Critical Portions of AnestheticsRichard H. Epstein, M.D., C.P.H.I, M.S.,* Franklin Dexter, M.D., Ph.D.†
Anesthesiology, V 116 • No 3 March 2012
“If nurses want to be sought out as health care resources and have their views reflected in health care policy, Nurses have to get off the porch to run with the big dogs”
-Mary Wakefield RN PhD
Abood, S.(2007). Influencing health care in the legislative arena. Online Journal of Issues in Nursing.
Aroskar, MA. Molodow, DG & good, CM (2004). Nurses’ voices: Policy, politics and Ethics. Nursing Ethics, 11(3), 266-276.
Boswell, C., Cannon,S., & Miller J. (2005). Nurses’ political involvement: Responsibility versus Privilege. Journal of Professional Nursing, 21(1), 5-8.
Kalisch, BJ & Kalisch, PA. (1982). Politics of Nursing. Philadelphia: JB Lippincott
Peters, RM (2002). Nurse Administrators role in Health Policy: Teaching the Elephant to Dance. Nursing Administration Quarterly, 26(4), 1-8.