Description
In this assignment, you will analyze a health policy. You will analyze the process of designing and implementing policy into place using the approach in your textbook, which we call the Milstead framework. Think of yourself as a consultant to the policymakers here, the scientist they ask to help them understand what it would take to put to put his policy into action and how well it can solve a given problem. After this assignment, you can do this in your own communities, serve as the clinical expert on the effects of a health policy. In policy working groups, others look to us as clinical experts. You will begin to use that expertise to analyze a policy in this assignment. The focus of the paper should not be APRN scope of practice or access to care. In this course, we are considering how other determinants of health impact the health of our communities. See this link for additional information about determinants of health: https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health
In this assignment, you will analyze a health policy in two ways.
You will analyze the process of putting it into place using the approach in your textbook, which we call the Milstead framework. You will analyze its effect by using your skill at finding and evaluating evidence.
Steps
- Review feedback on topic you submitted for the assignment, and begin to write your paper once the topic is approved.
- Read the following chapters from Short (2026) on the policy process. The Policy Process is also called the Milstead Process.
Chapter 1 The Policy Process: Nurses Shape Health Policy Chapter 5 Policy Process: Problem Identification and Agenda Setting Chapter 6 Policy Process: Policy Analysis and Design Chapter 7 Policy Process: Policy Enactment: Power, Strategy and Enactment of Legislation Chapter 8 Policy Process: Implementation: Avoiding Unintended Consequences Chapter 7 Policy Process: Evaluation of Policies 3. . Read Milstead and Knestrick article (1998) applying the framework to a health policy issue.
- Follow APA 7th ed. formatting. For this assignment, this means title page, no running head, numbered pages, headings as appropriate, and a reference list. Use a clear progression of ideas with topic sentences, and correct grammar and style. Papers not written clearly and correctly in APA Style will be returned for revision. You will also earn a score on writing style. Please use topic sentences and stick to one topic in each paragraph.
Search Strategy
You will look for a piece of legislation that has been passed in your state. Sometimes these are called statutes. You can choose a piece of federal legislation and describe how it impacts your state. Use Google to find information on the legislation you choose. Example google search: medicare reimbursement law Kentucky You will also need to summarize the evidence by answering the following: Is there evidence that the procedure itself leads to better health outcomes (clinical evidence)? Use MEDLINE or CINAHL for this. Search for your intervention combined with “health outcome*”. Example: reimbursement* AND “health outcome*”. Quotations are used around your keyword/phrase if it’s more than one word. Use * at the end of “outcome” to tell the database to find all the other iterations of the word (outcome or outcomes). Is there evidence that the policy leads to more appropriate use of the procedure (more utilization, which is policy evidence)? Try MEDLINE or CINAHL for this. Example: reimbursement* AND polic*. In addition to scholarly sources, you may also use governmental or non-profit agency summaries, reputable and in-depth newspaper accounts, policy analyses (the part where they address the problem, not the policy solution). You can find these via Google. Just google your particular intervention combined with “policy”. If you use a source like the CDC or WHO website, make sure it is not a consumer-oriented page. Local and state newspapers can be very helpful in learning about the players for the legislation. Do not use: Wikipedia, patient education materials, or any page that does not provide references for the information given
Suggested Format
Paragraph 1: Introduction – Use one paragraph to introduce the diagnosis. Explain why we should care about this medical problem. Include the ICD 10 diagnosis code for the diagnosis. You should discuss the medical diagnosis health issue as it is related to your jurisdiction. Review the nature of the clinical issues leading to the need to think about a policy issue. Do not address your policy solution here (meaning you do not talk about the bill or the law, only the medical diagnosis or problem as related to the state where you live). The introduction is where you try to make us care about the problem, not where you persuade us you have a solution to it. There is no need to mention your solution here at all; it only takes up space that could be better used to give the prevalence and sequelae of the clinical issue. You should discuss what is going on in your state regarding the diagnosis. You should focus on state-level data and statistics. The focus of the paper should not be the NP scope of practice or access to care. You should include data and facts related to your jurisdiction and not national data unless there is no data specific to your jurisdiction, and that should be noted. In the next four paragraphs, apply the Milstead Process/Policy Process to this policy. Write one paragraph for each of the four stages in the framework, similar to the analysis in Short (2026) and Milstead and Knestrick (1998). Paragraph 2: Law or Policy Name/Agenda Setting – Explain what players or events precipitated action on this policy. This is the background on how the law was passed. Who were the stakeholders? Who were the advocates? How did the bill get signed into law? Paragraph 3: Government Response – What government action (legislative or executive) made this policy official? What did the law do? What is the problem that the law solves? How does this problem relate to the health care topic that interests you? Paragraph 4: Policy and Program Implementation (include funding sources) – What action makes this policy real? How did the government operationalize the law? Was the law funded? Paragraph 5: Policy and Program Evaluation – Clearly identify both the process and outcomes measures needed to evaluate this policy, even if they were not used in an evaluation that was actually completed. Process (formative) measures – Did it happen? Was this policy implemented as intended? Outcomes (summative) measures – Did it work? Did this policy have the intended outcomes? This should circle back to your introduction, the problem the policy addresses. If your issue has not proceeded yet to program evaluation, give some ideas on how the program might be evaluated. Paragraph 6: Summarize the evidence. Summarize what you found out about whether this policy leads to the health outcome desired. Do we have the evidence we need to establish that? How good is it? Give a brief summary of what evidence we have for this policy solution. Draw on expertise gained in the evidence courses to search for, identify, and evaluate evidence that addresses what we know about what might resolve this problem. Summarize your findings in terms of what we know about effective interventions for this problem. Be sure to comment on the nature of the evidence you have found, particularly if you find only recommendations or minimal research evidence to support the policy. Draw on what you learned in the course on evidence-based practice, distinguishing between weak and strong evidence and commenting on what you find. Think about the following questions: Is there evidence that the procedure itself leads to better health outcomes (clinical evidence)? Is there evidence that the policy leads to more appropriate use of the procedure (more utilization, which is policy evidence)? Or, even better, can you establish that the policy leads to better health outcomes (policy evidence)? Paragraph 7: Conclusion – Give your opinion on whether this policy issue has been successfully resolved or not. Explain your rationale. Include whether evidence supports the policy process to date. Include what steps you think most useful for the future.
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