Patient-Centered Health Care
Patient-centered care refers to the involvement of not only health care policy makers but also patients and their families in the design of novel care models. In the patient-centered care, it is important to address ethnic, racial, and socioeconomic issues in health outcomes. Patient-centered care can be determined by the level of interactions of patients with clinicians. Research shows that patient-centered care helps in giving a lot of improvement in the quality of life and disease outcomes (Epstein, Fiscella, Lesser, & Stange, 2010). So, it is important for policy makers to look at health care not only from the perspective of technology but also from the perspective of patient. In this case, policy process can be consisted of evaluation, analysis, and revision.
Evaluation Stage
Evaluation is an act of fixing or ascertaining the worth or value of something. With the help of evaluation, a process, project, program, or policy is critically checked. In the process of evaluation, information about a policy or program activities as well as outcomes is collected and analyzed. Primary purpose of evaluation is to identify weak areas, and make appropriate decisions to enhance the efficiency of policy or program. It is also considered important to correctly identify and evaluate any patient centered care policy or program during good times to confirm success of the processes developed for it. Evaluation is based on defined outcome measures as well as indicators. After implementation of a policy, evaluation stage is considered as an appropriate stage as it is helpful in evaluating the effectiveness of policy and its ability to fulfill the desired objectives (Andersen, Fagerhaug, & Beltz, 2009).
An evaluation plan works on the collection of data and its relevance to the development of patient-centered care policy. Moreover, evaluation stage explores the short-term as well as long-term outcomes from the process of implementation. This stage also considers new issues and problems that could develop during the process of implementation of policy as well as alternations in policy by using problem solving process.
In order to know whether stated policy objectives could be achieved, evaluation process can be divided into different steps. In the first step of policy evaluation, stakeholders gather important information that is relevant to the policy and analyze the information to know its ability to help in the achievement of desired goals or objectives. In the second step, evaluation process as well as activities are described to the relevant people to help them in completing the evaluation process. In the third step, evaluation design is considered that would become a guidance for stakeholders in developing a process of evaluation. In the forth step, more information and evidence is collected with the help of stakeholders. In the next step, the information is checked and justified whether it helps in reaching an outcome to achieve policy objectives. Eventually, the objectives of the patient-centered care policy are achieved and required or desired outcomes are obtained. At the end of program evaluation, learned lessons are shared with others. All these steps of evaluation, work on some standards that are helpful in assessing the quality of evaluation studies. These standards may include feasibility, utility, accuracy, and propriety (Centers for Disease Control and Prevention, 2014). Following image shows the six process of evaluation that are helpful in identifying the probability of achieving policy objectives.
Figure 1: Framework for evaluation of program (Source: Centers for Disease Control and Prevention, 2013)
The evaluation framework is not only helpful in producing or providing practical and useful evaluation design, it is also helpful in integrating evaluation into program planning as well as routine program operations. The early processes in this framework help in engaging stakeholders and describing the planning of program, and those processes also clarify the situation to planners, implementers, and evaluators. In this framework, stakeholders may include managers, business leaders, and employees, along with evaluation experts, and the involvement of all these stakeholders can become a driving force in planning health care strategies, and improving existing policies and programs (Centers for Disease Control and Prevention, 2014).
Analysis Stage
Policy analysis refers to the determination of the ability of a policy to attain required goals. It is also considered as the investigation of the components of a policy and their relation to the policy as a whole. Health care policy analysis is considered as a multi-disciplinary process in which a policy is evaluated, past successes and failures are studied, and better plan is built for the policy execution in the future. In health care policy analysis, interaction between the government bodies, health care institutions, and other such organizations, and their interests are also studied.
Health care policy analysis consists of different stages including verification, definition, and detailed explanation of the problem; establishing an evaluation criteria; identifying, evaluating, and distinguishing alternative policies, and monitoring the policy that has been implemented (Harrington & Estes, 2008).
In order to meet policy objectives, health care policy makers develop their decisions on the basis of different factors such as technical merits of the issues; the probable influence of reform policy on the political relationship within different government groups, bureaucracy, and their beneficiaries; probable influence of the policy on the regime's stability and support; the apparent severity of the issue and the condition of the government; and support or pressure from international agencies and organizations of health care. These factors are also thought to prevent the achievement of policy objectives by policymakers. Moreover, unclear and unexplained business objectives, poor research, incomplete work on timing and scheduling, and execution errors can also prevent policy objectives from being achieved.
The policy analysis is more complicated process as compared to problem identification as policymakers have to study various factors. Policy analysis works on the political costs as well as benefits of health care policy reforms (Harrington & Estes, 2008).
Revision Stage
Revision stage consists of revising and/or altering involving reconsidering and modification of the policy objectives. In the revision stage, governmental bodies and health care organizations follow legal procedures including legislative stage as well as governmental organization's approval process.
Usually, two types of revisions are considered in a policy implementation process. One is substantive and the other is minor. A substantive revision to a policy statement includes significant and considerable changes that are required in a policy. They may affect the principles, rules or intent of the policy. Substantive revision may include change in the ownership of the policy, change in the initial policy objective or intent, modifying the initial policy requirements, and writing a new policy. On the other hand, minor revision or update may include addition of new definitions in order to enhance understanding of the policy statement and business objectives, proper research and rearrangement of information in a flow, correction of spelling or punctuation, and addition of guidelines (University of Oregon, 2012).
The revision stage is helpful in modifying the policy on the basis of principles for regulating and planning the health care. In the revision stage of policy, various steps are involved such as voting, debate, referral to committee, scheduled floor action, executive action, final floor action, congressional override, and committee action. Moreover, some changes in the legislature can also occur during the process of policy implementation (Andersen et al., 2009). On a further note, positions of stakeholders are also considered important during the process of revision of a policy. It has to be considered that most of the stakeholders are of opinion that revision is not necessary for the policy implementation as the objectives have already been well defined.
References
Andersen, B., Fagerhaug, T., & Beltz, M. (2009). Root Cause Analysis and Improvement in the Healthcare Sector: A Step-by-step Guide: ASQ Quality Press.
Centers for Disease Control and Prevention. (2013). Evaluation. Retrieved from: http://www.cdc.gov/workplacehealthpromotion/evaluation/
Epstein, R. M., Fiscella, K., Lesser, C. S., & Stange, K. C. (2010). Why the nation needs a policy push on patient-centered health care. Health Aff (Millwood), 29(8), 1489-1495. doi: 10.1377/hlthaff.2009.0888
Harrington, C., & Estes, C. (2008). Health policy: crisis and reform in the US health care delivery system: Jones & Bartlett Publishers.
