Conducting health policy analysis in primary care research: turning clinical ideas into action

Abstract

Healthcare guidelines play a prominent role in the day-to-day practice of primary care providers, and health policy research leads to the formation of these guidelines. Health policy research is the multidisciplinary approach to public policy explaining the interaction between health institutions, special interests and theoretical constructs. In this article, we demonstrate how primary care providers can conduct high-impact health policy research using Eugene Bardach’s eightfold policy analysis framework in a primary care context. In a medical case, a woman with a history of total hysterectomy had scheduled a visit for a Papanicolaou (Pap) smear screening test as part of a well-woman health check-up with a family medicine resident. Conflicting recommendations on Pap smear screening after total hysterectomy sparked an investigation using the US Preventive Services Task Force criteria for conducting a health policy analysis. We illustrate broadly how clinical care dilemmas can be examined by using Bardach’s broadly applicable health policy framework in order to inform meaningful policy change. Bardach’s framework includes (1) defining the problem, (2) assembling evidence, (3) constructing alternatives, (4) selecting criteria, (5) projecting outcomes, (6) confronting trade-offs, (7) decision-making and (8) sharing the results of the process. The policy analysis demonstrated insufficient evidence to recommend Pap test screening after hysterectomy and the findings contributed to national recommendations. By following Bardach’s steps, primary care researchers have a feasible and powerful tool for conducting meaningful health policy research and analysis that can influence clinical practice.

Continuous quality improvement methodology: a case study on multidisciplinary collaboration to improve chlamydia screening

“…All participants should be encouraged to provide feedback on the process, new barriers and new solutions. This can be done by surveying or interviewing the staff and by reviewing internal policies 22–24…”

Linking the Saudi Arabian 2030 vision with nursing transformation in Saudi Arabia: Roadmap for nursing policies and strategies

“…A total of five features were considered while comparing the policy alternatives including, social acceptability, political feasibility, fairness, cost, and contribution. The selection of these features was based on the appropriateness in conducting health policy analysis for turning ideas into actions ( Engelman et al, 2019 , Collins, 2005 ). Amongst these features, the contribution of policy is the most essential feature to achieve the preferred objectives, specifically to transform nursing standards and practices.…”

Discovering and doing family medicine and community health research

“…Ursu, McKee and Greenberg13 discuss the steps in a rigorous, research-driven quality improvement project that they illustrate with a project conducted to improve chlamydia screening rates using the plan-do-check-act model. Next, Engelman Case, Meeks and Fetters14 cover steps in conducting health policy research that can be prompted by everyday dilemmas in clinical care. Fabregues and Fetters15 discuss and illustrate case study as a useful methodology in primary care research for examining in depth a phenomenon, curriculum or clinical programme in its natural setting using multiple methods to ensure the context is captured.…”