Questions: Of the four steps in the policy process, which step is most crucial for the DNP-prepared leader to influence change? Explain your reasoning.

Define the Problem and Get It on the Agenda

This occurs through a series of actions to define the real issue. Policymakers need to understand what the problem is, what the concerns of the interest groups are, why it requires a policy solution, what trends are supporting the growth and criticality of the problem, and what if any relationship this problem has to other issues of concern.

Research the Problem

Learning is as much as possible about the problems is critical to understanding it and formulating possible solutions. Evidence may range from empirical research to expert opinion and come from all sectors such as economics, sociology, health services research, and biological sciences. An important source for utilizing data to transform health practices are the outcomes from translational research. Translational research is taking knowledge gained from research and instituting this practice in the clinical environment. In relation to the policy process, translational research provides new knowledge on incentives within healthcare to improve quality and can assist policymakers evaluate options about different incentive models. In nursing practice, translational research can provide evidence that a middle of care such as the translational care model can reduce hospital readmission rates (Mason, Leavitt, & Chafee, 2012).

The idea is to make the case that the problem is significant from both an evidence-based perspective, as well as a public or political perspective. Public policy generated through political and public discourse may not always use data in a strictly empirical way. Healthcare organizations and providers must decide how these changes in the recommendations will impact their own practice standards and policies.

Develop Policy Option

This step relies on evidence and option. For example, if DNP leaders were developing alternative options for improving access to healthcare for uninsured underinsured individuals, they might look at three issues related to access. Access is often characterized by its structure, its process, and its outcomes. Any of these three factors may lead to alternative options for seeking access to care. Solutions are also influences by whether policymakers believe that one or more options are likely to solve the problem. The process of selecting alternative options for considerations requires considerable analyses of various options (Mason, Leavitt, & Chafee, 2012).

Involve Interest Groups and Stakeholders

There are many ways to think about stakeholders and interest groups. Policy development that is dominated by public interest generally follows a course of action that is based on data, information, and community values and addresses a solution to an actual or potential problem. It tends to be based on practical decision making. Policy generated by self-interest often follows a course of action with a predominantly special interest focus connected to the concerns of individual preferences or group interests over public interest. Both are important in generating dialogue and debate during the policy process so that all sides of an issue are considered (Mason, Leavitt, & Chafee, 2012).