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Making clinical policy explicit. Legislative policy making and lessons for developing practice guidelines

J Lomas1

  • 1McMaster University.

International Journal of Technology Assessment in Health Care
|January 1, 1993
PubMed
Summary
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Clinical policy making can be improved by adapting legislative processes. Applying generic decision-making steps enhances policy explicitness and stakeholder satisfaction.

Area of Science:

  • Health Policy
  • Medical Decision Making
  • Public Health

Background:

  • The rise of practice guidelines has spurred interest in clinical policy making structures.
  • Clinical policy making shares similarities with legislative policy making, focusing on explicit rules and processes.
  • Existing legislative models offer valuable experience for refining clinical policy development.

Purpose of the Study:

  • To explore the analogy between legislative and clinical policy making.
  • To outline generic steps for improving the explicitness and control of clinical policy making.
  • To illustrate the application of these steps in developing and implementing a clinical policy for cesarean birth.

Main Methods:

  • Defining policy generically as rules governing behavior.

Related Experiment Videos

  • Outlining generic steps: decision-making with incomplete information, synthesizing facts/interests/values, stakeholder involvement, and policy implementation.
  • Illustrating these steps with a case study on cesarean birth policy.
  • Main Results:

    • The generic steps provide a structured approach to clinical policy making.
    • Implementation of the cesarean birth policy demonstrated impact on stakeholder behavior and satisfaction.
    • The process allows for retaining control within the medical field.

    Conclusions:

    • Clinical policy making can benefit from the structured, explicit processes developed in legislative policy making.
    • A systematic approach enhances the development, implementation, and evaluation of clinical policies.
    • Improved clinical policy making leads to better outcomes and stakeholder engagement.