scholarly journals Operational research leading to rapid national policy change: tuberculosis-diabetes collaboration in India

2014 ◽  
Vol 4 (2) ◽  
pp. 85-88
Author(s):  
A. M. V. Kumar ◽  
S. Satyanarayana ◽  
N. C. Wilson ◽  
S. S. Chadha ◽  
D. Gupta ◽  
...  
Keyword(s):  
Policy Change ◽  
Operational Research ◽  
National Policy

scholarly journals An Economic Evaluation of Disallowing Body Checking in 11- to 12-Year-Old Ice Hockey Leagues

2021 ◽  
pp. 194173812110215
Author(s):  
Gillian R. Currie ◽  
Raymond Lee ◽  
Amanda M. Black ◽  
Luz Palacios-Derflingher ◽  
Brent E. Hagel ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care System ◽  
Policy Change ◽  
National Policy ◽  
Ice Hockey ◽  
Public Health Care ◽  
Public Health Care System ◽  
Body Checking ◽  
Care System

Background: After a national policy change in 2013 disallowing body checking in Pee Wee ice hockey games, the rate of injury was reduced by 50% in Alberta. However, the effect on associated health care costs has not been examined previously. Hypothesis: A national policy removing body checking in Pee Wee (ages 11-12 years) ice hockey games will reduce injury rates, as well as costs. Study Design: Cost-effectiveness analysis alongside cohort study. Level of Evidence: Level 3. Methods: A cost-effectiveness analysis was conducted alongside a cohort study comparing rates of game injuries in Pee Wee hockey games in Alberta in a season when body checking was allowed (2011-2012) with a season when it was disallowed after a national policy change (2013-2014). The effectiveness measure was the rate of game injuries per 1000 player-hours. Costs were estimated based on associated health care use from both the publicly funded health care system and privately paid health care cost perspectives. Probabilistic sensitivity analysis was conducted using bootstrapping. Results: Disallowing body checking significantly reduced the rate of game injuries (−2.21; 95% CI [−3.12, −1.31] injuries per 1000 player-hours). We found no statistically significant difference in public health care system (−$83; 95% CI [−$386, $220]) or private health care costs (−$70; 95% CI [−$198, $57]) per 1000 player-hours. The probability that the policy of disallowing body checking was dominant (with both fewer injuries and lower costs) from the perspective of the public health care system and privately paid health care was 78% and 92%, respectively. Conclusion: Given the significant reduction in injuries, combined with lower public health care system and private costs in the large majority of iterations in the probabilistic sensitivity analysis, our findings support the policy change disallowing body checking in ice hockey in 11- and 12-year-old ice hockey leagues.

The Rising Hegemony of Mass Opinion

1998 ◽  
Vol 10 (1) ◽  
pp. 19-50 ◽  
Author(s):  
Paul J. Quirk ◽  
Joseph Hinchliffe
Keyword(s):  
Policy Change ◽  
American Politics ◽  
Policy Making ◽  
National Policy ◽  
Founding Fathers ◽  
Mass Public ◽  
Mass Opinion ◽  
Public Concerns

The Founding Fathers warned about the dangers of an “excess of democracy” and designed the Constitution in large part with a view toward preventing it. Judging from most commentary on American politics, with respect to most of the intervening two hundred years, they need't have worried: The mass public has only occasionally been a dominant force in national policy making. Elites, although often responding to broad public concerns, have usually defined the specific directions of policy change.

scholarly journals Program directors’ reflections on national policy change in medical education: insights on decision-making, accreditation, and the CanMEDS framework

2021 ◽  
Author(s):  
Kelly Dore ◽  
Bryce James Mack Bogie ◽  
Karen Saperson ◽  
Karen Finlay ◽  
Parveen Wasi
Keyword(s):  
Decision Making ◽  
Medical Education ◽  
Policy Change ◽  
Large Scale ◽  
Descriptive Analysis ◽  
National Policy ◽  
Program Directors ◽  
Policy Changes ◽  
Future Policy ◽  
High Level

Background: Outcomes of national policy change impact all levels of the organizational hierarchy. The medical education literature is sparse on how reflections from program directors (PDs) on past large-scale policy changes can inform future policy initiatives. To fill this gap, we conducted a national survey on PDs’ perceptions of, and reflections on, decision-making in medical education, accreditation procedures, and the CanMEDS framework implementation. Methods: The survey was distributed to former Canadian specialty medicine PDs (N = 684). Descriptive analysis was performed on quantitative data, thematic analysis was performed on qualitative comments, and comparisons between the quantitative and qualitative findings were performed to identify areas of convergence and/or divergence. Results: A total of 265 (38.7%) former PDs participated. Quantitative analysis revealed that 52.8% of respondents did not feel involved in decision-making regarding policy changes, 45.1% of respondents did not feel prepared to assess the CanMEDS Roles, and PDs were divided on the reasonableness of accreditation documentation. Qualitative analysis produced four themes: communication, resources, expectations of outcomes, and buy-in. Nine sub-themes were also identified. A high level of convergence was identified across the content, with only four areas of divergence identified. Conclusions: Our findings have the potential to inform future policy and/or accreditation changes. Without the lens of those charged with overseeing the implementation, policy evaluation and quality improvement will remain uninformed. PDs, therefore, bring unique insights into our understanding of national policy changes, and without the voices of these frontline implementers, the true success of policy change implementation will be hindered.

Explaining Policy Change in Samoa’s Mental Health System

2019 ◽  
Vol 39 (1) ◽  
Author(s):  
Timothy Fadgen
Keyword(s):  
Mental Health ◽  
Policy Change ◽  
Policy Development ◽  
Single Case ◽  
National Policy ◽  
Systems Change ◽  
Small Island ◽  
Mental Health Systems ◽  
Change Initiatives ◽  
Middle Income

Modern mental health systems are the products of successive waves of policy development and adaptation. This is particularly so in many low to middle income countries that inherited colonial mental health laws, and institutions often followed by legislative shifts at independence. But how otherwise do these systems change? And why do these systems change? This article applies historical institutionalism to consider policy change over time, in a single case study of a small island state, Samoa. In doing so, the article will consider three discrete policy change episodes to argue that national policy change in the area of mental health has been the result of foreign direction or influence. These three critical change events occurred leading to policy change: colonisation, independence and the intervention of an intergovernmental organisation. These findings are instructive for future, domestically-driven policy change initiatives, in providing the importance of historical policy development and the continuing importance of international policy advocates in promoting policy change.

The strategies of policy entrepreneurs in water transitions around the world

Water Policy ◽  
2011 ◽  
Vol 13 (5) ◽  
pp. 717-733 ◽  
Author(s):  
Dave Huitema ◽  
Louis Lebel ◽  
Sander Meijerink
Keyword(s):  
Policy Change ◽  
Water Policy ◽  
National Policy ◽  
Management Policy ◽  
Coalition Building ◽  
Institutional Setting ◽  
Policy Entrepreneurs ◽  
Windows Of Opportunity ◽  
Venue Shopping ◽  
Policy Systems

This paper discusses sixteen instances of radical water policy change across the globe. The key question we seek to answer is about the role of individuals in such transitions. We call these individuals ‘policy entrepreneurs’ and we suggest that they can affect transitions through a set of strategies, such as idea development, coalition building, the detection and exploitation of windows of opportunity, network management, and venue shopping. Our empirical analysis shows that individuals do contribute to transitions. They do so in collectives, dividing tasks over various members. The way in which they manage to affect transitions depends, at least partly, on the institutional setting they operate in. Some national policy systems offer better opportunities for centralized direction (and thus top-down pattern of transitions) whilst other systems offer better chances for bottom-up change. In either case, change has to be prepared for before windows of opportunity open. One way to prepare change is to instigate pilot projects, showing the feasibility of other approaches to water management. Policy change is a political game: networks must be built, issues need to be framed strategically, forums manipulated or by-passed, and strategies adjusted to the peculiarities of the institutional system the entrepreneur is working in.

Supreme Court Voting and Realigning Issues: A Microlevel Analysis of Supreme Court Policy Making and Electoral Realignment

1989 ◽  
Vol 13 (3) ◽  
pp. 255-283
Author(s):  
John B. Gates
Keyword(s):  
Supreme Court ◽  
Policy Change ◽  
Policy Making ◽  
Voting Behavior ◽  
Party System ◽  
Separation Of Powers ◽  
National Policy ◽  
Structural Factors ◽  
Congressional Voting ◽  
Electoral Support

Realignment of the American party system is a major focus for students of voting behavior, congressional policy making, and political history (Key, 1955; Burnham, 1970; Clubb, Flannigan, and Zingale, 1980; Kleppner, 1979; Sundquist, 1973; Campbell, 1977; Trilling and Campbell, 1980; Ladd and Hadley, 1978; Brady and Stewart, 1982; Brady, 1985; Sinclair, 1982). The transformation of the party system encompasses significant shifts in electoral support for the major political parties, changes in congressional policy making, and a redirection of national policy making. The rise of new party eras is intriguing because the constitutional structure seeks to minimize such major institutional and policy change. The separation of powers, federalism, and different recruitment patterns for political leaders are structural factors inhibiting major policy change (Brady, 1985). Realignment overcomes these barriers as highly volatile and cross-cutting issues arise. These issues produce linkages between electoral choice, congressional voting, and the broad shape of national policy making.

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