The impact of regional policies on emergency department management and performance: the case of the regional government of Sicily

Abstract

The quality of local policy and management are key aspects of efficient promotion of performance improvement. Copyright © 2015 John Wiley & Sons, Ltd.

A systematic review and meta-synthesis of policy intervention characteristics that influence the implementation of government-directed policy in the hospital setting: implications for infection prevention and control

“…Clinician acceptance Policy intervention involved activities undertaken to align policy changes with current practices Altman, 2012;Back et al, 2017;Dharampal et al, 2016;Dyers et al, 2017;Fassl et al, 2012;Jorgensen et al, 2010;Ketko et al, 2015;McHugh et al, 2011;Mittler et al, 2013;Morrow et al, 2012;Padula et al, 2015;Resar et al, 2011;Sautter et al, 2007;Yelland et al, 2017 (n = 14) Policy functions Policy intervention involved activities undertaken to align policy changes with other regulations/policies and their functions Calikoglu et al, 2012;Canaway et al, 2017;Fanelli et al, 2017;Hafner et al, 2011;Jorgensen et al, 2010;Ju et al, 2015;McHugh et al, 2011;Resar et al, 2011;…”

“…Even in examples where a 'strong evidence base' for policy content was specifically referenced, interventions still sought to provide clarity, with authors describing interventions which actively aimed to facilitate change by translating the evidence included in the policy into specific practice changes or actionable guidelines (Deasy et al, 2016;Fassl et al, 2012;Gasparini et al, 2015;Iorio, 2015;Kahin et al, 2017;Kozhimannil et al, 2013;Lombarts et al, 2009;Martínez et al, 2009;McClain et al, 2017;Mittler et al, 2013;Nisly et al, 2013;Padula et al, 2015;Richards et al, 2008;Russ et al, 2015;Smith and Metzger, 2011;Tung and Chang, 2016;Wald et al, 2012;Weeks et al, 2014;Yelland et al, 2017). In some cases, policy-related interventions were performed by external government entities or networks, such as professional colleges or funding bodies (Canaway et al, 2017;Deasy et al, 2016;Dharampal et al, 2016;Dumartin et al, 2011;Fanelli et al, 2017;Heitmann et al, 2017;Jorgensen et al, 2010;Ju et al, 2015;Lambert et al, 2015;Martínez et al, 2009;McClain et al, 2017;Molina et al, 2016;Morrow et al, 2012;Shiloach et al, 2010;Weeks et al, 2014). In other policy implementation examples, hospital clinicians and staff developed interventions internally to link policy directives and requirements with 'real-life' application often in the form of official policies or procedures...…”

“…Alignment of information technology (IT) or data reporting procedures were also described when attempting to align working processes with policy requirements (Amland et al, 2015;Bell et al, 2013;Chukmaitov et al, 2015;Hassanain, 2017;Jorgensen et al, 2010;Lombarts et al, 2009;Nisly et al, 2013;Padula et al, 2015;Smith and Metzger, 2011). In some articles, discussion of policy interventions introduced at an organisational level also involved ensuring activities aligned with other policy interventions or safety and quality interventions, which may have impeded or competed with implementation and/ or practice changes (Fanelli et al, 2017;Jorgensen et al, 2010;Ju et al, 2015;McHugh et al, 2011;Resar et al, 2011;Sautter et al, 2007).…”

“…The last subtheme within the theme of alignment was goal alignment. Again, examples of policy interventions which involved the alignment of goals was observed across all levels of the health system (Back et al, 2017;Fanelli et al, 2017;Kozhimannil et al, 2013;Lanese, 2016;Morrow et al, 2012;Molina et al, 2016). Alignment of goals varied in their application.…”

“…Alignment of goals varied in their application. In some cases, alignment of goals was presented as a component of policy development and the reason for policy introduction in the first instance (Fanelli et al, 2017;Kozhimannil et al, 2013;Marsteller et al, 2014;Martínez et al, 2009;Resar et al, 2011;Stone et al, 2015;Weeks et al, 2014). In other examples of goal alignment, the focus of the policy intervention itself was on identifying clinician goals and priorities and ensuring implementation activities aligned with these (Barbash et al, 2017;Duckers et al, 2009b;Iorio et al, 2016;Ketko et al, 2015;Lanese, 2016;McHugh et al, 2011;Jurkowski et al, 2016;Padula et al, 2015;Sautter et al, 2007;Wiig et al, 2013;Yu et al, 2017).…”