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Leadership and Policy
In Introduction to Key Concepts
Leadership: Some initial questions to ponder
• What needs to be ‘led’ in the health care system and beyond?
• Who are some of the leaders in the health care system and beyond? What makes them leaders?
• What are some leadership qualities? (note that the answer to this question is tied to worldview and political compass)
The health care system
• What other systems are articulated to the health care system?
• How do these articulations challenge leadership?
• What are some of the main challenges in health care today?
Pulling it all together: The social, economic and political contexts of health
Leadership and the social determinants of health
0.18 0.20 0.22 0.24Share of Income
Held by Lower 50%
300
425
550
675
800R
ate
per
100,0
00 P
opula
tion
Working-Aged Male (25-64) Mortality by Median ShareU.S. States and Canadian Provinces
Mortality Rates Standardized to the Canadian Population in 1991
U.S. States with weighted linear fit (from Kaplan et al., 1996)Canadian Provinces with weighted linear fit (slope not significant)
MSLA
AL
CA
TX
FL
NH
MN
PEI
NFLDNB
SASK
ONT
ALTABC
MAN
QUE NS
SC
ME
Source:Ross N., et al. BMJ 2000;320(7239):898-902.
WA
Infant Mortality, Canada 1996
0 1 2 3 4 5 6 7 8
Q1-Richest
Q2
Q3
Q4
Q5-Poorest
per 1,000
Source: Wilkins et al., 2002, Health Reports
Life Expectancy, Males, Canada 1996
72 73 74 75 76 77 78 79
Q1-Richest
Q2
Q3
Q4
Q5-Poorest
Yrs
Source: Wilkins et al., 2002, Health Reports
Life Expectancy, Females, Canada, 1996
80 80.5 81 81.5 82 82.5 83
Q1-Richest
Q2
Q3
Q4
Q5-Poorest
Yrs
Source: Wilkins et al., 2002, Health Reports
So if the strongest determinant of health is poverty…
What are some Nursing Leadership Priorities
So…what are some key areas for Leadership in Canadian Nursing?
• Nursing Education…The Aboriginal and Black Student Success Program (STFX)
• Professional Nursing Practice…(Cultural Competency; Moral Distress)
• Political Areas (Government policy…privitization)• National Leadership…(Nurses for Medicare)• Global Leadership… (ICN Girl Child Education
Fund)
What is the policy cycle and how do these nursing leadership
successes reflect the policy cycle?
The Policy Cycle Simplified
• 1. Setting the policy agenda and objectives: Identifying social problems and getting them on the policy agenda
• 2. Moving policy to action: Policy formulation and adoption
• 3. Policy implementation: Finding effective, ethical, and practical solutions
• . Policy evaluation, reassessment, and revision: Measuring outcomes and moving forward
2. MOVING POLICY INTO ACTION: Policy formulation & adoption
4. POLICY EVALUATION & REVISION: Measuring outcomes & moving forward
3. POLICY IMPLEMENTATION: Finding effective, ethical & practical solutions
Figure 7.#: The Policy Cycle
1. SETTING THE POLICY AGENDA & OBJECTIVES: Identifying social problems & getting them on the policy agenda
Source: McGibbon, E. & Etowa, J. *2009). Anti-racist health care practice: Toronto: Canadian Scholars Press.
Trace the Policy Cycle for each of these Nursing Leadership Initiatives
• Nursing Education…The Aboriginal and Black Student Success Program (STFX)
• Professional Nursing Practice…(Cultural Competency Models; Moral Distress Theory)
• Political Areas (Government policy…privitization)• National Leadership…(Nurses for Medicare)• Global Leadership… (ICN Girl Child Education
Fund)
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