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)