Question

imagine you are adapting this policy to the health care organization at which you work (or where you wish to work).

Describe the organization and discuss the following:

The stakeholders involved in policy formation and their impact on health care policy formation and structures.

The response you expect from those stakeholders. The specific impact this governmental policy will make (positive, negative, indifferent) and why?

Answer 1

Answer: Health organization involves a vast complex of stakeholders and participants, suppliers and purchasers, regulators and direct providers, and individual patients, and their decision-making. These include pyramidal and network organizations and ethical decision-making based on public interest, resource allocations, priority selection, and assurance of certain codes of law and ethical conduct. This chapter discusses how complex organizations work, with potential for application in health, and the motivations of workers and of the population being served. Organization theory helps in devising methods to integrate relevant factors to become more effective in defining and achieving goals and missions.

Stakeholders are those who may be affected by or have an effect on an effort. Or stakeholder is a party that has an interest in a company and can either affect or be affected by the business. They may also include people who have a strong interest in the effort for academic, philosophical, or political reasons, even though they and their families, friends, and associates are not directly affected by it.

One way to characterize stakeholders is by their relationship to the effort in question.

• Primary stakeholders are the people or groups that stand to be directly affected, either positively or negatively, by an effort or the actions of an agency, institution, or organization
• Secondary stakeholders are people or groups that are indirectly affected, either positively or negatively, by an effort or the actions of an agency, institution, or organization
• Key stakeholders, who might belong to either or neither of the first two groups, are those who can have a positive or negative effect on an effort, or who are important within or to an organization, agency, or institution engaged in an effort. The director of an organization might be an obvious key stakeholder, but so might the line staff – those who work directly with participants – who carry out the work of the effort. If they don’t believe in what they’re doing or don’t do it well, it might as well not have begun.

The stakeholders are generally said to have an interest in an effort or organization based on whether they can affect or be affected by it. The more they stand to benefit or lose by it, the stronger their interest is likely to be. The more heavily involved they are in the effort or organization, the stronger their interest as well.

Stakeholders’ interests can be many and varied. A few of the more common:

• Economics. An employment training program might improve economic prospects for low-income people, for example. Zoning regulations may also have economic consequences for various groups.
• Social change. An effort to improve racial harmony could alter the social climate for members of both the racial or ethnic minority and the majority.
• Work. Involving workers in decision-making can enhance work life and make people more satisfied with their jobs.
• Time. Flexible work hours, relief programs for caregivers, parental leave, and other efforts that provide people with time for leisure or taking care of the business of life can relieve stress and increase productivity.
• Environment. Protection of open space, conservation of resources, attention to climate change, and other environmental efforts can add to everyday life. These can also be seen as harmful to business and private ownership.
• Physical health. Free or sliding-scale medical facilities and other similar programs provide a clear benefit for low-income people and can improve community health.
• Safety and security. Neighborhood watch or patrol programs, better policing in high-crime neighborhoods, work safety initiatives – all of these and many other efforts can improve safety for specific populations or for the community as a whole.
• Mental health. Community mental health centers and adult day care can be extremely important not only to people with mental health issues, but also to their families and to the community as a whole.

The most important reason for identifying and understanding stakeholders is that it allows you to recruit them as part of the effort. A participatory effort that involves representation of as many stakeholders as possible has a number of important advantages:

• It puts more ideas on the table.
• It includes varied perspectives from all sectors and elements of the community affected, thus giving a clearer picture of the community context and potential pitfalls and assets.
• It gains buy-in and support for the effort from all stakeholders by making them an integral part of its development, planning, implementation, and evaluation. It becomes their effort, and they’ll do their best to make it work.
• It’s fair to everyone. All stakeholders can have a say in the development of an effort that may seriously affect them.
• It saves you from being blindsided by concerns you didn’t know about. .
• It strengthens your position if there’s opposition.
• It creates bridging social capital for the community. Social capital is the web of acquaintances, friendships, family ties, favors, obligations, and other social currency that can be used to cement relationships and strengthen community
• It increases the credibility of your organization.
• It increases the chances for the success of your effort.

Regardless of the purpose of your effort, identifying stakeholders and their interests should be among the first.

• Stakeholders in a participatory process should be part of every phase of the work, so that they can both contribute and take ownership. Their knowledge of the community and understanding of its needs can prove invaluable in helping you to avoid mistakes in your approach and in the people you choose to involve.
• If your intent is a participatory action research project, stakeholders should be included in any assessment and pre-planning activities as well as planning and implementation. That way, they’ll understand the research process and project much more clearly, and can add to them.
• If you want your process to be regarded as transparent, stakeholder involvement from the beginning is absolutely necessary. The community will only believe in an open process if it’s truly open.
• If your effort involves changes that will affect people in different ways, it’s important that they be involved early so that any concerns or barriers show up early and can be addressed.
• In situations where there are legal implications, such as the building of a development, involving stakeholders from the beginning is both fair and can help stave off the possibility of lawsuits down the road.

In short, in most cases, the earlier in the process government policy can be involved, the better.