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Policy implementation: the influence of frontline staff, the nature and meaning of policy, and the organisational environment

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1. Policy implementation: the influence of frontline staff, the nature and meaning of policy, and the organisational environmentErmin Erasmus, Centre for Health…
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  • 1. Policy implementation: the influence of frontline staff, the nature and meaning of policy, and the organisational environmentErmin Erasmus, Centre for Health Policy<br />Delivering Effective Health Care for All<br />Monday 29th March, 2010<br />
  • 2. The research<br /><ul><li>Case study work in two SA district hospitals
  • 3. 5 months in each hospital
  • 4. In-depth interviews from facility and community perspectives
  • 5. Observation of staff and patient interactions
  • 6. Surveys of organisational trust and culture
  • 7. The implementation of two equity-oriented policies:
  • 8. Understand the influences over implementation, particularly institutional influences and power</li></li></ul><li>The central argument<br />
  • 9. The influence of frontline staff<br />
  • 10. User fee/exemption implementation<br />
  • 11. Patients’ Rights Charter implementation<br />
  • 12. Implications for policy and practice<br />How are change processes likely to develop and what are realistic timeframes?<br />Need for managers to be mentored in navigating implementation obstacles, not just trained<br />More than “hardware”. Also the need to manage “soft” elements such as policy meaning, e.g. through performance metrics or tone set by management<br />Need for managers to be able to engage constructively with others’ understandings and interpretations<br />Need for management training that is strategic, not just operational<br />
  • 13. Research partners<br />Centre for Health Policy, University of the Witwatersrand<br />Health Economics Unit, University of Cape Town<br />London School of Hygiene and Tropical Medicine<br />
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