Continuous Quality Improvement Discussion Paper

Authorizing NPs to order cardiac and pulmonary rehabilitation services.

Consider the following as you develop your plan:
How will you ensure the bill is assigned to the appropriate committee, agency, or department?
How will you ensure the appropriate rules are written for the bill?

Write a 525-word paper in which you identify:

What role does the coalition play in the legislative process?
What can the coalition do to influence the bill\’s passage into law?
If the bill is signed into law, how will you ensure it is implemented as intended?
How will the effects of the law be monitored?
What outcomes do you anticipate will result from the bill\’s passage?

Continuous Quality Improvement

What role does the coalition play in the legislative process?

Elections do not typically yield a legislative majority for a single party in both the Senate and Congress. This creates the need for legislators to engage in a complex bargaining process that forms a coalition that then strives to retain the confidence of most of the legislators.  Continuous Quality Improvement Discussion Paper The coalition is made of partners with divergent preferences and who are expected to make joint legislations and policies with a focus on cooperation to reduce dominance of any one party (Finkelman & Kenner, 2014). In this respect, the coalition ensures that the legislation being discussed gains support from the majority of the legislators across the party and political divide so that it standards a higher chance of proceeding through the legislative process.

What can the coalition do to influence the bill’s passage into law?

Coalitions have an influence on a bill’s passage into law through setting agendas that are spelled out in the coalition agreement. The agreement decides the policy program for the coalition, acting as the policy declaration to which the members commit themselves. As such, it is not surprising that a bill with coalition support will have a special status and easily pass through the law-making process as it touches on agendas to which the members are committed. In fact, the very nature of a coalition is contradictory as it engages members with different interests and from different particles. This contradiction ensures that the coalition is able to focus on the agendas presented in its agreement as this is the core element that keeps the members together. Once the members are unable to follow the agreement, then the coalition is likely to break up (Finkelman & Kenner, 2014). In this regard, a bill that touches on the agenda presented in the coalition agreement is likely to speedily pass into law.

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If the bill is signed into law, how will you ensure it is implemented as intended?

Ensuring that a law is implemented as intended requires regulatory activity. In this case, it is understood that the legislative process does not halt once the bill has been signed into law. For that matter, the law must be put into effect and implemented by a regulatory agency of the government’s executive branch. The president delegates the regulatory authority by making a regulatory agency responsible for the law’s implementation. The agency proceeds to present and promulgate administrative regulations that explain how the law will be implemented and what other stakeholders must do to ensure compliance (Mason et al., 2016). As such, identifying a regulatory authority to implement the law, and presenting administrative regulations is important for ensuring that the law is implanted as intended.

How will the effects of the law be monitored?

A law is best monitored by mapping the areas where the law applies as well as stakeholders/societal expectations that apply to the law. Societal expectations are a significant tool for monitoring a law because any law that fails to live up to expectations can be damaging. For each area of application for the law and societal expectation, there is a need to identify how to collect up to date evaluation data as well as who is responsible for ensuring that the expectation is met. Another strategy for monitoring a law is through setting targets, describing and forecasting specific events, status descriptors and definitions, and reporting on milestone events (Mason et al., 2016).

What outcomes do you anticipate will result from the bill’s passage?

The bill seeks to authorize NPs to order cardiac and pulmonary rehabilitation services. The bill’s passage is anticipated to improve health care access by allowing NP to provide services that were previously the sole domain of physicians. Adding NPs to the mix implies that more medical personnel can authorize the rehabilitation services (O’Toole, Chamberlain & Giles, 2019). In addition, the bill’s passage is expected to reduce the cost of health care by avoiding the duplication of billing and services costs associated with nurse practitioners identifying the need for care provision and yet requiring physicians to conduct similar assessments before ordering rehabilitation. Besides that, it would streamline care and improve the efficiency of care delivery by eliminating delays (Woo, Lee & Tam, 2017).

References

Finkelman, A., & Kenner, C. (2016). Professional Nursing Concepts: Competencies for Quality Leadership (3^rd ed.). Jones Bartlett Learning, LLC.

Mason, D., Gardner, D., Outlaw, F., & O’Grady, E. (2016). Policy & Politics in Nursing and Health Care. Elsevier Inc.

O’Toole, K., Chamberlain, D., & Giles, T. (2019). Exploration of a nurse practitioner‐led phase two cardiac rehabilitation programme on attendance and compliance. Journal of Clinical Nursing, 29(5-6). 785-793. https://doi.org/10.1111/jocn.15133

Woo, B., Lee, J., & Tam, W. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human Resources for Health, 15, Article number63. https://doi.org/10.1186/s12960-017-0237-9

Continuous Quality Improvement Discussion Paper