Browsing by Subject "implementation strategies"

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    Expanding the political market framework to explain executive decision-making during the COVID-19 crisis
    (ASPA, 2023-09) Curley, Cali; Federman, Peter Stanley; Shen, Ruowen; School of Public and Environmental Affairs
    The traditional political market framework (PMF) argues that elected officials respond to policy demands by adopting policy that furthers their goal of reelection. However, an emerging crisis can make this approach to decision-making challenging as the immediacy of response, the needs of the public, and technical expertise may conflict with reelection goals. This conflict can encourage elected officials to engage in blame avoidance by delegating policy-making powers to the bureaucracy. Utilizing a mixed methods approach to analyze state-level governor responses to COVID-19, this paper expands the PMF by capturing the influence of bureaucratic demands on elected official decisions to delegate or transfer power to the bureaucracy. We find evidence that bureaucratic expertise, under the right set of circumstances, influences policymaker decisions to delegate policymaking power. Lastly, we advocate for a renewed focus on democratic principles and the consequences of delegation for transparency, accountability, and social equity. In understanding the specific dynamics at play when bureaucrats and executives work to develop policy in crisis, practitioners may gain a better understanding of how to navigate difficult decisions. The specific executive orders across states are not particularly well-known, and providing evidence of the steps other states took to combat the crisis may prove useful to practitioners in the emergency management space. If practitioners have a more complete understanding of why policy is made and by what mechanisms, they may apply a focus on implementation strategies that are effective and relevant.
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    Implementing a Mandated Program Across a Regional Health Care System: A Rapid Qualitative Assessment to Evaluate Early Implementation Strategies
    (Wolters Kluwer, 2019-09-01) Sperber, Nina R.; Bruening, Rebecca A.; Choate, Ashley; Mahanna, Elizabeth; Wang, Virginia; Powell, Byron J.; Damush, Teresa; Jackson, George L.; Van Houtven, Courtney H.; Allen, Kelli D.; Hastings, Susan N.; Medicine, School of Medicine
    Rapid qualitative assessement was used to describe early strategies to implement an evidence-based walking program for hospitalized older adults, assiSTed eaRly mobIlity for hospitalizeD older vEterans (STRIDE), mandated by a regional Veterans Affairs health care system office (VISN). Data were collected from 6 hospital sites via semi-structured interviews with key informants, observations of telephone-based technical assistance (TA), and review of VISN-requested program documents (e.g., initial implementation plans). An overaching framework of actionable feedback for VISN leadership and specification of locally initiated implementation strategies, using the Expert Recommendations for Implementing Change (ERIC) compilation, was used. Actionable feedback was shared with VISN leadership one month after the initiative. ERIC implementation strategies identified were: 1) Promoting Adaptability- Four sites had physical therapists (PT)/ kinesiotherapists (KT) instead of assistants walk patients, 2) Promoting Network Weaving- Strengthening nursing and PT/ KT partnership with regular communication opportunities or a point person was important for implementation, 3) Distributing Educational Materials – Two sites distributed information about STRIDE via email and in-person, and 4) Organizing Clinician Implementation Team Meetings – Three sites used interdisciplinary team meetings to communicate with clinical staff about STRIDE. This qualitative study sheds light on early experiences with implementing STRIDE; the results have been instructive for ongoing implementation and future dissemination of STRIDE, and the approach can be applied across contexts to inform implementation of other programs.