As nurses, we have extensive training on the nursing process, and because of this, we are knowledgeable on the essential step of evaluation (Milstead & Short, 2019). Like all the other steps of policy design, as nurses, we must collaborate and engage with political leaders on opportunities to assist with the evaluation process. According to Milstead and Short (2019), the step of evaluation offers feedback by identifying areas of improvement, validated resources and is a vital aspect of reforming the US healthcare system (pp.116). Two opportunities RNs and APRNs may assist with the evaluation process are joining a clinical research team and writing and presenting evaluation reports. According to Glasgow et al. (2003), there are two types of research: the efficiency and effectiveness of a program. Both focus on “does the program do more harm than good.”
The difference between efficiency and effectiveness research is that efficiency look at delivering the program under optimal conditions, whereas effectiveness research looks at delivery under real-world conditions (pp. 1261). Within a research group, an individual will be asked to contribute to data collection, comprehend the data, and report the data (Milstead & Short, 2019). Having professional experience in the research subject area gives validity to the research trial. That is why it is important to have healthcare experts such as RNs and APRNs part of research teams. Writing the formal report emphasizes the evaluation method and results (Milstead & Short, 2019). According to Milstead and Short (2019), the final step in the evaluation process is then distributing the data to other professionals, interdisciplinary teams, the consumer such as patients, and stakeholders such as political leaders. This type of scholarly assessment data is distributed in peer-reviewed articles in professional journals or books (Shiramizu et al., 2016). As RNs and APRNs, we have a professional obligation to policy evaluation to develop solutions to promote access, cost-effective, and quality healthcare for our nation (Laureate Education, 2018).
According to Milstead and Short (2019), challenges in the policy evaluation are best addressed early in the policy design process. Knowing the typical challenges can help prevent them and facilitate an optimal policy. The eight challenges in policy evaluations are lack of resources, not having a knowledgeable leader, not engaging the stakeholders, lack of qualified results, precipitous implementation, request from stakeholders for premature results, more inclusive evaluation, and public opinion that can be tainted by social media or poor campaigning (pp. 122-123). Although there are challenges to the evaluation process, it is a crucial step to reshape the US health care system (Milstead & Short, 2019).
To overcome the eight challenges in policy evaluation, the RN and APRN must carefully collect, analyze, and distribute reliable data in an unbiased, fully detailed report that focuses on answering the policy objectives (Milstead & Short, 2019). Milstead and Short (2019) state that another way to overcome the challenge of policy evaluation is to attain formal discussions on the policy to prevent the data from being biased, disorganized, or improperly reported to the stakeholders and consumers. Fortunately, all federal healthcare policies and programs must go through a rigorous evaluation process that is required by the National Performance Review and the Government Performance and Results Act of 1993. This Act was developed to emphasize accountability, performance measures, and proper results. Last, policy evaluation should focus on short -term and long-term outcomes of the policy design (pp. 118).
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