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Policy into action : a case study of the educative efforts associated with the implementation of new health care legislation in British Columbia McFadyen, Carol Jean

Abstract

The main goal of this study was to understand the role of education in public policy implementation through an exploration of how professional health care providers were educated about legislative change implemented in February 2000. Two key questions guided this study: First, what happened in the implementation phase of new health legislation in British Columbia? Relative to this question, what did the government and professional health organizations do to educate professional health care providers? What challenges did they face? What do stakeholders think about the effectiveness and sufficiency of their educative efforts? The second key question was: What lessons can be learned about planning and implementing educational activities that inform professionals of legislative changes that affect their practice? The investigation focussed on the three main areas of practice that were involved in educative initiatives related to the implementation of adult guardianship legislation. These included the Ministry of Health, the Public Guardian and Trustee Office, and several health care professional organizations. Fourteen participants representative of these areas were interviewed and documents utilized in their educative efforts were collected and analyzed. Several key findings emerged during the study. It became apparent that the government initiatives were responsible for the majority of education available to professional health care providers. Among the health care profession organizations, there were differences in educative initiatives as well as in their interpretation of the mandate for education of professional health care providers when legislation is implemented. There were differences in the educative efforts undertaken by the two separate government offices and each of them had very different impressions about their success. The Ministry of Health focus was on the Health Care Consent Act and that educative effort specifically targeted professional health care providers. The Public Guardian and Trustee Office focus was on the Adult Guardianship Act and that educative effort specifically targeted the public but included professional health care providers. The latter initiative had significantly greater financial resources for education as well as an extended time period in which to offer and reinforce education. Participants who represented the Ministry of Health expressed concern that professional health care providers are not adequately informed about the full legislative package, whereas participants who represented the Public Guardian and Trustee Office expressed confidence that their educative work was successful. The particular legislation package that is the subject of this study is difficult and complicated; it consists of four different Acts and its effects include significant changes in the practice and power of health care providers. The findings highlight the politics of planning for education about legislation that originated from the grassroots in order to protect the vulnerable public and at the same time had implications for the practice of professional health care providers. These differing and sometimes competing interests, along with variation in resources and mandates, are two main policy influences that are in part addressed from the perspective of the power in planning literature. The study offers conclusions and recommendations for how major policy change might be addressed in future. Recommendations are made to government policy makers, to health profession organizations, and for future research in the area of education about policy change. The study concludes with an exploration of its implications for the future work of this researcher.

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