Health Planning in the United States Issues in Guideline Development, Report of a Study (1980) / Chapter Skim
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IV. The Process of Developing National Guidelines for Health Planning
IV. The Process of Developing National Guidelines for Health Planning
Pages 41-54
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From page 41... ...
Constraints on the Process of Developing National Health Planning Guidelines In an open and democratic society, the process by which governmental policy is made can be as important as the policy itself. Given a view of the guidelines as a means for establishing and expressing national interests at local and state levels, and for being helpful to the planning agencies in strengthening their knowledge and negotiating ability, it is the committee's judgment that the process by which the national guidelines are developed are important.
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From page 42... ...
. The general goal for health planning activities -- achievement of equal access to quality health care at a reasonable cost cannot be incorporated in a single standard.
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From page 43... ...
Recommendations for Guideline Development The committee identified a number of characteristics and five phases of development of national guidelines. Each phase is discussed separately with specific recommendations for consideration in the immediate future of guidelines development.
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From page 44... ...
Among the tasks that might be assigned to the Council are: -- solicitation of topic suggestions from the public, planners, professional organizations, and other interested parties -- identification of the interests that should be represented in formulating any particular guideline -- conduct of public meetings at which topics would be evaluated in light of congressional and departmental priorities, the needs of the planners, and the concerns of the public and the health establishment -- identification of topics for guidelines development, based on need and technical feasibility, for transmittal to the Secretary -- dissemination of its recommended agenda to the public. To ensure the proper development of such an agenda and advising on related activities, the committee recommends that the Council be given an adequate staff ?
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From page 45... ...
The committee recommends that adequate staff within DHEW be assigned to developing the guidelines and that adequacy be recognized as being both a quantitative and qualitative concept. The committee believes that provision of adequate staff support for the guidelines development effort within DHEW will be a critical element in its success.
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From page 46... ...
A desirable process for guidelines development will also set an important example for the development at local and state levels. Features of the Development Process The committee does not suggest that there is any "best" way to develop national health planning guidelines, including goals and standards.
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From page 47... ...
Without liaison with the guidelines development process, existing technology assessment activities may stop short of addressing issues of central importance to health planning. Limitations of the federal activities include an emphasis on technology, and not on facilities, manpower, or resource standards; none of the agencies mentioned above is concerned primarily with health planning, and planning issues may not receive the necessary degree of attention in their activities.
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From page 48... ...
The development of health planning guidelines should concentrate on the problems of planning and address the goals set forth in the planning law. Second, it should be oriented toward the use of scientific evidence from clinical trials, epidemiological research, and health services research.
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From page 49... ...
The 1979 requirement that DHEW provide material, including options under consideration, and to consult with planning agencies, associations, and specialty societies at least 45 days before proposing guidelines will help reduce fears that a decision has been made.
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From page 50... ...
Evaluation of the effects and usefulness of planning guidelines should be viewed as the final stage in the guidelines development process. The evaluation of past guidelines should feed into their revision and the development of new guidelines.
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From page 51... ...
Further, the evolution of the health planning program and the committee's engagement in simulation of guideline development have helped to reveal the importance of an agenda for needed research. ' A two pronged attack to improve the availability of sound analytical methods and research, as well as the dissemination of findings, might include the funding of research in planning methods and application by NCHSR and HCFA, and an emphasis on synthesizing and disseminating research and experience in applying methods through the Centers for Health Planning and universities involved in research.
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From page 52... ...
More concentrated attention should be given to developing and testing less expensive data collection methods especially those which produce data linked to a defined population. The size of most of the agency's grants is not large enough to permit much primary data collection.
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From page 53... ...
Further, as soon as there is sufficient knowledge which could help to inform and guide planning decisions, it should be shared with planning agencies. Summary In general, the committee believes that the entire process of guidelines development (from agenda development through evaluation and revisions)
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