On the importance of being policy-ready

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      Catherine L. Gilliss, DNSc, RN, FAAN
      Throughout the last decade, the leadership of the American Academy of Nursing (AAN) has refined the Academy's mission and developed a series of specific, strategic plans to accomplish that mission. The mission of the AAN is to serve the public and nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. Our stated vision is to transform health and health care policy and practice through nursing knowledge. At the AAN's November 2009 Annual Meeting, outgoing President Pamela Mitchell provided a comprehensive report of the organization's strategic accomplishments as guided by the strategic plan that is coming to a close. (The 2009 AAN's Annual Report is available at As to be expected in any dynamic organization, the process of strategic review is cyclic; the time has come for the Academy to review and recommit to our strategic priorities.
      Early in 2009, the Board of Directors began a process of analysis reviewing our recent accomplishments, the rapidly changing landscape of health care, and the unique role that nursing—and specifically the AAN—should play in advancing health policy and practice through knowledge. In our conversations, we grappled with the criteria that would guide us toward the best set of strategic priorities. Equally challenging, we closely examined the ways in which we could act to bring about the changes we envisioned. How could we know when the right moment would emerge? How could we create the needed opportunities to be influential? How would we be organized when the right moment came along?
      That's when we realized the importance of being policy-ready.
      Although somewhat predictable in course, the progress of change driving today's health policy reforms is rapid and the shifts occur both within full view and in private. As the old adage advises, “Chance favors the prepared mind.” If we are to influence health policy, we must be prepared to seize the opportunities that come without much notice and without clear invitation. How can we be ready?
      First, we must be clear about the AAN's mission and the issues we are mission-driven to advance. In the case of the AAN, we are broadly committed to advancing healthcare policy and nursing through the use of knowledge, particularly knowledge derived within the profession of nursing. But that broad direction requires greater specificity, which is why we are now narrowing our commitment for the next 3 years through the development of our strategic plan. As those participating in the Annual Meeting have heard, the Board has identified 3 areas we believe are important to our work and will be topical in the near term: nurse-led innovations in care delivery; meaningful use of technology; and quality and safety. We have asked our members to comment on these broad areas and to advise us on relevant tactics within these areas. A plan will be available for comment by the AAN Fellows in early 2010. We expect that the plan advanced by the AAN will focus on our mission, which we believe is largely distinct from that of other nursing groups.
      Once we have a plan, we must “do the work” to be ready. Given our commitment to use of knowledge, we need to have completed evidence-based reviews. This includes careful examination of what is known and the gaps to be addressed. We also need to know about the innovative work going on in practice and the impact data associated with those innovations. Our Edge Runners Program, a component of the Raise the Voice Initiative, is an example of our work to catalogue and promote these innovations and their successful results. Expert Panels, Task Forces, and Commissions have also advanced our work by organizing the background knowledge to substantiate our positions.
      When engaged in policy work, we must have proposed solutions in mind. “What's the ask?” is more commonly being spoken in our circles. Knowing what you hope to ask for is a critical step in being strategic. You need to know what problem you are trying to solve and have an idea of how you believe the problem should be solved. When we initiate interesting intellectual projects, such as the development of a research agenda on “x,” we need to begin to think beyond that product to the next steps. What do we want to do with that agenda? Who will help to advance the agenda? Pay for the research? Who else has a stake in this outcome? Which brings us to the next step in being policy-ready….
      We must have working relationships and partnerships in place that will help promote the topic and the solution. Almost all of our issues of concern also matter to other professional or lay groups, and finding the right partners on our groups will provide us with broader perspective and broader leverage. The development of our relationships and the strong coalitions we develop aid us in being influential.
      While all this may sound logical, relatively few of us have much experience with the full range of activities required to be policy-ready. That's why having so many members well-organized and working together is critically important for the AAN.
      The AAN leadership and I hope to make policy-readiness more accessible to our members in the next few years. Our collective ability to influence policy is dependent upon this, as is the health of the public.

      Policy Resources




      Catherine L. Gilliss, DNSc, RN, FAAN, is the Dean at the Duke University School of Nursing, where she is the Helene Fuld Health Trust Professor of Nursing and the Vice Chancellor for Nursing Affairs for Duke University.