Thematic Analysis of Health Professions Sunset Reports: Foci, Gaps, Impacts, and Best Practices

IF 4.2 4区 医学 Q1 NURSING
David C. Benton PhD, RN, FRCN, FAAN, Alyson S. Brenton RN, MSN, CNL, Peggy Seller Benson MSN, RN, MSHA, NE-BC, Katherine Stansfield MN, RN, Phyllis Johnson DNP, MSN, RN, FNP-BC
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引用次数: 0

Abstract

Background

Sunset reviews, along with performance audits and judicial reviews, orientate regulatory boards to act in the public interest and to address any weaknesses in the boards’ efficiency. Although sunset reviews gained popularity after their introduction in the 1970s and 1980s, their limited success in terminating agencies, along with the resources needed to conduct the reviews, have led to sunset legislation being repealed in several jurisdictions in favor of broader program evaluation or general audit processes. Increased interest in trying to limit the growth of the number of professions requiring a license to practice has seen a revival of interest in both sunrise and sunset reviews over the past decade.

Purpose

To review existing sunset reports related to nursing and other health professions licensing boards and identify the foci, best practices, and criteria used by states in their evaluations.

Methods

A review and systematic examination of existing literature was performed with a mixed-methods approach and a range of analytical techniques. Manual and computer-based qualitative analyses were used to identify themes. Documents were analyzed for thematic content, the centrality of various themes, and how they may inform the development of more standardized approaches to assess the performance of regulatory bodies.

Results

A total of 329 reports were identified from 24 US states. The 329 reports were analyzed and varied in length from 3 to 727 pages with an average report length of 68 pages. Collectively, 22,420 pages were analyzed. The review identified that many evaluations were based on opinion or survey responses rather than quantifiable or empirical evaluations. As a result, objective analysis of the approaches is difficult to assess, both within and across jurisdictions. The study identified 26 themes with considerable overlaps and connections between them. By coding various themes to the content of the reports, researchers identified groups of the most strongly related themes. The most connected group, main areas of performance scrutiny, relates to the major responsibilities and functions of licensing boards. The next most connected group encompasses the administrative and operational concerns involved in the conduct of the review. The least connected group is those elements that delineate the authority and focus of the review and encompass the basis of the legislative authority used to enable the review. Best and promising practices were also identified, including the following: (a) information provision (e.g., guidance notes that explain the process and provide public input); (b) comparative data sets (e.g., conducting reviews on a range of boards simultaneously); (c) accountability and publication of responses (e.g., improvement recommendations or commendation for best practices are made available).

Conclusion

Analysis of published sunset review report thematic content identified a range of potential metrics that, if standardized, could offer greater interdisciplinary board and interjurisdictional learning. The criteria used to conduct sunset reviews and the foci contained within reports provide insights for board members and staff education content creators. Related opportunities for further research were also identified.

卫生专业夕阳报告的专题分析:焦点、差距、影响和最佳做法
背景日落审查,连同绩效审计和司法审查,引导监管委员会为公众利益行事,并解决董事会效率方面的任何弱点。虽然日落审查在20世纪70年代和80年代引入后受到欢迎,但在终止机构方面取得的有限成功,以及进行审查所需的资源,导致日落立法在一些司法管辖区被废除,转而支持更广泛的项目评估或一般审计过程。在过去的十年里,越来越多的人试图限制需要执照的职业数量的增长,这使得人们对日出和日落审查的兴趣重新燃起。目的审查与护理和其他卫生专业许可委员会有关的现有日落报告,并确定各州在其评估中使用的重点、最佳做法和标准。方法采用混合方法和一系列分析技术对现有文献进行综述和系统检查。使用手工和计算机定性分析来确定主题。分析了文件的主题内容、各种主题的中心地位,以及它们如何为制定更标准化的方法来评估监管机构的绩效提供信息。结果从美国24个州共鉴定出329份报告。对329份报告进行了分析,报告长度从3页到727页不等,平均报告长度为68页。总共分析了22,420页。审查发现,许多评价是基于意见或调查答复,而不是可量化或经验性评价。因此,很难对这些方法进行客观分析,无论是在司法管辖区内还是跨司法管辖区内。该研究确定了26个主题,它们之间有相当大的重叠和联系。通过将各种主题编码到报告的内容中,研究人员确定了相关性最强的主题组。联系最紧密的一组,即审查工作表现的主要领域,与发牌委员会的主要责任和职能有关。下一个联系最密切的小组包括进行审查所涉及的行政和业务问题。联系最少的一组是那些描述审查的权威和重点并包含用于使审查成为可能的立法权威基础的要素。还确定了最佳和有希望的做法,包括以下内容:(a)提供信息(例如,解释流程并提供公众意见的指导说明);(b)比较数据集(例如,同时对一系列委员会进行审查);(c)问责制和公布回应(例如,提供改进建议或对最佳做法的表彰)。对已发表的日落评审报告主题内容的分析确定了一系列潜在指标,如果将其标准化,可以提供更大的跨学科委员会和跨司法管辖区学习。用于进行日落审查的标准和报告中包含的重点为董事会成员和工作人员教育内容创作者提供了见解。还确定了进一步研究的相关机会。
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来源期刊
CiteScore
4.60
自引率
12.50%
发文量
50
审稿时长
54 days
期刊介绍: Journal of Nursing Regulation (JNR), the official journal of the National Council of State Boards of Nursing (NCSBN®), is a quarterly, peer-reviewed, academic and professional journal. It publishes scholarly articles that advance the science of nursing regulation, promote the mission and vision of NCSBN, and enhance communication and collaboration among nurse regulators, educators, practitioners, and the scientific community. The journal supports evidence-based regulation, addresses issues related to patient safety, and highlights current nursing regulatory issues, programs, and projects in both the United States and the international community. In publishing JNR, NCSBN''s goal is to develop and share knowledge related to nursing and other healthcare regulation across continents and to promote a greater awareness of regulatory issues among all nurses.
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