Implementation of specific strategies or solutions demands an effective and comprehensive approach that guarantees consideration of all issues vital for the improved outcomes. Under these conditions, the implementation strategy acquires the top priority as one of the major goals to attain success and avoid failures. For the healthcare setting, the given aspect becomes more topical as it directly impacts the health of patients and their ability to enjoy the high quality of lives. The existing perspective on strategic implementation defines it as the process that ensures that all strategies and plans will be put into action to achieve existing goals and attain beneficial outcomes (McLaughlin & McLaughlin, 2014). The process of implementation presupposes the following critical stages: scope, or planning, work breakdown, funding, risk management, stakeholder engagement, resources (sourcing and procurement), and quality assurance (McLaughlin & McLaughlin, 2014). The existence of these phases guarantees that positive outcomes will be attained.
Implementation Phases
The suggested case 340B Drub Pricing Program can be analyzed regarding the stages mentioned above. As for the planning phase, the implementation of the strategy was considered a beneficial way to improve the state of specific groups by providing the discount drug purchasing program for Veteran Administration (McLaughlin & McLaughlin, 2014). In such a way, it was planned that the introduction of this strategy would contribute to the achievement of the positive outcomes and improve the functioning of the healthcare sector (McLaughlin & McLaughlin, 2014). However, the agencies failed to consider all factors, such as the specific nature of medications that were covered by the act. Additionally, the extension of the program to Medicaid purchases created a new precedent as there was the need to consider specific reporting policies and avoid misunderstandings when implementing the plan. However, the central activities and scope were determined as the major cause of the initiation of the project.
During the breakdown phase, the HRSA and other agencies responsible for the successful launching of the program had to consider all dates and possibilities to introduce the discount program within the existing healthcare setting. However, during the given phase, some problems start to appear because of the issues with self-reporting and funding. In such a way, the integration of the program became associated with some difficulties at different levels and some drawbacks in the initial planning, such as the inability to consider the possible issues with Medicaid purchases (McLaughlin & McLaughlin, 2014). The current literature devoted to the selected problem is united in the opinion that the breakdown phase should be supported with an in-depth analysis of all possible complications as it will help to avoid failures (Smith, 2018). In such a way, it could have contributed to enhanced outcomes during the implementation.
The funding phase of the discussed case revealed some problems with billing and the inability to consider all costs that might be demanded to support low-income communities or individuals with the required medications (McLaughlin & McLaughlin, 2014). HRSA and ACA were not able to consider the major discount sources and hospitals that could work in terms of the proposed program. In such a way, this issue became one of the possible factors deteriorating the implementation phase and preconditioning the emergence of debates and discussions about the offered discount program and its relation to Medicare purchases (McIsaac et al., 2018). The success during the planning phase can be achieved by the implementation of more effective cost analysis strategies as one of the basic tools to attain positive outcomes (Ginter, Duncan, & Swayne, 2018). For this reason, it was vital to ensure the use of these tools regarding the given case.
As for the risk management phase, it should be stated that low attention was devoted to the consideration of all factors that might precondition the emergence of additional problems with the project and its deteriorated outcomes. Thus, Congress, HRSA, and other agencies responsible for the project were not able to consider all possible risks and include practical management tools to avoid them. It resulted in the need for additional debates and amendments introduced during the implementation process.
The next phase should be devoted to stakeholder engagement and the need to inform all actors and parties affected by the planned change. Being the project of governmental agencies, such as HRSA and ACA, the planned discount, however, failed to consider the interests and demands of all stakeholders as the Medicaid purchases and planned discount on drugs failed to meet all policy regulations and the practice of self-reporting for low-income populations. In such a way, there was a need for some improvement to avoid conflict of interests and undesired outcomes.
The resources phase presupposes consideration of all required aspects such as personnel, equipment, and support systems. The critical importance of the issue means that the congress and other responsible agencies counted on resources available for care providers within the healthcare sector and Medicaid program. For this reason, the scope of the program and the resources devoted to it could be considered sufficient to achieve the desired goal and ensure that all population groups covered by the discount will be able to acquire the need costs and benefit from the improved quality of care.
Finally, any policy proposal or implementation strategy presupposes the quality assurance phase meaning that the change will contribute to the improved outcomes and, at the same time, needed establish an effective monitoring scheme that might help to trace any alterations caused by the change and ensure that no gaps in knowledge will emerge. As for the case, during the quality assurance phase, the policymakers lacked effective monitoring tools needed to avoid deterioration of outcomes because of the impact of some external factors that were not considered previously.
In such a way, analyzing the case, it is possible to state that some phases of the implementation strategy were not considered. Thus, risk management, breakdown, or quality assurance could have been improved by implementing methods that are viewed as comprehensive ones by existing managerial literature. For instance, the analysis of risks can be performed by using a toolkit that is recommended to policymakers to avoid problematic outcomes (Dunn, 2015). At the same time, there is also a place for some improvements that can be achieved by altering the rest of the phases.
Conclusion
Altogether, the case evidences the critical importance of the implementation strategy and the high price of drawbacks in planning or ineffective management during the integration of a certain solution into the practice. In such a way, the observation of the given paradigm is critical for healthcare projects as it ensures that there will be no failures that will deteriorate outcomes or affect clients negatively. It is also fundamental to accept the idea that the continuous improvement in terms of different projects is vital for the given field and serves as the basis for future achievements.
References
Dunn, R. (2015). Dunn & Haimann’s healthcare management (10th ed.). Health Administration Press.
Ginter, P., Duncan, J., & Swayne, L. (2018). The strategic management of health care organizations (8th ed.). Wiley.
McLaughlin, C., & McLaughlin, C. (2014). Health policy analysis: An interdisciplinary approach (2nd ed.). Jones and Bartlett Learning.
McIsaac, J., Warner, G., Lawrence, L., Urguhart, R., Price, S., Gahagan, J., McNally, M., & Jacson, L. (2018). The application of implementation science theories for population health: A critical interpretive synthesis. AIMS Public Health, 5(1), 13-30.
Smith, M. C. (2018). Revisiting implementation theory: An interdisciplinary comparison between urban planning and healthcare implementation research. Environment and Planning C: Politics and Space, 36(5), 877–896.