An analysis of policy to practice initiatives in Scotland: what are the key lessons learned?

AIM: The study sought to identify and explain common issues and lessons arising from four national health policy initiatives related to nursing, midwifery and allied health professions (NMAHPs) in Scotland between 2005 and 2010.

BACKGROUND: The Scottish government has been seeking effective practice developments in NMAHPs through enacting policy initiatives to improve patient care. Despite many of these initiatives being individually evaluated, no integrative systematic study has been undertaken to synthesise better understandings.

DESIGN: Multiple case study design involving qualitative research was the main methodology.

METHODS: The study used purposive and snowball sampling and in-depth interviews to elicit the views of 24 stakeholders.

FINDINGS: This study enabled identification and explanation of key generic lessons such as internal policy alignment, good leadership and governance at all levels, effective communication, and sustainability linked to policy external alignment.

CONCLUSION AND IMPLICATIONS FOR NURSING MANAGEMENT: Findings highlight the importance of strategy for internal policy alignment involving top-down and cross-sectional cooperation and appraising external policy alignment when progressing a sustainable policy initiative. At all levels, leadership is important to provide clear guidance, manage different expectations and enable understanding of initiatives for enactment. Analysis of such initiatives would be useful in preparing nurse managers.