Policy-writing is not a fun task, and the outcome is generally not a purpose-driven policy. Most people write a policy because it is a requirement of the Baby-Friendly Hospital Initiative. Hospitals each tend to have a “house” format for their policies. This often includes a spot for the purpose of the policy. (If it doesn’t include this section, it should!) Policy-writers take on the “what-to” aspect of the policy. Few give any thought to the “why-to” aspect. Yet, unless everyone is persuaded of the policy’s importance, it’s unlikely to be implemented.
The few “purpose” statements I’ve seen aren’t convincing. They consist of some long, flowery language about wanting to do the best thing for breastfeeding mothers and babies. But, that doesn’t cut it.
In order to create an effective policy that drives clinical outcomes, ask yourself, “What is the purpose of this? What should the policy do?” Your purpose statement should be brief, meaningful, measurable, and achievable.
Make it brief
First, before you even begin writing, aim to keep the purpose statement short. Since Baby-Friendly criteria doesn’t require it, I doubt assessors will even look at your policy’s “purpose” statement. But I’m urging you to see beyond meeting requirements.
Stating a short, clear, clinically-focused outcome helps staff members to tie their actions to clinical outcomes. That’s true whether they are staff nurse, a top-level nurse administrator, or anyone else. But you need not — and should not — include “everything” including the kitchen sink!
Make it meaningful
Take a step back for a moment. Many people are prompted to write a breastfeeding policy in order to comply with Step 1 of the Baby-Friendly Hospital Initiative. However, it’s better to think of your document’s higher goal.
From a clinical standpoint, the primary purpose of a hospital policy is to establish structure for implementing care that achieves optimal clinical outcomes as evidenced by quality indicators.
It helps to orient all staff to the “why” of what they’re doing. Staff nurses can be notorious for not complying with breastfeeding policies. However, they’re more likely to comply with the policy’s directives if they understand that those directives are intended to accomplish a bigger goal. The “purpose” section is the perfect place to emphasize that message.
A purpose statement should be inextricably linked to the intended clinical outcomes. That’s your basis for quality improvement studies.
Make it measurable
Ideally, your purpose-driven policy outcome should be measurable. The “number” you choose is up to you; it’s your hospital. But it’s a good idea to write the purpose of the breastfeeding policy so that it aligns with the outcome that you are looking for. I would write a one-sentence goal statement like this: “To achieve an 80% exclusive breastfeeding rate for healthy term newborns at discharge.” That’s all! (Other than improving exclusive breastfeeding rates, is there any other reason why you’re doing the Ten Steps?) Sometimes, one sentence is all you need!
Make it achievable
I’ll repeat: The primary purpose of a hospital policy is to establish structure for implementing care that achieves optimal clinical outcomes as evidenced by quality indicators. But while the hospital is in the business of providing optimal clinical outcomes, it is also in business! All businesses have policies. While facilitating better clinical outcomes is a key reason for clinical policies, a well-written, purpose-driven policy should also:
- communicate to internal and external stakeholders and staff the expectations and clinical ideals the hospital embraces (congruent with the hospital’s mission and vision).
- influence staff behavior and support compliant and ethical decision-making.
- create an organizational culture that is focused on best practices and quality improvement.
- foster credibility and trust with clients and staff, and hence overall market share.
- improve compliance and performance.
- meet mandates to operate (from the state Department of Health, The Joint Commission, and others) avoid litigation for practice errors and omissions.
- protect the hospital’s employees, reputation, and financial bottom line.
- prevent, detect and respond to misconduct.
The purpose of your policy
Also think about what you want to accomplish in writing your policy. The statement of purpose just may be the most important part. Without a strong purpose, the policy is just a check-off from your to-do list, not the valuable asset in guiding clinical practice it can be.
Without looking at it, would you be able to tell me the purpose of your hospital policy? (If you can’t, it’s probably that flowery language I advised against.) Do you see a need for revising your policy’s purpose into a purpose-driven policy? Let me hear from you in the comments below!
Marie, this is just the greatest information and will assist me as I hope our department revise our current breastfeeding policy.
I do need to extend an apology to you. I said our small hospital was a baby friendly hospital, it is not. Not yet anyway. This is a “term” that has been thrown around d in meetings and at closer investigation they have implemented much of the 10 steps but have not officially been accepted or certified as baby friendly.
Much love and respect, Cindy
Cindy, I’m so glad this could give you some practical help for actually writing your policy. (I was the policy queen when I worked at the hospital!) If you do a search for “policy” in my blog, you’ll find at least one more, maybe more. On the “name”, yeah, that’s a real sticking point. During my 10-year stint as President of Baby-Friendly USA, I worked hard to make sure that the term “Baby-Friendly” be used in the most authentic way, and we were finally successful in getting it trademarked. So, just like other trademarked terms, it should not be used to describe the hospital unless the hospital has officially earned the designation. Always great hearing from you, Cindy.