Differences at the State Level
At the state level, a protocol refers to a detailed, step-by-step plan used by healthcare providers to manage specific clinical situations, often aligned with licensure boards or health departments. A standard of care delivery represents the benchmark of quality based on evidence-based practices and guidelines that a prudent provider would follow under similar circumstances. A policy, in contrast, is a formal directive issued by a healthcare institution or state legislature that governs actions and decisions across settings. These elements differ in their scope and enforcement: protocols guide clinical procedures, standards set expected outcomes, and policies dictate overarching regulatory requirements (Mason et al., 2021).
Differences at the Federal Level
At the federal level, protocols are developed by agencies like the Centers for Disease Control and Prevention to standardize procedures nationwide. Standards of care are supported by federal agencies such as the Agency for Healthcare Research and Quality and set clinical expectations across all states. Policies, such as the Affordable Care Act, represent legally binding mandates enacted by Congress and affect all providers and payers. While all three ensure quality and consistency, policies have the broadest reach and legal authority, whereas protocols and standards serve more as tools for achieving compliance and optimal care (Austin & Wetle, 2017).
Perceptions of Health Care Delivery Systems
Perspectives of Providers
Healthcare providers often perceive the delivery system as fragmented and overly bureaucratic. Many report that administrative burdens and regulatory requirements, such as prior authorizations and documentation mandates, reduce the time available for direct patient care. This perception can lead to dissatisfaction and burnout among clinical staff, ultimately affecting the quality of care. Streamlining administrative tasks and enhancing interoperability across systems could address some of these provider concerns (Mason et al., 2021).
References
Austin, A. & Wetle, V. (2017). The United States healthcare system: Combining business, health, and delivery. (3rd ed.). Pearson.
Mason, D., Dickson, E.L., Perez, G.A., & McLemore, M. (Eds.). (2021). Policy & politics in nursing and healthcare. (8th ed.). Elsevier.
