The Distinction Between Protocols, Standards of Care, and Policies in Healthcare
Protocols
These refer to well-elaborated clinical processes that outline the steps a health care professional should follow in specific clinical situations. At the practice level, protocols are more specific guidelines on how the evidence-based interventions will be put into practice to minimize variation and improve the safety of the patients (Militello et al., 2023). For example, a sepsis management plan in a hospital may call for a fluid bolus, blood culture, and empirical antibiotics within a given time. The regulating boards or the state’s health department may develop protocols at the state level. For instance, the department of health of a certain state may develop the reporting procedures of infectious diseases (Ifrim et al., 2022). At the federal level, organizations like the CDC or CMS may develop national clinical guidelines for implementing practices in an epidemic, pandemic, or some high-risk conditions. Basically, protocols are the practical implementation of the standard and policies followed in the health care setting from one phase to another.

Standards of Care
These refer to formal requirements to measure the acceptable level of care in the clinical practice. At the practice level, these standards represent the norms expected in the organization for providing adequate, standard care, like the policy on the time taken to administer medication or the number of patients that can be assigned to a nurse (Coleman et al., 2022). At the state level, standards are incorporated into state nurse practice acts or licensure standards to guarantee that all the licensed practitioners possess the minimum level of competence to safeguard the public. At the federal level, various institutions like the Agency for Healthcare Research and Quality (AHRQ) and the Joint Commission provide overarching guidelines that guide the nation’s quality improvement strategies (American Diabetes Association, 2022). For instance, CMS requires compliance with the value-based care models that encourage healthcare organizations to achieve specified performance standards (Downs et al., 2021). Legal and ethical norms that outline the practice of care and provide a reference point for measuring the negligence or malpractice claims are known as the standard of care.

Policies
Policies are documented guidelines used in decision-making and in regulating activities within organizations or in certain geographical areas. Some practice-level policies are the rules that guide the institution’s functioning and may include infection control measures or documentation practices (Schnelli et al., 2024). Interdisciplinary committees normally formulate these and comply with the best practices and the law. At the state level, health policies include state laws, rules, and regulations, such as the criteria for Medicaid expansion or telehealth reimbursement passed by the state legislatures (Novilla et al., 2023). While state policies are made at the state level and are broader in focus than hospital or system-level policies, they may involve agencies such as the Department of Health and Human Services and the Affordable Care Act that shifted the insurance and care delivery models (Mac-Seing et al., 2023). In a nutshell, protocols are considered the set of procedures, standards are defined as the set of performances, and policies are strategic tools that define the structural, financial, and legal conditions of care provision.

Perceptions of the Healthcare Delivery System
Patients often perceive the healthcare delivery system as fragmented, impersonal, and difficult to navigate. Several challenges, especially the lack of convenient access to quality care, long waiting times, expensive health care, ineffective communication, and lack of coordination, contribute to patient dissatisfaction and overall mistrust in healthcare practice (Tarafder, 2024). Most patients state that the opacity of billing and treatment contributes to their decision-making process, increasing health-related stress and financial burden. On the other hand, the providers might find the system a burden because of the administrative work involved, rules and regulations governing the system, and lack of adequate time to spend with patients (Shunmuga Sundaram et al., 2022). On the other hand, payers tend to focus on cost; therefore, they view overuse and lack of value for the costs as a significant issue (Carroll et al., 2022). Finally, issues like health disparities, access to health facilities, and the health system’s sustainability attract policymakers’ concerns and perceptions. These different views therefore call for person-centered and integrated approaches to care that enhance accessibility and affordability.
 
References
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Carroll, C., Sworn, K., Booth, A., Tsuchiya, A., Maden, M., & Rosenberg, M. (2022). Equity in healthcare access and service coverage for older people: a scoping review of the conceptual literature. Integrated healthcare journal, 4(1), e000092. https://pmc.ncbi.nlm.nih.gov/articles/PMC10327458/Links to an external site.

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