THE IMPLEMENTATION OF A COST-EFFECTIVE POLICY FOR NURSING PROGRAMS IN CITY UNIVERSITY OF NEW YORK
Introduction. This case study describes and analyzes the efforts of the City University of New York to formulate, implement and evaluate a cost-effective policy for its nursing programs. These initiatives were triggered by the financial crisis of New York City in 1976 and the high costs and poor productivity of the nursing programs.^ The study uses Nakamura and Smallwood's concept of the politics of policymaking, in particular, the notion that policies go through three separate environments: formulation, implementation and evaluation. These environments, with their varying arenas and actors are linked together by diverse communication and compliance mechanisms. Data were gathered by intensive interview with key political actors and by examination of important minutes, documents and records.^ Findings. Based on a major report of a blue-ribbon Task Force, City University formulated a policy to reduce radically, the number and size of its nursing programs--an event which set the stage for the study. At the implementation stage, college officials engaged in all kinds of adaptive, coalition-building behavior in their attempts to save enrollments and faculty. First, college deans and presidents delayed as long as possible, the implementation of the directive. Second, rather than firing staff, they shifted enrollments to "pre-nursing." And finally, nursing programs were actually increased by 20 percent. Evaluation of the cost-effective policy might indicate that survival of staff and programs assumed a higher priority than the CUNY directive of greater efficiency and productivity.^ One can draw the following concepts about the politics of policymaking from the study: (1) Policies were changed because of external pressures. (2) Centralized policymaking did not guarantee implementation in a decentralized system. (3) Nursing programs had incentives to maintain their size, which overrode the directive from City University. (4) While quality has improved, overall expenses for pre-nursing and nursing programs has expanded. (5) Top-down change does not occur without support of the system, careful monitoring, sustained interest and goal maintenance. City University did not appear to pursue its policy of closing and contracting programs thus, allowing the individual colleges to circumvent the directive. (6) Policymaking is highly political and involves negotiation, compromise and change at all levels. ^
TRAETTA, MARIE ROSE SICILIAN, "THE IMPLEMENTATION OF A COST-EFFECTIVE POLICY FOR NURSING PROGRAMS IN CITY UNIVERSITY OF NEW YORK" (1985). ETD Collection for Fordham University. AAI8508132.