Implementing Change on the Front Lines: A Management Case Study of West Feliciana Parish Hospital

In the policy implementation field, theorists are challenged to develop stepwise frameworks that facilitate the implementation of public policy. This case studies the implementation of a Medicare charity care policy in a small rural hospital using the top-down implementation framework. It offers an overview of top-down implementation theory and a discussion of top-down research findings as they relate to the real implementation experiences of hospital administrators. The case presents six recommendations for the effective implementation of a new policy on the front lines.