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12 March 2009 Quick links: News Register of Networks Discussion Resources

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Best practice: we all need it but what is it, again?

Best practice is a tricky commodity. A bit like the great bottle of local wine that tastes like nectar on holiday but mysteriously turns into brake fluid by the time you get it home, best practice doesn’t travel well.

What works for one group or provides a stunning success in one area can fail to deliver spectacularly when tried elsewhere. We all spend a lot of time looking for best practice, either by developing it ourselves or by persuading others to share it, but the reason the quest is so often fruitless is that we don’t actually know what it is.

Wikipedia defines best practice as a way of doing things that is more effective at delivering a particular outcome than other ways of doing them, which sound about right but tells us only what to aim for in the most general terms. Consult other sources and you will find a wealth of academic discussion and theory, most of it perfectly admirable in the abstract but fairly useless when applied to anything concrete.

Then there is the problem of the linguistic drift that occurs when what was considered best practice goes out of fashion and new terminology has to be invented to fill the void. So best practice becomes excellence or TQM or continuous improvement. As the excellent MBA Jargon Buster website puts it, “companies often confuse latest or trendiest with best, and the best practices of one era are soon superseded by the ever-more-ludicrous fads of the next”.

Perhaps because we recognise the truth of this, we have quietly switched “best” for “good”. It may also be that the change reflects our distaste for value judgements or it may simply be that we agree that it's too simplistic to assume that there is only one way to do things well.

More likely, though, is that “good practice” gets us off the hook. Explaining why something is merely good is a lot easier than justifying its claim to be best. Next in line is quite good practice, followed by really not bad practice with frankly mediocre practice waiting to take its place.

So let's agree that best practice is not a scientific term, nor something that can be measured or delivered like a sack of coal. It is an aspiration: a common quest for what we believe to be important even though it may not be perfect.

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News items
Conference: Clinicians, quality and data: analysing and sharing information to drive health care improvement
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Launch of 2009 Social Science Workplace Experience Programme
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Young people in Hounslow get Chlamydia screening testing kits online and results by text
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New reports focus on out of hours and urgent care by GPs
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Celebrating Sex and Relationships Education: Past, present and future
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PCTs go on the road for 'No Smoking Day'
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HSJ conferences in June & July 2009
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HSJ conferences in May 2009
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HSJ conferences in April 2009
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Advance care planning guideline
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Register of Networks
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Updated: Network of Doctors who write Medico-Legal Reports on Asylum Seekers
Suggested Reading List for Those Preparing Medico-Legal Reports on the Survivors of Torture document added
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Discussion
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