A Better Practices Model: A Critical Tool

When you are required to make a judgment under uncertainty, do you rely on best practices?  Whether you believe it or not, there is a serious downside to anything...

 labeled a best practice.  Some practices that are labeled as best practices lead to errors both predictable and unpredictable. The reality is that the label of best practice is no more than disparate groups of rules, policies, procedures, and standards that have been framed by industry leaders as universal truths that should always be applied.  The reality is there is no such thing as a best practice.
The reality is two companies may adopt the same practice based on external benchmarks and face very different outcomes. The idea of best practices is currently predicated on the assumption that certain practices are grounded in fact or fundamental truth.  These practices are also predicated on the assumption that the production and management of processes are uniform enough so that “best practices” can be identified and then adopted without the need for variation by a company.
So how can we do better?
Best practices should be treated as theories. In the best-case scenario, a proffered practice is backed by empirical evidence and professional experience rather than blind appeals to authority.  For example, instead of stating to a packed convention hall that the best practice is that “a nurse should be make a call to a patient within 48-72 hours after a patient is discharged...”, the better approach would be to approach the best practice as a theory and then support the theory with empirical data and professionally derived knowledge. Following the method, the expert would opine,
“The best practice theory I am offering today is that a nurse should make a call to a patient within 48-72 hours after a patient is discharged. The goals of the practice are to increase clinical outcomes and reduce costly return visits. Research shows that post-discharge phone calls can reduce adverse events and decrease costly return visits to the medical facility. I have found this to be also true in my experience studying all-cause 30-day readmissions in general medicine populations.  It is important to note that, in offering this practice, the true relationship between post-discharge phone calls and readmissions in a real-world setting is uncertain. 
The above explanation of a proffered best practice theory is helpful because it includes a discussion of the theories, assumptions, and methodologies underlying the proffered practice as well as any factual basis for the practice and any intended results. In short, the goal of industry leaders should be to provide industry professionals with the critical information they need to seriously evaluate the theory as it relates to the unique culture and structure of their organizations.
Rather than pursuing best practices as a solution for real or perceived problems within an organization, a better approach is focus on the evaluation of best practices as the beginning of a critical assessment process.  Industry proffered best standards should be viewed for what they are: a generalized methodology which may or may not be appropriate for an organization.  After critically reviewing the basis for the proffered procedure, industry should ask itself whether the proffered practice is congruent with, for example, the context, circumstances, and long-term strategic plan of the organization.
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