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Best Practices

Abstract and Keywords

This entry describes best practices as these are used in social work. The term best practices originated in the organizational management literature in the context of performance measurement and quality improvement where best practices are defined as the preferred technique or approach for achieving a valued outcome. Identification of best practices requires measurement, benchmarking, and identification of processes that result in better outcomes. The identification of best practices requires that organizations put in place quality data collection systems, quality improvement processes, and methods for analyzing and benchmarking pooled provider data. Through this process, organizational learning and organizational performance can be improved.

Keywords: best practices, practice guidelines, empirically supported practices, evidence-based practice, performance measurement, outcomes measurement, quality improvement, benchmarking

The term best practices first emerged in the business management field, specifically the area of knowledge transfer where researchers grappled with the concept of “sticky” information (Szulanski, 1996). The problem, which exists to some extent in all organizations, is that most job-related knowledge is held by individuals, and most organizations lack systems to facilitate information sharing among coworkers. In this context, best practices refer to performance measurement and quality improvement, and the term is defined as the preferred technique or approach for achieving a valued outcome (for example, Szulanski, 1996). Indeed, an organization's capacity for recognizing, disseminating, and implementing best practices frequently distinguishes industry leaders from unsuccessful companies (Kramer & Glazer, 2001) because the shared knowledge raises the overall level of effectiveness and productivity. Although the term originated in a business model, the concept of best practices has spread to every field, with each domain seeking to identify its particular set of best practices to enhance productivity or outcomes.

The term best practices originated in the organizational management literature in the context of performance measurement and quality improvement where best practices are defined as the preferred technique or approach for achieving a valued outcome (for example, Szulanski, 1996). The ability to identify and implement best practices differentiates successful organizations from unsuccessful ones by using comparative techniques in order to distinguishing best and worst performers (Kramer & Glazer, 2001).

Identification of best practices requires measurement, benchmarking (that is, identifying the standard against which the practice will be compared), and identification of processes that result in better outcomes (Watson, 1993). The steps in describing best practices include (a) identifying the practice of interest; (b) identifying potential benchmarking candidates (for example, other organizations of similar size or other units within an organization); (c) comparing data; and (d) establishing goals and activities to improve the benchmarked practice (Cortada & Woods, 1995). Determining what comprises best practices requires that organizations implement high-quality data collection systems, systematic quality improvement processes, and sound methods for analyzing and benchmarking pooled provider data (Rosenthal, 2004). Through identifying, documenting, and implementing best practices, the organizational learning (that is, knowledge transfer) and the quality of organizational performance can be improved. The best practice framework links outcomes measurement with process measurement. Identifying best practices seeks to answer the key question of what activities incorporated into routine practice will result in preferred outcomes (Mullen, 2004; Mullen & Magnabosco, 1997).

In social work, best practices most often refers to recommendations regarding the practices most appropriate for routine use in service systems with particular populations and problems (Roberts & Yeager, 2004). Best practices have been identified in a range of practice areas, including professional training (Hoge, Huey, & O'Connell, 2004) and evaluation (Patton, 2001). Best practices have been developed and applied at the individual, program (Bedell, Cohen, & Sullivan, 2000), and system levels of practice (for example, Minkoff, 2001).

The development of best practice guidelines and treatment protocols has been one approach to codifying best practices for application to social work. These guidelines have been described as emerging from empirical and evidence-based outcome studies conducted within communities, and supported as a means to allow practitioners to provide “optimal treatment or intervention to any individual, family, or group seeking assistance” (Roberts & Yeager, 2004, p. 3).

Many organizations such as federal governmental agencies, authoritative review groups (for example, committees set up by professional organizations), and nonprofit organizations have produced recommended assessment, intervention, and evaluation practices identified as best practices (Roberts & Yeager, 2004). The specific methods used by each organization to identify best practices have varied; however, review groups have often used both available scientific evidence and professional consensus, while also weighing the feasibility and cost of the recommended best practices (Roberts & Yeager). Other methods of identifying best practices have been described outside of social work, such as the use of benchmarking or performance measures in business and health care (Billings, Connors, & Skiba, 2001) and formalized consensus panel methods in medicine (Rycroft-Malone, 2001). According to Rosen and Proctor ( 2003), best practices should be developed from deliberate research and yield best practice protocols.

Although there is broad agreement that best practices should be identified through sound scientific research based on high-quality comparative data, it is generally acknowledged this has not always been the case. As noted by Mueser and Drake (2005, p. 221), best practices “can be biased by the current beliefs or theories of experts, by the prejudices of guild organizations (for example, professional groups), or by the successful marketing of industry. Best practices are often proven incorrect by scientific research.” Currently, there are no generally accepted criteria for identifying best practices, and although research evidence and expert testimonials may be considered, other factors such as lobbying and marketing may promote the adoption of interventions and assessment tools as best practices (Munson, 2004; Rosenthal, 2004). Sources of knowledge or evidence that may be used to develop best practice recommendations include empirical evidence, practice wisdom, client need, consensus between stakeholders, case studies, program evaluations, and other research efforts of varying quality, or some combination thereof. Best practices have been criticized for being overly general, failing to adequately address the specific context and individual needs of clients, and in some instances, appearing indistinguishable from other general terms such as lessons learned (Patton, 2001; Woolf, 1998). Therefore, if best practices are to be useful in social work, clarification of the criteria and procedures for determining what constitutes a best practice is needed, including specific guidelines that will ensure that practices are evidence based (Munson, 2004).

However, the concept of best practices may soon be replaced in social work by newer terms such as clinical practice guidelines, empirically supported practices, and evidence-based practices (Corcoran & Vandiver, 2004; Roberts, Yeager, & Regehr, 2006). Clinical practice guidelines in health care have been defined by the Institute of Medicine as “systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances” (Field & Lohr, 1990). Although consensus guidelines (that is, based on expert practitioner judgment) have been predominant, there is a rapid movement toward evidence-based guidelines, which are systematically developed through critical appraisal of the empirical evidence (Rosen & Proctor, 2003). Similarly, empirically supported practices are based on evidence from systematic scientific research. Nevertheless, it is important to recognize that best practices in current use, unlike empirically supported practices or evidence-based practice guidelines, may or may not be based on systematic research evidence.

However, as defined in the organizational literature, best practices differ from these newer terms in important ways. Guidelines, empirically supported practices, and evidence-based practices focus on specific practice questions and specific client situations, whereas identification of best practices requires an organizational approach for assessing variations in practice (measurement, benchmarking, and identification of practices that enhance outcomes; Rosenthal, 2004). It is likely that guidelines, empirically supported practices, evidence-based practices, and best practices will complement one another to the extent that all come to be based, to a greater degree, on high-quality empirical evidence. Current trends suggesting a continued emphasis on improving the quality and accountability of social work practice in the future should influence the development and application of best practices to social work.

References

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                              Roberts, A. R., Yeager, K. R., & Regehr, C. (2006). Bridging evidence-based health care and social work. In A. R. Roberts & K. R. Yeager (Eds.), Foundations of evidence-based social work (pp. 3–20). New York: Oxford University Press.Find this resource:

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