The Seductive Allure of ‘Best Practices’: Improved Outcome is a Delicate Dance between Structure and Process

Abstract

In the drive to improve quality of care, a great deal of attention has been directed towards process improvement and identification and diffusion of best practices. An understanding of the history of best practice adoption in the manufacturing industry reveals its dependence upon the transfer of primarily explicit knowledge. When the task is highly context-dependent and involves tacit knowledge, the success drops. In healthcare, especially when dealing with complex problems and chronic disease, the intertwining of structure and process is necessary to produce positive outcomes. In such situations, best practices should serve as the starting point, not an end.