A Tool for Sharing Internal Best Practices > Key Steps
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Part II. Key Steps in Identifying and Sharing Best Practices
To share internal best practices, you first need to recognize and define them and to identify the “experts” within your organization who already know how to perform them. With this information, you can develop and carry out a plan to share knowledge of a best practice and help managers, supervisors, providers, and other staff members adapt and apply the practice within their own context.
Here are five basic steps to identify and share best practices within your organization:
Step 1. Look for successes
Lack of awareness of existing best practices in an organization may be the single biggest obstacle to sharing best practices (Simard and Rice, 2001). Thus the first step is to look for people, sites, and projects within your organization that are performing well in ways that are important to the organization. Assign a best practices team or coordinator to take charge of this process (O’Dell and Grayson, 2000). (See the case study on DISH for an example of this.) Depending on the size of the organization and the resources available, the team or coordinator can try some of the following approaches:
Listen to what staff members say about their own and each other’s work. What approaches and techniques are being spoken of highly, featured in newsletters, earning awards, or attracting outside attention (Singleton, 2005)? Look for patterns suggesting that some particular practice is associated with good results (Skyrme, 2001).
Establish routine procedures to look for successes inside the organization. One common approach is to schedule after-action reviews at the end of every event and project to discuss what went well and what did not. (See box on after-action reviews.)
Compare the performance of different people, units, or sites that carry out similar tasks based on routine indicators. Which ones are performing the best? (See box on internal benchmarking.)
If the process seems overwhelming, focus your efforts by thinking about where in your organization improvements in practice could add the most value. One approach is to determine which processes are currently most critical to achieving the organization’s objectives and concentrate on them (Vitasek and Manrodt, 2005). Another approach is to focus on performance problems, since best practices might offer a solution (Advance Africa, 2001).
| After-Action Reviews |
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During after-action reviews, participants in an activity, event, or project conduct a structured discussion of what happened and why in order to learn from the experience (NHS, 2001). They ask four key questions:
The reviews are a good way to document what people have learned before they forget what happened. After-action reviews can range from a few minutes of conversation at the end of a meeting to a formal, all-day event capping a large project. Because after-action reviews ask what went well and try to get to the root of the reason, they are a useful way to identify successes and begin defining best practices. After-action reviews also seek to learn from obstacles, mistakes, and other problems. All lessons learned, both positive and negative, are documented and shared with others. |
The second step is to identify which practices account for the success of top performing people, sites, and projects. Here are some possible approaches:
Observe people, sites, and projects that are producing excellent results. What do they do differently from average performers? What do they know that others do not? Consider which part of their approach or methodology makes the difference and thus constitutes a best practice. Internal benchmarking is one way to accomplish this (see box).
Conduct focus group discussions and interviews with top performers to explore why and how they excel. Collect stories and detailed examples illustrating their practices (Gallup Organization, 2005).
Determine whether environmental or personal factors, rather than internal practices, account for a unit's success. For example, a warehouse’s outstanding track record might be due to its proximity to roads and rail rather than any special approaches to the storage and distribution of contraceptive commodities. Other successes may depend on the enthusiasm and commitment of the people carrying them out—characteristics that cannot be readily transferred but nonetheless can be inspired.
Use quantitative measures to test whether a practice is truly linked to the desired end result (Singleton, 2005). Staff members sometimes propose best practices based purely on anecdotal evidence. You should probe further. For example, check whether family planning clinics that engage in a proposed best practice offer better quality services, attract more clients, or have higher contraceptive continuation rates than other clinics. When rigorous cause-and-effect analysis is not practical, as is often the case, try to make a considered judgment about what is an effective practice in your organization based on thorough discussion with practitioners and managers (NHS, 2001; Skyrme, 2002).
Avoid outdated and unproven clinical practices. Make sure that any clinical practices under consideration are based on sound research evidence (NHS, 2001).
| Internal Benchmarking |
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Benchmarking is a common business tool that usually compares an organization’s performance with that of successful competitors. The goal is to identify, understand, and adopt superior practices and processes from outside the organization (US DOD, 2002). Benchmarking can be done internally, too, by comparing the performance of different units within an organization (PSBS, 2005). It is especially useful when many units perform similar activities—as is the case, for example, in reproductive health programs that operate multiple clinics.
Managers use quantitative measures to determine which units are performing the best and how far their performance exceeds others (Vitasek and Manrodt, 2005). In the case of reproductive health programs, managers could analyze service statistics on key indicators such as contraceptive stock-outs, the quality of HIV/STI counseling, or contraceptive continuation rates. Different facilities could excel on different indicators. Managers choose one indicator to focus on (preferably one that shows wide variation in performance levels) and then compare the methods used by top performers and others in order to identify best practices. This kind of assessment requires good information about the organization’s internal processes and practices or a careful examination once the top performers are identified.
CARE turned to internal benchmarking in the early 1990s to improve the impact of its projects, which are scattered around the world and for the most part managed by country offices (Letts et al., 1999). Headquarters staff worked with project managers to identify CARE’s most effective and efficient projects in each sector, from agriculture to reproductive health. Then they determined what practices distinguished the best projects from the rest. For example, they concluded that the 15 best water projects shared several key traits: they involved both sanitation and water supply, offered health education as well as infrastructure, and sought community contributions to construction and maintenance. These kinds of benchmarking exercises enabled CARE’s project managers to evaluate their own projects and develop self-improvement plans to apply best practices. Internal benchmarking also helped CARE develop criteria to assure greater effectiveness in future projects.
For guidance on how to conduct internal benchmarking, see the Public Sector Benchmarking Service. |
Step 3. Document best practices
The third step is to document internal best practices so that information about the practice can be disseminated.
Identify people in your organization who have hands-on experience with the practice. Recruit them to help document the practice and, even more importantly, to share lessons learned, tips, and other practical knowledge with potential users.
Write a description of the best practice. (See box on tips for communicating best practices.) Keep it brief: give potential users enough information to decide whether a practice is worth investigating further, and then direct them to experienced practitioners for more information (O’Dell and Grayson, 2000). Try to answer the following questions (NHS, 2001; Skryme, 2002):
- Title and description: What is the practice, and who developed it?
- Context: Where is the practice applicable, and what problems does it address?
- Tools and techniques used?
- Resources: What skills or other resources are needed to implement the practice?
- Lessons learned: What has proved to be difficult? What suggestions do experienced practitioners have about applying the practice?
- Links to resources: What people or documents can a potential user consult for more information about the practice? How can they be accessed?
Create a central repository—which can be a simple as a drawer in a file cabinet or as complex as a computerized database—to house detailed information about internal best practices, including instructions, guidelines, copies of all tools and materials, and contact information for experienced practitioners. This is especially important in decentralized organizations, where sharing ideas is more difficult (Vitasek and Manrodt, 2005). (See the case study on DISH for an example of a central repository.) Make the repository readily accessible, and encourage potential users to draw on its resources.
Step 4. Strategically plan to share best practices
The fourth step is to design and carry out a strategic plan to share knowledge about an internal best practice with the potential users who can most benefit from it.
Raise awareness, share information, and promote discussion among potential users:
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Write about internal best practices in newsletters, reports, group e-mails, and electronic discussions (see the case study on the CMS Project in Uganda for an example of this approach);
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Create and tell stories about the implementation and impact of best practices that raise interest, convey experience, and encourage learning;
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Discuss best practices during regularly scheduled staff meetings;
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Plan special events to celebrate and spread best practices, and publicly recognize and reward those who develop and share best practices;
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Organize learning events, such as workshops and knowledge fairs, that bring people from different units and sites together to share knowledge and experience.
Keep records that describe best practices, list contact information for experienced practitioners, and point to other sources of information. This may take the form of written notes or a searchable database.
Actively champion best practices. Sharing information does not change practice by itself (Buxbaum et al, 2004).
Identify and recruit the support of people who can help create demand for a best practice (Advance Africa, 2001; Buxbaum et al., 2004; Rogers, 1962; Simard and Rice, 2001). These include:
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Opinion leaders or champions: respected employees who can convince others, by word and deed, of the value of a best practice;
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Change agents: employees who, because they care deeply about changing an established practice, can effectively lead the effort to bring that change about;
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Translators: employees who, because they are knowledgeable about and trusted by multiple divisions, can explain a practice from the perspective of another division; and
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Early adopters: potential users who recognize the potential of new practices and are eager to try a practice first, before others adopt it.
Identify and focus on those people in your organization who could benefit the most from a specific practice or who are in the best position to implement it. What positions do they hold, and where are they located? What are the best ways to reach these potential users with knowledge about a practice? Reach out to them:
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Invite them to meetings and workshops advocating a certain practice.
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Use interactive technologies, such as telephones, radio, and email, to link experienced practitioners with potential users at distant locations.
Promote on-the-job learning about best practices. This is the best way to share hands-on knowledge and lessons learned, and it can also a stimulate dialogue from which both experienced practitioners and novices can benefit.
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Organize formal study tours or informal site visits for potential users so they can observe a best practice in action and ask questions of those who use it.
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Assign an experienced practitioner to mentor or coach someone interested in adopting a best practice.
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Arrange temporary job exchanges that permit potential users to spend time at another facility and learn their practices firsthand (Skryme, 2002). Alternatively, temporarily transfer experienced practitioners to other sites. Even if they cannot articulate all of their knowledge regarding a best practice, they can apply it to the task at hand and thus demonstrate what to do (O’Dell and Grayson, 2000; Simard and Rice, 2001).
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Establish an ongoing learning relationship between a unit that wants to adopt a best practice and a unit that is already using it. Twinning of this kind enables the transfer of knowledge and skills that are essential to a best practice.
| Communities of Practice |
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A community of practice (CoP) brings people with a shared professional interest together to exchange insights and experiences. Most CoPs are grassroots networks that develop informally, but sometimes managers establish or encourage them. A CoP can and often does support the replication and adaptation of internal best practices. It gives people from different units and facilities a forum where they can share written information and practical experience regarding a practice and where they can find help with problems. Over time, their interaction can build a knowledge base of lessons learned, experiences, stories, tools, and guidelines. It can also produce new insights regarding the practice.
The World Bank has nurtured dozens of internal communities of practice, called thematic groups, to link its employees around the world. People with similar skills and responsibilities (for example, in reproductive health or rural development) join together to help one another adapt practices to local circumstances, solve problems, generate knowledge on good practices, and disseminate knowledge to other Bank staff (APQC, 2003). Members meet both virtually and in person.
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Step 5. Adapt and apply the practice
The last step is to help people apply best practices in their own settings—which may be different than in the place where the practice was first developed. Consult the box on lessons learned on sharing internal best practices (p.x). Use the following guidelines.
Bring people together in networks to adapt, apply, and improve best practices. Working together and sharing knowledge can help people meet the challenges of adapting and applying best practices. Networking avoids duplication of effort, harmonizes approaches, makes better use of limited resources—and can help create new knowledge about how to implement an internal best practice. One common approach is to nurture communities of practice (see box, p. x).
Compare the setting where the practice was first developed with the setting where the practice will be applied (CFAR, 1999; Simard and Rice, 2001).
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Consider the work setting. Can the new practice be easily integrated into existing systems and activities? Does the new practice demand any special technology or workers with particular talents or qualifications? If so, are they available, or can staff be trained?
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Consider the broader environment, including language, geography (such as urban versus rural settings), health indicators (such as the incidence of HIV infection), and cultural norms (such as attitudes toward reproductive health services for adolescents). How will any differences affect the application of the best practice?
If the setting is similar in all respects, you may be able to copy a best practice unchanged. For example, a practice developed at one rural clinic can probably be applied as is at other rural clinics that have similar staffing and resources and serve similar communities.
If the setting is different in some way, adapt the practice to suit local conditions before applying it (Vitasek and Manrodt, 2005). Adaptation can range from the simple (for example, translating counseling materials into a different language) to the complex (for example, reconfiguring a service and the associated training so that it can be delivered by rural midwives instead of urban doctors).
Focus on transferring the idea behind a best practice, rather than some specific technique (Gallup Organization, 2005), and engage the local knowledge of the staff to ensure the adaptation will work. For example, it is essential to transfer the idea of letting clients schedule visits with providers when adopting an appointment system to reduce client waiting times. However, local staff members should be responsible for working out the details of how and when clients actually make appointments; this will ensure that the system is feasible for and appropriate to the setting.
Instead of—or in addition to—adapting a practice to fit the local situation, consider changing the situation to be more hospitable to the practice. For example, community attitudes towards adolescent sex and marriage might make it difficult to implement a new package of adolescent-friendly reproductive health services. Instead of changing the service package, managers, with the help of opinion leaders, could mount a communication campaign to influence prevailing attitudes.
Think long and hard before implementing a best practice in a setting that is unreceptive to new practices or extremely different from where a practice was first developed. It is not worth investing in adapting and applying a best practice if it is likely to be soon abandoned (Advance Africa, 2001).
Develop guidelines and pointers on how to adapt a best practice to different settings, based on your organization’s experiences in transferring the practice. Seek input from people who have been on the sending and on the receiving ends of a transfer. Try to anticipate the challenges presented by a wide variety of settings.
Monitor the application of a best practice, and assess the results to make sure that users stay on course toward their desired goals. Analyze opportunities for improvements.
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What problems, if any, arose during the implementation process? Are the results as good as expected? If not, why not?
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Be adaptable and make adjustments as needed (Setty, 2004). Get feedback from clients and other stakeholders when making decisions about changes.
