Best practice is a term used to describe agreed standards of professionalism and service delivery that a patient can expect to receive whilst under the care of a doctor or hospital. Best practice issues revolve around quality of care, transparency, patient safety and respect for patient’s autonomy. Professionalism may be further defined as ‘a set of values, behaviours and relationships that underpins the trust the public has in doctors. 1
Confidence or trust in the profession means that practitioners must be able to demonstrate and explain their skills and knowledge to the public. A passive, meek, accepting general public is being replaced by a more informed client base that may wish to challenge doctors opinions as the clients become better informed and more assertive. 2
Establishing what is best practice progresses from initial consultations with doctors, surgeons, patients, healthcare professionals and healthcare organisations.3 To this list may be added lawmakers, Parliament in the case of the UK, ethicists and the Judiciary. All the information that is gathered is then refined into an understandable formula. Where objective scientific evidence is lacking, lesser but valid, substitute standards are produced from panels of experts who provide their opinions.
Standards change in response to clinical developments, interpretation of the law and system reviews such as the Francis Report, prompted after catastrophic failings in healthcare provided at one UK hospital. 4 Implementing best practices is not necessarily about implementing the latest treatment or medicine and may be about how to reliably deliver existing established techniques. 5 At the heart of all attempts to establish best practice is the patient.