Differentiating the types of good practice matters

In my theoretical and practical travels I find that all good practice (however you'd like to define it) tends to be regarded as similar. What I mean by this, is there is little distinction as to whether the practice is designed to
a) make something happen
b) avoid something happening
This "commission" or "ommision" differentiation may be important. I'm working on it and if you have any ideas please then do put a comment in this post so we can add to the body of knowledge and share it openly. Or email me if you prefer.

Let's look at a couple of healthcare examples. In (a) we might be creating a new healthcare service for patients who have developed diabetes. Part of this might be to design and implement a new form of consultation called a group visit where a number of patients are seen together by a variety of different professionals. This has been successful in a number of places and we may like to copy what they have done. Yes, this may be to avoid something happening, but mostly, it is about adding something new into the system.

In contrast, we may be concerned at our hospital about the high level of MRSA infections. We want to avoid something happening. Yes, this may include something new being created, though the emphasis is on avoiding a situation.

The reason I feel this differentiation may be important is that the change process for the individuals and teams may be quite different. Understanding that they may be going through a different learning process whether they are taking on something more creative and new, or whether they are designing to avoid, may streamline and accelerate the adoption process.

For example, in the (b) avoidance example, the learning process is likely to be enhanced if the emphasis is on understanding the "near misses" so the individual / teams can discover how best to take action before the situation arises. Raising awareness and linking a "near miss" awareness to the ability to make a decision to fix it, may enable the individual to learn and sustain a new behaviour more rapidly. "Near misses" will also allow for the customisation nearly always required for the local context.

In contrast, in the (a) commission example, the learning process may be less organic and it may be possible to apply and use more straight forward project implementation techniques. These are unlikely to reduce the need to pay attention to the people issues, however, there may be as much success in using well known management tools as in using the more esoteric "spread" techniques.

"Making something happen" or "avoiding something happen" - do you think it makes a difference?


(c) 2008, Sarah Fraser