A Real-World Best Practice

Added on Feb 24, 2014

The expression “best practice” has lost its meaning, according to journalist Timothy Egan. In fact, the New York Times contributing Op-Ed writer included it in his list of“the most annoying, overused and abused words” of 2013 and called for its relegation to the word dumpster. 

The argument that Egan and others have made is that, whether in business or in health care, there is no such thing as a single “best practice.” Rather, a practice can only be “best” in the precise, specific context in which it exists. In other words, what works in one unit or hospital or region of the country will be subject to unique variables and circumstances that preclude easy generalization. 

Lestevia Moore, RN, a charge nurse at Grady Memorial Hospital in Atlanta might disagree. As per a system-wide best-practice implementation, the staff nurses at Grady call all patients 24-48 hours post-discharge in an effort to improve quality and service and promote a sense of continuity through the continuum of care. 

During one such call, Ms. Moore realized that her patient was experiencing signs and symptoms of a stroke. She instructed the family to call 911 to have the patient brought to the emergency department for an evaluation, and she notified the neurology nurse practitioner on duty. The patient arrived at the ED with a new active stroke in progress, but because treatment was initiated in the optimal window, all of the patient’s neurologic deficits were resolved and he was discharged soon after. 

Clearly, not every post-discharge phone call will save a life, but the fact that every call has the potential to do so means calling the exercise anything less than a best practice would seem like an understatement. Hats off to Ms. Moore and the entire Grady care team who work every day to make sure best practices live up to their label.