‘Best practice’ references abound in contemporary human resource literature and are seen in most human resource websites. These practices are often discussed as discrete measures, giving rise to a temptation to cherry pick 'best practices'.  However, we are then left wondering why we do not experience the same stellar results.

Taking lessons from case studies of successes in other organizations can be helpful, however transplanting single discrete ‘best practices’ from one organization into another rarely produces the same effects. Indeed, recent studies suggest that to maximize the impact of adopting a change in human resource management, be it in process, organization or culture, whole bundles of mutually supportive practices need to be implemented.

Researchers in the United Kingdom studied the impact of various human resource management practices on patient mortality.  While many human resource practices were considered, their analysis suggested an important role for three human resource systems:

• a sophisticated performance management/appraisal system;

• employment security; and

• IiP (Investor in People) status (an indicator of the emphasis on effective people management in general and learning and development in particular).

The strong relationship between the use of various  high performance human resource management systems and patient mortality indicated that it is the combination of a ‘bundle’ of these three particular practices that is necessary to achieve significant improvement in patient mortality.  The researchers suggested that such practices are likely to be mutually reinforcing and coherent as an interconnected system,  and therefore produce behaviors that lead to the provision of high quality health care and, as a consequence, lower patient mortality.  These practices resulted in employees who  

1. were clear about their roles and goals in their organizations (a result of appraisal and team working);
   
2. have relatively higher levels of knowledge and skill (e.g., through an emphasis on training and performance management);
   
3. are both able and willing to share and utilize their tacit knowledge as a result of decentralization of decision-making and higher levels of involvement;
   
4. are better able to act upon the ambiguous information often found in health care settings because of their training, involvement in decision making and the shared learning associated with team working;
   
5. are empowered to bring their higher skills, tacit knowledge and higher-quality information to bear upon complex healthcare problems because of decentralization of decision making and employee involvement practices enabling them to influence their work and working conditions;
   
6. are likely to coordinate more effectively as a result of team working;
   
7. have higher satisfaction levels because of these high performance HR systems and high employment security (which spill over into better patient satisfaction); and
   
8. are therefore less likely to leave, leading to a retention of both human and social capital – vital in a context in which staff shortages are an international problem.

These are highly desirable outcomes and organizations may wish to learn from the examples set by the high performing organizations.  However, when we as human resource professionals recommend that our organizations embark on improved human resource management practices, we must acknowledge that an isolated 'best practice' is unlikely to transform a struggling organization into a high performing paragon; it is only as we build an integrated bundle of mutually supportive best practices that we should expect significant improvement in organizational performance.

West, Michael. A, Guthrie, James P., Dawson, Jeremy F., Borril, Carol S., Carter, Matthew, Reducing Patient Mortality in Hospitals: The Role of Human Resource Management, Journal of Organizational Behaviour, Volume 27, Issue 7