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Purpose

– The purpose of this paper is to define best practice, while identifying the impediments to its implementation.

Design/methodology/approach

– The paper takes the form of a commentary.

Findings

– There is as of yet no accepted definition of best practice that has both face and construct validity.

Practical implications

– Defining what best practice means for health systems around the world will require a collaborative approach, adapting recommendations to local culture and resources. Avoiding a silo approach that could result in unintended consequences and conflicting recommendations can only be achieved with a patient-centric approach. Holistic patient care with consideration of varying societies' needs as a whole is the only way to truly offer best practice recommendations. Emergency medicine needs to be a leader in stepping away from the silo approach and establishing what truly is best in patient care.

Originality/value

– Practical application of concepts of best practice will be difficult. Of necessity they will vary from country to country and from one level of care to another.

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