In the beginning, the notion of using  best practice guidelines (BPG) to bring evidence-based nursing to health-care settings across Ontario was nothing more than an idea (or seed) in the minds of RNAO CEO Doris Grinspun and former Best Practice Guideline (BPG) Program director Tazim Virani.

 As the association’s BPG program got off the ground in the late 1990s, and the first four guidelines were published and spread by champions, that seed began to sprout roots. As more BPGs were created and shared over the next four years, those roots became more expansive and, before long, a tree started to take shape as BPG implementation in organizations across the province nourished the roots and helped the tree to grow. 

Imagine this growing tree is RNAO’s Best Practice Spotlight Organization (BPSO) program (officially launched in 2003), and visualize its evolution as a metaphor for a program that, like a tree, continues to grow deeper roots while also sprouting new branches that stretch higher and wider. 

Seven years after it was launched, the BPSO program extended beyond provincial borders with the creation of the host model, first in Spain, to allow the program to grow internationally. Now, with even more branches and leaves to represent BPSO hosts around the world and their BPSO directs, RNAO’s symbolic tree has changed the way people view the culture of nursing to one that is evidence-based. 

“The program has seen tremendous growth over the years, and much of that has been through conscious and intentional decision-making about when to slow down and when to accelerate growth and expansion,” Grinspun says, explaining this concept is one she refers to as ‘purposeful evolution.

“I think the program has grown at the exact speed it needs to grow,” she adds. “If we had let it grow faster, it probably would not have the depth of quality and breadth of resources that it has. If we had let it grow slower, likely the program would have stagnated.”

The BPSO program is now 15 years old, and has added  a new component: the BPSO regional host initiative, whereby communities at home and abroad have the opportunity to co-ordinate and oversee the program and support organizations in their own respective regions (i.e. provinces, states, local health authorities or health integration networks).  

Here we take a look at two of the first examples of this new initiative…