High-performing organisations - inside and outside the NHS - have a number of management techniques in common, explains Paul Allen

I cannot claim to be an even half decent cook, but I can remember from my school days some of the basic ground rules for creating something vaguely edible. The first of these is that having decided what it is you want to make, you need to have a recipe and the right ingredients to hand. Second, the ingredients have to be in the right quantity and the right mix.

This formulaic approach will not guarantee a prize-winning product, but it is likely to be better than ignoring the recipe completely.

A recipe for leadership and management practices that produce superior results sounds like a wish list, but there is some evidence to suggest that such recipes do exist and can be applied.

Good practice

There have been more than 30 public inquiries over the past 30 years to address failures in the quality of healthcare. Common themes as to root causes include inadequate clinical engagement in leadership, poor communication and disempowerment of staff and service users.

However, trusts with an effective safety culture demonstrate, among other things, the following features: effective leadership, commitment to continuous learning, good use of data, effective teamwork, openness and honesty and a willingness to commit resources.

Studies in the private sector have also produced some interesting insights. Research into more than 200 management practices in business, written up by Harvard Business School in 2003, has concluded that there are four primary practices that all organisations must excel at if they are to perform well.

The first requirement is to have a strategy built on deep knowledge of the customer base and the organisation's core capabilities. Second, there must be flawless operational delivery of the strategy which achieves the desired results at ground level. A third requirement is to build the right culture that supports the way you want to run the business. Last but not least, leaders must do away with unnecessary bureaucracy and maintain a relatively flat management structure.

In addition to these four primary practices, there are four secondary practices that have an impact on performance. These are innovative products and services, growth through partnerships and mergers, workforce development, and leaders who are fundamentally committed to the organisation and its success.

Top brass

The study also concluded that choosing the right chief executive had a material impact on the performance of the business. It was shown that chief executives can personally influence 15 per cent of the variance in a company's profitability.

Interestingly, it did not matter whether the chief executive was charismatic or not, big picture or detail conscious . What matters is his or her ability to build relationships with people at all levels in the organisation and to reach out and connect with people on the front line, together with the ability to spot opportunities and problems early.

So, while it would be too simplistic to suggest that there is a magic recipe which, if applied, will yield instant results, there is sufficient evidence to take a look at your existing recipe book and see if there are any ingredients worth adding or changing. And remember, even with the right recipe, it is still possible to burn the cake if you take your eye off the ball.

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