

The Best Practice Spotlight Organization® (BPSO®) designation was launched as a key knowledge translation strategy in 2003. It is targeted to support the uptake and sustainability of best practice guidelines (BPG) to optimize outcomes at the individual, organizational and health system levels. BPSOs have been established across Ontario and throughout the world, in all sectors. BPSO designation is an opportunity for health service and academic organizations to formally partner with RNAO, or a Host organization over a three to four-year period (depending on the model) to achieve designation. Following this period, the partnership is renewed biennially, based on the achievement of required deliverables. The goal is to create evidence-based practice cultures through systematic implementation and evaluation of multiple RNAO clinical BPGs.
There are more than 1,500 BPSOs provincially, nationally and internationally. There are three main types of BPSOs, and several BPSO models to consider for organizations interested in applying to become a BPSO.
Models of BPSOs |
Types of BPSOs |
BPSO Direct: Organizations sign a contract directly with RNAO/BPSO host to systematically implement BPGs. |
Service BPSOs: focus on BPG implementation in their sector* to impact health outcomes. *Public health, primary care, mental health and social services, acute care, home care, long-term care and other sectors |
BPSO Host: Host organizations sign a contract with RNAO to oversee the BPSO Directs in their jurisdiction. National – e.g., government, regulatory body |
Academic BPSOs: focus on evidence based education, to impact faculty teaching, student learning, and patient/client outcomes. |
BPSO OHT: Integrated systems of care such as Ontario Health Teams (OHT) sign a contract with RNAO to work across multiple sectors to collectively implement BPGs. |
Indigenous-focused BPSOs: collaborate with RNAO to create a tailored BPSO program to honour Indigenous ways of knowing and to support holistic community wellness. |
BPSO Consortiums |
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BPSO Consortiums: provide a forum for knowledge exchange, support and collaborative activities within specific jurisdictions. Currently include Latin America and China. |
BPSO Hosts and BPSO Direct Organizations outside of Ontario, regardless of their location, are fully supported by RNAO with methodology, materials and ongoing mentorship; but do not receive any funding from RNAO.
The direct model is best suited for single organizations wishing to apply to RNAO (or a BPSO Host organization) to engage in a three-year partnership. These organizations work directly with RNAO/BPSO Host to meet the BPSO requirements of designation.
The host model is best suited for organizations that have a capacity to supervise, on behalf of RNAO, the full BPSO designation program for a group of health and/or academic settings within a country, region, community or particular specialty. In this model, the BPSO Host enters into a formal agreement with RNAO to deliver and oversee the RNAO BPSO designation in the country or region where it is located. The BPSO Host is responsible for selecting their BPSO Direct organizations; providing orientation, education and support; monitoring progress; and evaluating outcomes.
The BPSO model for Ontario Health Teams (OHTs) was established to respond to health system transformation in Ontario. The model helps OHTs advance all four pillars of the Quadruple Aim as well as the United Nations Sustainable Development Goals (see Figure 1). The goal is to optimize outcomes through the use of evidence-based practice and robust staff engagement. The BPSO OHT focuses its efforts on uptake of best practices across all sectors of the OHT ensuring spread and scale into cultures of excellence. Results are closely monitored and continuous learning is facilitated by coaches to ensure success and sustainability of achievements.
The BPSO program supports the above framework which incorporates the United Nations Sustainable Development Goals (SDGs) (outer circle) together with the Quadruple Aim, addressing population health, supporting underserviced populations and promoting health equity. [Registered Nurses’ Association of Ontario (RNAO). (February, 2021). Nurse Practitioner Task Force Report: Vision for Tomorrow]
RNAO provides a cutting-edge multilevel and multifaceted approach to implementing BPGs in order for BPSOs to achieve sustainable change in practice.
The BPSO Host Coaches, including the RNAO Coaches working with BPSOs directly, use the Leading Change Toolkit to guide their regular consultative sessions. This assists BPSOs in making progress to achieve the BPSO requirements and deliverables over the pre-designation period. These deliverables are monitored by the BPSO Hosts and by RNAO for their BPSO Directs.
BPSO Coaches use a variety of approaches to support BPSOs in both the pre-designate and designate period in their quality improvement efforts. These include regular meetings with Coaches and BPSO leads, scheduled presentations to BPSO knowledge exchange networks, semi-annual MyBPSO reports and data submission to the Nursing Quality Indicators for Reporting and Evaluation (NQuIRE®) data system.
Established in 2022, the Best Practice Champions Network consists of thousands of nurses and other health providers, within Ontario and globally, in all roles and health sectors, who are passionate about evidence-based practice and improving care and health. These champions are dedicated practitioners who raise awareness of BPG's, have an understanding of change management processes, motivate their colleagues, and influence the uptake of BPGs among workplace peers.
Get more information about the Best Practice Champions Network.
The Leading Change Toolkit is a foundational resource for BPSOs. It is an online, open-access evidence-informed implementation resource designed to help change agents and change teams make lasting improvements in health care. It focuses on the uptake and sustainability of knowledge – or evidence – and uses two complementary frameworks to accelerate success: Social Movement Action and Knowledge-to-Action.
Access the Leading Change Toolkit.
RNAO delivers, locally and internationally, professional development programs that focus on guideline implementation and evaluation. These institutes provide in-depth information on how to use RNAO's BPGs to create evidence-based cultures and others that focus on specific topics such as wound care and program planning
Get more information about the Clinical BPG Institutes.
Get more information about the Wisdom in Wound Care Webinar Series: Pressure injury assessment.
RNAO’s BPG Order Sets are evidence-based interventions and clinical decision support resources derived from the RNAO’s clinical BPGs. They enable the integration of the best available evidence into daily clinical practice using technology to facilitate access at the point-of-care. BPG Order Sets support the evaluation of guideline implementation by providing a mechanism to link specific interventions to corresponding evidence-based NQuIRE indicators.
Get more information about the BPG Order Sets.
The BPG Program monitors and evaluates – through NQuIRE and MyBPSO Reports – the process of guideline implementation, and the resulting patient, health provider, organizational and health system outcomes
The NQuIRE data system consists of: a database, an on-line data entry system, a collection of data dictionaries, including a set of organization-level structural indicators as well as a set of process and outcome indicators for each BPG and data collection and reporting processes.
Through NQuIRE, RNAO collects, analyzes and reports quality indicator data submitted by health service organizations participating in the BPSO program. NQuIRE supports BPSOs to make effective and sustained practice improvements by providing organizational BPG-directed care processes and resultant clinical outcomes. With NQuIRE data reports, BPSOs are able to track their progress by linking evidence-based practice with quality-of-care outcomes, supporting rapid learning and quality improvement to optimize clinical, organizational, and health system outcomes.
By monitoring, evaluating and reporting quality improvements in evidence-based care across the globe, NQuIRE is producing BPSO-validated and endorsed quality indicators that will contribute to sustainability, and enhance understanding of the full impact of evidence-based practice on health quality outcomes.
Get more information about NQuIRE.
Another key element of the RNAO's BPSO Evaluation Model is the MyBPSO report that each BPSO, whether provincial, national or international, submits twice per year during the pre-designate phase and annually for designate organizations. These reports provide an opportunity for BPSO leads, champions and teams to reflect on their progress towards achieving the BPSO deliverables, and results in a documented story of their evolution as a BPSO. The standardized, online MyBPSO template asks questions about organizational demographics as well as key deliverables related to capacity development, implementation, evaluation, dissemination and sustainability planning. The database of qualitative data resulting from the submission of MyBPSO reports provides RNAO and its BPSO partners a mechanism to analyze qualitative outcomes, and identify areas to continuously strengthen the program. The RNAO BPSO team, including BPSO Coaches and evaluation specialists, review each report and meet with every BPSO individually to provide feedback and linkages to resources to support rapid learning and improvement.
In addition to the BPSO Coaching and Consultation, Best Practice Champion Network, BPG Institutes, NQuIRE and MyBPSO Reports, all BPSOs have access to the following resources (click on the link for more information):
Become a Spotlight
LTC BPSO
BPSO program for Ontario Health Teams
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