Our research team noted a great deal of variation in what the study states described as best practices. Programs varied in how best practices were defined, where they originated, and how they were positioned among the state's other quality improvement programs. Some states defined best practice simply as an innovative idea originating at the facility level that was seen as potentially valuable to other facilities. For example, Iowa posts on its website innovative best practices deemed to be among the best in the state. Other states define best practices based on expert-derived, clinical protocols that should be adopted by facilities so as to raise the standards of practice. This is the approach used in Maryland, Texas and Missouri.