Positive deviance in healthcare study

  • Research type

    Research Study

  • Full title

    Positive deviance in healthcare study: A broad qualitative inquiry.

  • IRAS ID

    177435

  • Contact name

    Laura Sheard

  • Contact email

    laura.sheard@bthft.nhs.uk

  • Sponsor organisation

    Bradford Teaching Hospitals NHS Foundation Trust

  • Duration of Study in the UK

    1 years, 0 months, 1 days

  • Research summary

    We are researching a concept called ‘positive deviance’, which is essentially about high performance in healthcare and how services achieve their success. The main idea behind positive deviance is that highly performing services are doing something different to the norm (‘deviating’) in a positive manner to other healthcare providers. In this study, we want to look at orthopaedic services – and in particular hip and knee replacement healthcare - to understand how services operate and what they might be doing differently to each other to achieve their performance level. The focus is on why the service is successful rather than usual approach of finding problems.

    Our research team have already undertaken a thorough exercise to categorise all the Trusts in the Yorkshire and Humber region based on their performance in relation to: i) emergency readmissions ii) Patient Reported Outcome Measures. We have then categorised all these Trusts into four categories: excellent, good, average and poor. In this research, we will be working with four Trusts, three of whom are in the excellent category and one who is in the good category.

    We will use qualitative methods to uncover how different hospitals are achieving their success.
    1. Mapping exercise using focus groups and documentary analysis. Clinicians will be asked where they think areas of positive deviance may lie (at all four Trusts)
    2. Orientation stage – researchers will observe staff members on the ward and in different settings, looking for areas of positive practice (at two Trusts)
    3. Focus stage – researchers will hone in on where they think the positive deviance lies by conducting further observations and interviewing key people (at two Trusts)

    We will use a method of analysis called ‘constant comparison’. We will produce novel findings which focus on success rather than the usual emphasis in healthcare research which tends to focus on improving previous failures.

  • REC name

    South Central - Oxford B Research Ethics Committee

  • REC reference

    15/SC/0274

  • Date of REC Opinion

    1 May 2015

  • REC opinion

    Favourable Opinion