PR - Learning from successful wards to improve patient safety.
Research type
Research Study
Full title
Learning from successful elderly medical wards to improve patient safety: applying the positive deviance approach.
IRAS ID
152209
Contact name
Ruth Baxter
Contact email
Sponsor organisation
University of Leeds, Faculty Head of Research Support.
Duration of Study in the UK
1 years, 9 months, 15 days
Research summary
There is no evidence that patient care is becoming any safer and recent UK government reports indicate patient safety problems continue to exist throughout the NHS (Vincent et al. 2008; Berwick, 2013). Traditional patient safety approaches are reactive, focusing on errors which have already occurred. In contrast positive deviance offers a more proactive, asset based approach to improvement. Positive deviance assumes that within communities, such as healthcare organisations, some individuals or groups overcome common problems and succeed despite facing the same constraints as everyone else. A four stage process has been proposed to apply positive deviance within healthcare organisations (Bradley et al. 2009). This study addresses the first two stages; identifying positive deviants and generating hypotheses about how they succeed. Previous applications of positive deviance within healthcare focus on specific care processes or outcomes such as hospital acquired infections. Currently the approach has not addressed broader issues of patient safety, nor has it been applied within the NHS.
The routinely collected NHS Safety Thermometer data has been used to identify 5 elderly medical wards who, based on their high performance are potential positive deviants. 5 averagely performing wards, matched on key variables will form a comparison group. This study will firstly explore whether positively deviant elderly medical wards, who deliver safe patient care, can be reliably and validly identified using Safety Thermometer data. Validated measures of safety will be collected from patients and staff on each ward and this data will be correlated with the wards Safety Thermometer data. The second part of the study will qualitatively explore how ward teams deliver safe patient care. Multidisciplinary focus groups and fieldwork diaries will be used to identify concrete strategies and behaviours used by the team and how dynamics and culture differ between positively deviant and averagely performing ward teams.REC name
South East Scotland REC 01
REC reference
14/SS/1085
Date of REC Opinion
27 Nov 2014
REC opinion
Further Information Favourable Opinion