Learning from positively deviant wards to improve patient safety: an observational study protocol.

Area of Science:

• Healthcare quality improvement
• Patient safety research
• Geriatric medicine

Background:

• Positive deviance is an asset-based improvement approach.
• It identifies successful solutions within communities despite similar resources.
• Previously applied at individual/organizational levels in healthcare.

Purpose of the Study:

• Explore the application of positive deviance to multidisciplinary ward teams.
• Address patient safety among elderly patients.
• Assess concurrent validity of identifying positively deviant wards using NHS Safety Thermometer data.

Main Methods:

• Analysis of National Health Service (NHS) Safety Thermometer data from 34 elderly medical wards.
• Identification of 5 'positively deviant' and 5 matched 'comparison' wards.
• Multimethod, observational study including patient/staff surveys, focus groups, and fieldwork.

Main Results:

• Concurrent validity of NHS Safety Thermometer data for identifying positively deviant wards will be assessed.
• Hypotheses on successful strategies, behaviors, team cultures, and dynamics will be generated.
• Acceptability and sustainability of identified strategies will be explored.

Conclusions:

• The study protocol outlines a rigorous approach to investigate positive deviance in elderly care wards.
• Findings are expected to generate hypotheses for improving patient safety through team-based strategies.
• The research will contribute to understanding how to foster safer care environments for elderly patients.