Identifying positively deviant elderly medical wards using routinely collected NHS Safety Thermometer data: an...

Area of Science:

• Healthcare Management
• Patient Safety
• Quality Improvement

Background:

• The positive deviance approach identifies exceptional performers but lacks implementation guidance in healthcare.
• Its application at ward level, using broad outcomes, and within the UK is underexplored.

Purpose of the Study:

• To develop and appraise a pragmatic method for identifying positively deviant hospital wards.
• To utilize routinely collected, broad patient safety measures for this identification.

Main Methods:

• A two-phased observational study involving 34 elderly medical wards in the UK.
• Phase 1: Analyzed Safety Thermometer data to identify consistently exceptional wards.
• Phase 2: Surveyed staff and patients on identified wards to validate findings.

Main Results:

• Five positively deviant wards were identified, outperforming regional and organizational averages over 12 months.
• Staff perceptions generally supported the identification of these wards.
• Patient perceptions showed less concordance with the routinely collected safety data.

Conclusions:

• A pragmatic method using routinely collected data can identify positively deviant elderly medical wards.
• Challenges exist in implementing the initial stage of the positive deviance approach.