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Positive Deviance Theory: Leveraging Compliments Data to Guide Strategic Planning for Patient Experience Improvement

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Identifying positive patient experiences through compliments reveals key drivers of high-quality care. This approach helps health systems improve patient-centered care by highlighting exemplary staff and practices.

Keywords:
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Area of Science:

  • Healthcare Quality Improvement
  • Patient Experience Research
  • Health Services Management

Background:

  • Patient-centered care (PCC) is crucial for enhancing healthcare quality and patient outcomes.
  • Patient experience, a key component of PCC, is measurable and linked to care coproduction.
  • A Positive Deviance approach can identify high performers to guide strategic improvements in care experience.

Purpose of the Study:

  • To identify characteristics of positive deviance in patient care experiences.
  • Analyze unsolicited compliments from patients and families to understand exceptional care delivery.

Main Methods:

  • A mixed-method analysis was conducted on 213 unsolicited patient/family compliments from January 2021 to January 2022.
  • Content and thematic analysis, including single, blinded inductive coding, were used to synthesize findings.
  • Data were analyzed to identify patterns and themes in positive feedback regarding care experiences.

Main Results:

  • The main campus received the majority of compliments (89%).
  • Key drivers of care quality identified include thankful sentiments (36.8%), compassion (26.8%), competence (11.6%), communication (10.6%), feeling cared for (8.5%), care team support (8.0%), and overall supportiveness (8.0%).
  • Physicians (37.3%) and nurses (34.2%) were most frequently complimented, with surgery teams (17.0%) also noted for exemplary care.

Conclusions:

  • Findings align with established research on key drivers of patient experience.
  • This Positive Deviance approach enables identification of exemplars within health systems.
  • The insights gained can inform organizational planning and strategic initiatives for care improvement.