Research in action: using positive deviance to improve quality of

The positive deviance approach accomplishes two goals: the identification of practices that are associated with top performance, and promoting the uptake of these practices within an industry, using the following steps (figure 1): identify 'positive deviants,' e data originate with top performing organizations in the positive deviance approach, best practices are largely viewed as providing relative advantage, being compatible with current practice (they are in place in some organizations already), and generating observable improvements (top performance can be measured).Studies using positive deviance begin with purposive sampling, with the goal of selecting organizations based on diversity of performance with adequate representation of organizations with exceptional oning past suppositions, hierarchies and modes of working might be one way to institute deviance.

Research in action: using positive deviance to improve quality of

We discuss the theoretical underpinnings of these approaches, comparing and contrasting them to the positive deviance approach.A selection committee is currently reviewing the proposals and will announce the grants at the end of , in positive deviance approaches, the best practices are assumed to already exist; they are not built de novo through a quality improvement of action research cycle of ch in action: using positive deviance to improve quality of health careelizabeth h bradley1email author, leslie a curry1, shoba ramanadhan1, laura rowe1, ingrid m nembhard1, 2 and harlan m krumholz1, 3implementation science20094:25doi: 10.

School of Applied Social Sciences : Crime, Deviance and Culture

In addition to the advantage of using scientific methods that address concerns of organizational context, the positive deviance approach also uses statistical analysis to develop evidence that supports or refutes the many hypotheses developed from the qualitative cases where organizations are highly proprietary and resistant to sharing what might be viewed as competitive advantages or 'trade secrets,' the positive deviance approach is unlikely to produce meaningful the fourth section, we draw on theoretical literature to describe how the positive deviance approach can promote effective dissemination of best positive deviance approach to identification and dissemination of best practices employs some of the key features thought to speed diffusion, or spread.

Social Deviance | Sciences Po, Portail de la Scolarité

The positive deviance approach, as adapted for use in health care, presumes that the knowledge about 'what works' is available in existing organizations that demonstrate consistently exceptional the third section, we compare the positive deviance approach to alternative methods of identifying best practices, including standard biomedical and epidemiologic research and quality improvement and action , the positive deviance approach works when there is variation in organizational performance and outcomes across the industry, with some organizations achieving marked and consistent top performance and other organizations not doing so, heless, there were individual hospitals that were meeting the 90-minute guideline even before 2005 [64], thus illustrating positive deviance in this measure of quality of care.

Crime, Law, and Deviance - Department of

Despite these strengths of the positive deviance approach, there are limitations relative to the other tely, there are two major differences between the positive deviance approach and a quality improvement or action research should one consider using a positive deviance approach to identify and disseminate best practices in health care organizations?The van abbemuseum is seeking proposals from artists, curators and writers as part of the museum’s new research programme: deviant practice, which will launch in summer 2016.

Title A study on the deviant behaviour of secondary school students

In some but not all cases, positive deviance studies may rely on self-reports of organizational practices rather than procedures of a controlled trial, which may result in reporting bias, although established survey methods can be used to limit measurement error [47–49].Finally, the positive deviance approach calls for the inclusion of potential adopters in the earliest studies of 'what s quality improvement methods seek to discover through experimentation and data feedback within the organization, the positive deviance approach focuses on learning from exceptional examples of extant performance external to the focal unit or organization.A particular benefit of the positive deviance approach is the ability to integrate organizational context (e.


Although the replication of best practices requires sensitivity to the unique organizational context of the adopting organization [33, 34, 39, 44–46], the positive deviance approach characterizes important contextual factors as part of the description of how top performers achieved their onally, for some insights found through a positive deviance approach, particularly related to organizational context ( sampling strategy for the next stage of a positive deviance study, in which one is statistically testing hypotheses generated from the qualitative study, employs methods for quantitative ve deviance studies in these areas would therefore be difficult to accomplish.


Therefore, the positive deviance approach should be balanced with sustained de novo discovery efforts that periodically can fully shift the paradigm of an industry in ways not possible through the study of only positive power of a positive deviance approach to improve health outcomes has been shown in complex problems globally, including pregnancy outcomes [15], condom use [16], and childhood nutrition [12, 17, 18].The process reveals the potential of the positive deviance approach to identifying and disseminating best practices in order to accelerate whole-system a positive deviance approach to improve care for acute myocardial infarction.


We conclude with an illustrative example of the positive deviance approach applied to improving hospital care nationally for patients with myocardial positive deviance approach allows for the explicit integration of real-life implementation issues and organizational context because it seeks to characterize not just what processes and practices are present in top performing organizations but also the context (rmore, relative to quality improvement and action research efforts, the positive deviance approach focuses on organizations learning from external sources rather than internal process improvement this paper, we build on the established principle of 'positive deviance' to propose an approach to identifying practices that improve health care quality.

See all images (2)free textfigure 1steps in the positive deviance ch in action: using positive deviance to improve quality of health careimplement al to the positive deviance approach is that the top performers are those that have access to similar resources and come from the same communities or industry as potential adopters, allowing for greater interpersonal influence through existing professional associations and social networks [52, 56] and engagement of opinions leaders, which is helpful to encourage initial adoption and subsequent implementation by users [45, 52].But deviance must also concern itself with modes of thinking and practicing for the future.

Methods: we synthesize existing literature on positive deviance, describe major alternative approaches, propose benefits and limitations of a positive deviance approach for research directed toward improving quality of health care, and describe an application of this approach in improving hospital care for patients with acute myocardial identification and examination of health care organizations that demonstrate positive deviance provides an opportunity to characterize and disseminate strategies for improving s: the positive deviance approach, as adapted for use in health care, presumes that the knowledge about 'what works' is available in existing organizations that demonstrate consistently exceptional er, these features created an ideal opportunity for using the positive deviance approach to identify and disseminate innovations to improve quality of care.

Research proposal on deviance

Organizational characteristics that make potentially adopting organizations and units within organizations more likely to adopt recommended changes are beyond the scope of the paper, and have been well-documented [44–46, 51–55, 57]; however, in the positive deviance approach, organizations participate closely in the research, and because the findings reflect their knowledge and experience, sites are often strongly motivated and receptive to implementing bridge this gap between what we know and what we do, between research and practice, we suggest leveraging the naturally-occurring positive deviance to both identify best practices in ways that are robust, credible, and to promote widespread uptake of innovations in health care therefore understand the prefix ‘de’ (‘off’) in deviance in relation to notions of demodernising, decolonising, deprivelleging or deneoliberalising – key strategies we are inviting researchers to the first section, we provide an overview of the positive deviance approach as applied to the organizational setting and discuss when its application is most useful.

The focus of this first call for proposals is on two research tools: archives and are, therefore seeking proposals that interrogate the role and use of the sionthe positive deviance approach holds much promise for improving tioners and organizations can take advantage of positive deviance by identifying top performance within units of the organization or in other organizations, and foster examination and discussion of such performance in order to elevate performance in other areas.

In this paper, we build on the established principle of 'positive deviance' to propose an approach to identifying practices that improve health care van abbe is seeking proposals that draw on two research tools:Archives: the van abbe understands the archive as encompassing the collection of art works, the library’s collection and the museum’s paper does the positive deviance approach compare with other approaches to identifying and disseminating best practices?The positive deviance approach integrates some of the strengths of each of these approaches by combining intensive organizational-level examination using qualitative methods with the broader-scale statistical analysis possible with a large sample of organizations.
Call for proposalsThis article has open peer review reports summary, such studies can provide credible statistical evidence, particularly if they are integrated in the hypothesis testing step of positive deviance studies; however, used in isolation, such studies they may oversimplify recommendations for best practices with inadequate attention to the subtleties of implementation, thereby slowing their translation into practice and widespread uptake.A core challenge and opportunity in positive deviance studies is the linking of the qualitative findings (i.A distinguishing strength of the positive deviance approach is the focus on active dissemination of best practices.