Identifying positive deviants in healthcare quality and safety: a mixed methods study

Journal of the Royal Society of Medicine
Jane K O'HaraRebecca Lawton

Abstract

Objective Solutions to quality and safety problems exist within healthcare organisations, but to maximise the learning from these positive deviants, we first need to identify them. This study explores using routinely collected, publicly available data in England to identify positively deviant services in one region of the country. Design A mixed methods study undertaken July 2014 to February 2015, employing expert discussion, consensus and statistical modelling to identify indicators of quality and safety, establish a set of criteria to inform decisions about which indicators were robust and useful measures, and whether these could be used to identify positive deviants. Setting Yorkshire and Humber, England. Participants None - analysis based on routinely collected, administrative English hospital data. Main outcome measures We identified 49 indicators of quality and safety from acute care settings across eight data sources. Twenty-six indicators did not allow comparison of quality at the sub-hospital level. Of the 23 remaining indicators, 12 met all criteria and were possible candidates for identifying positive deviants. Results Four indicators (readmission and patient reported outcomes for hip and knee surgery) offered indica...Continue Reading

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Citations

Jun 18, 2019·Clinical Obstetrics and Gynecology·Elizabeth A HowellJennifer Zeitlin
Aug 14, 2018·Journal of the Royal Society of Medicine·Kamran Abbasi
Oct 4, 2019·Journal of Comparative Effectiveness Research·Sonal SinghKimberly A Fisher
Sep 10, 2019·Journal of Health Services Research & Policy·Lesley HughesRebecca L Lawton
Jan 9, 2021·British Journal of Anaesthesia·Carol J PedenUNKNOWN Members of the Perioperative Brain Health Expert Panel
Sep 27, 2020·BMJ Quality & Safety·Elisa Giulia LiberatiUNKNOWN SCALING Authorship Group
Jul 15, 2021·Anesthesia and Analgesia·Carol J PedenZeev N Kain

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Methods Mentioned

BETA
coronary
hysterectomy

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