The use of positive deviance approach to improve health service delivery and quality of care: a scoping review
Published in Healthcare & Nursing
Healthcare systems worldwide are faced with a myriad of challenges in enhancing accessibility and delivering top-notch healthcare services on a global scale. These hurdles encompass deficiencies in data collection and monitoring systems, subpar organizational team culture and limited capacity, ineffective leadership, a lack of incentivization for outstanding performance, and a scarcity of evidence-based health policies to bolster implementation and enhance the proficiency of healthcare professionals. Consequently, there is an increasing imperative to explore and adopt innovative approaches to enhance and provide safe, effective, and high-quality healthcare services within the healthcare system.
The positive deviance approach emerges as an innovative strategy aimed at identifying exemplary practices existing within a given community. This community, within the healthcare context, encompasses various entities including teams, groups, departments, and organizations. For example, regional/provincial, zonal, and district-based administrative health offices, local health facilities, and their respective units can be considered as departments and organizations within this community. Notably, social service agencies, healthcare organization representatives, and local government bodies have been regarded as integral components of communities in studies employing the positive deviance approach to understand collaboration among social service and healthcare providers in communities achieving relatively low levels of healthcare utilization and expenses among senior citizens.
This approach acknowledges the intrinsic value of existing expertise and operates under the premise that solutions to problems already exist within the community. By identifying and disseminating these solutions, others can effectively address existing complex and intractable challenges. It further underscores that despite facing similar resource constraints, there are individuals who excel in their performance within organizations, and when given the opportunity, these positive deviants are eager to share their experiences, particularly when leaders facilitate the process.
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BMC Health Services Research
An open access, peer-reviewed journal that considers articles on all aspects of health services research, focusing on digital health, governance, policy, system quality and safety, delivery and access, financing and economics, implementing reform, and the workforce.
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