Disseminating positively deviant strategies through creative co-design


 The purpose of this research is to investigate whether creative practice and co-design methods can be used to support the dissemination of positively deviant strategies for improving patient safety on elderly patient medical wards. The study is funded through the Evidence Based Transformation Theme of the NIHR (National Institute for Health Research) CLAHRC (Collaborations for Leadership in Applied Health research and Care) YH (Yorkshire and Humber) and is supported by the Translating Knowledge into Action (TK2A) theme. 


Positive deviance is an asset-based, bottom-up approach to behavioural and social change within communities. It draws on individual and community strengths and pre-existing resources considered positively deviant (Tuhus- Dubrow, 2009, Sternin and Choo, R., 2000; and Singhal et al., 2010). The potential efficacy of this approach is currently being examined in the context of hospital services. 


Bradley et al. (2009) found the identification and examination of healthcare organisations that demonstrate positive deviance to provide an opportunity to characterise and disseminate strategies for improving quality. They proposed the following four-staged approach to identifying practices that improve healthcare quality: 

1. Identifying 'positive deviants,' i.e., organisations that consistently demonstrate exceptionally high performance in the area of interest; 

2. Using qualitative methods to study organisations in-depth, in order to generate hypotheses about practices that allow organisations to achieve top performance; 

3. Testing hypotheses statistically in larger, representative samples of organisations; 

4. Working in partnership with key stakeholders to disseminate evidence about newly characterised best practices 


This project builds on previous research undertaken by Baxter et al. (2015) at the University of Leeds. Baxter et al. (2015) examined whether a positive deviance approach could be used to identify elderly care ward teams that were performing exceptionally well on patient safety and then to explore what strategies are used to achieve success. 


Aim 

The purpose of this study is to investigate whether creative practice and co-design methods can be used to support the dissemination of positively deviant strategies within elderly patient medical wards. 

The study research questions are as follows: 

1) Can creative co-design help ward teams to disseminate positively deviant strategies? 

2) Does using creative practice and co-design methods to support the dissemination of positively deviant strategies have an impact on the ward? 

3) What is the experience of being involved in this process for staff on the units? 

4) Is there a difference in the experience and impact of the critical artefacts between wards engaged in creative practice and co-design of creative interventions and those that were not? 

5) Which types of creative co-design methods work well in this context? 



The full protocol can be found here

Chief Investigator Professor Paul Chamberlain, Sheffield Hallam University, Art and Design Research Centre
Design Researcher: Anne-Marie Moore , Sheffield Hallam University, Art and Design Research Centre