course materials

1. Examine a health care problem or issue and consider how you could apply
the concept of positive deviance to produce systems-level change that
leads to improved quality.
Discussion: Applying the Concept of Positive Deviance Focus on the successful exceptions
(i.e., positive deviants), not the failing norm. —
Pascale, Sternin, & Sternin, 2010 Positive
deviants—
those who are able to innovate and create affirmative results—
do so within the
same constraints that others face. These outliers reveal how the desired outcomes can be
achieved by expanding beyond the boundaries of the status quo, while maintaining a focus
on what is professionally, legally, and morally appropriate. Consider the following
example:In 1990, Save the Children (SC), a nongovernmental organization in the United
States, was asked by the government of Vietnam to create a program to enable poor villages
to solve the overwhelming problem of childhood malnutrition. Given just six months to
create a sustainable solution, those involved realized that they needed to look at the
positive results that some had been able to achieve relative to the lack of success others had
encountered under similar circumstances. They posed the question: “ If some individuals in
a community were better able to solve problems than others with access to exactly the same
resources, could we use that provocative discrepancy?” Taking this tack, they were able to
identify approaches that differed from the norm and apply this knowledge to produce
positive results that led to a dramatic improvement in child health (Dura, Singhal, and
Sternin, 2009). In this Discussion, you examine a health care problem or issue and consider
how you could apply the concept of positive deviance to produce systems-level change that
leads to improved quality. To prepare: Review the information in this week’ s Learning
Resources, including the first chapter in Pascale, Sternin, and Sternin book and the Bradley,
Curry, Ramanadhan, Rowe, Nembhard, and Krumholz article.Reflect on health care quality
problems or issues that warrant systems-level change. Consider the significance of each
problem/issue. Identify one, in particular, that you would like to focus on for this
Discussion. Note: You may use the quality improvement issue that you selected for your
Course Project, if appropriate.With this problem or issue in mind:How would you apply the
principles of positive deviance to aIDress this problem/issue? What specific steps would
you take to move from identification of the problem/issue through evaluation of outliers to
implementation of a larger scale change to improve quality?What examples of positive
deviance, if any, are you aware of related to this problem/issue? Conduct research as
necessary to see if you can locate one or more instances of positive deviance. Post a brief

2. description of the health care quality problem or issue you selected and explain how it
could be aIDressed using the principles of positive deviance. Read a selection of your
colleagues’ responses. Respond to at least two of your colleagues on two different days
using one or more of the following approaches:Ask a probing question, substantiated with
aIDitional background information or research.Share an insight from having read your
colleagues’ postings, synthesizing the information to provide new perspectives.Validate an
idea with your own experience and aIDitional resources. Required Readings Bradley, E. H.,
Curry, L. A., Ramanadhan, S., Rowe, L., Nembhard, I. M., & Krumholz, H. M. (2009). Research
in action: Using positive deviance to improve quality of health care. Implementation Science,
4(25), 1– 11.Retrieved from the Walden Library databases. The authors of this article
review literature on positive deviance as well as break down a step-by-step approach in
applying positive deviance in a research model to improve quality.Dingfelder, H. E., &
Mandell, D. S. (2011). Bridging the research-to-practice gap in autism intervention: An
application of diffusion of innovation theory. Journal of Autism & Developmental Disorders,
41(5), 597– 609.Retrieved from the Walden Library databases. The authors discuss the
need to apply Roger’ s diffusion of innovation theory in an effort to improve autism
intervention for patients.Seidman, W., & McCauley, M. (2009). A scientific model for
grassroots O.D. Organization Development Journal, 27(2), 27– 37.Retrieved from the
Walden Library databases. Seidman and McCauley explore the grassroots nature of an
organization’ s culture and the effect of positive deviance, fair process, and neuroscience on
creating change in the culture.Required MediaLaureate Education (Producer). (2013h).
Risks and benefits of positive deviance. Retrieved from
https://class.waldenu.edu Note: The approximate length of this media piece is 4
minutes. Dr. Kenneth Rempher discusses how to encourage positive deviance while
maintaining ethical and moral standards. Accessible playerOptional ResourcesPascale, R. T.,
Sternin, J., & Sternin, M. (2010). The power of positive deviance: How unlikely innovators
solve the world’ s toughest problems. Boston, MA: Harvard Business Press.Chapter 12,
“ Introduction: Against All OIDs” (pp. 1– 18)