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#83 – Positive Deviance as a Catalyst for Change with Cherie Burke, DNP, CRNA

“Positive deviance is really about… taking those things that people are doing right and sharing them with everyone so that everyone is doing things to improve our patients’ care, our patients’ outcomes.” 

Cherie Burke, DNP, CRNA

Dr Cherie Burke joins me to unpack how positive deviance can be a catalyst for change in healthcare.

Positive deviance is all about looking for what’s going right and transferring those lessons to other opportunities, processes & providers to improve performance.

Aggressive action & investigation is the norm when something goes wrong. Think about when a sentinel event happens. There’s mandatory reporting, root cause analysis (RCAs), critical incident debriefs and a concerted effort to prevent errors & improve processes in the future. Positive deviance is a process of applying a similar degree of effort to what’s working right. Can we find the high performers, figure out what they’re doing well and transfer those techniques, processes & beliefs to other domains?

Cherie Burke, DNP, CRNA completed her Master of Science in Nursing at DeSales (duh-sales) University, her Doctorate in Nursing Practice at La Salle (la-sal) University, a post-doctoral fellowship in patient safety at the VA Medical Center in Philadelphia and is currently a PhD candidate at Duquesne (do-cane) University.

Dr Burke and I worked together at Maine Medical Center in Portland, Maine and have also taught alongside one another with Cornerstone Anesthesia Conferences. Cherie is actually who connected me with Jayme Rueter, the CRNA who founded Cornerstone and who gave me my first shot at teaching other CRNAs at continuing education conferences.

I think you’re going to enjoy this conversation… learning how to find positive deviance at play in our organizations is key for us to improve the work that we do.

This episode was originally released on From the Head of the Bed on January 26, 2016.

Resources: 

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 science4(1), 1-11.

Ford, K. (2013). Survey of syringe and needle safety among student registered nurse anesthetists: are we making any progress?. AANA journal81(1).

Gary, J. C. (2013). Exploring the concept and use of positive deviance in nursing. AJN The American Journal of Nursing113(8), 26-34.

Lawton, R., Taylor, N., Clay-Williams, R., & Braithwaite, J. (2014). Positive deviance: a different approach to achieving patient safety. BMJ quality & safety23(11), 880-883.

Prielipp, R. C., Magro, M., Morell, R. C., & Brull, S. J. (2010). The normalization of deviance: do we (un) knowingly accept doing the wrong thing?. Anesthesia & Analgesia110(5), 1499-1502.

Rosenberg, T. (2013, February 27).  When deviants do good.  The New York Times, Retrieved from http://opinionator.blogs.nytimes.com/2013/02/27/when-deviants-do-good/?_r=0

By Jon Lowrance

Jon Lowrance, MSN, CRNA is the producer of Anesthesia Guidebook, the go-to guide for anesthesia providers.