Red Ribbon Club inculcation of positive deviance approach to promote blood donation among undergraduate medical college students

BACKGROUND

Blood is an essential part of human life and blood donation has become a necessity that every society must take into consideration. Health care professionals have a major responsibility in raising community awareness on blood donation.

OBJECTIVE

This study aims to find out the knowledge and attitude of undergraduate medical students on blood donation and to determine the effectiveness of positive deviance (PD) approach.

METHODOLOGY

This institutional based cross-sectional study was conducted as a part of World AIDS Days celebration by Red Ribbon club among 414 undergraduate students using convenient sampling technique. A baseline and endline survey were conducted using a pre-structured validated questionnaire. To address the knowledge gap PD approach was used for the students who had voluntarily donated blood, volunteered in providing health education, and shared their experience to their peers. Ethical principals were adhered.

RESULTS

The mean age of the students was 20.4 ± 1.2 years. Most respondents had moderate knowledge on blood donation and positivity attitude towards the same. The key finding of our study is that about 45 students (10.9%) have donated blood till now. As a result of PD training session more than half of them volunteered to donate blood in the future.

CONCLUSION

This study shows that awareness about blood donation were minimal among the medical students with misconceptions. After PD approach, the willingness was increased from 10% to 66%. Thus, PD approach builds capacity and leadership in volunteers is considered as the best approach for behavior change among their own peers.

The power of positive deviance behaviours: From panic-gogy to effective pedagogy in online teaching

This study examines university faculty members' successful behaviours and the factors influencing these behaviours, when dealing with the issues posed by emergency remote teaching during the COVID-19 pandemic. Data was gathered through interviews with 12 carefully chosen instructors who competently prepared and implemented their first online classes despite various challenges encountered during the crisis. Interview transcripts were analysed by applying the theoretical concepts of the positive deviance approach to identify exemplary behaviours in the face of crisis. The results revealed that the participants performed three unique but effective behaviours, called 'positive deviance behaviours', in their online teaching: philosophy-driven decision making informed planning and ongoing performance monitoring. These behaviours were affected by individual factors (e.g., community engagement and emotion management during different phases of emergency remote teaching) and organisational factors (e.g., networks/hardware and training/support). By examining the positive deviance behaviours of instructors who delivered effective classes, this study offers online teaching and faculty development strategies in both crisis and non-crisis situations.

Positive deviants for medication therapy management: A mixed-methods comparative case study of community pharmacy practices

BACKGROUND

To optimize medication use in older adults, the Centers for Medicare & Medicaid Services (CMS) launched Medication Therapy Management (MTM) services as part of Medicare Part D policy; however, strategies for achieving high quality MTM outcomes are not well understood.

OBJECTIVE

The objective of this study was to generate hypotheses for strategies contributing to community pharmacies' high performance on policy-relevant MTM quality measures.

METHODS

This mixed-methods comparative case study was guided by the Positive Deviance approach and Chronic Care Model. The study population consisted of pharmacy staff employed by a Midwestern division of a national supermarket-community pharmacy chain. Data consisted of demographics and qualitative data from semi-structured interviews. Qualitative and quantitative data were analyzed deductively and inductively or using descriptive statistics, respectively. MTM quality measures used to evaluate participant pharmacies' MTM performance mirrored select 2017 Medicare Part D Plans' Star Rating measures.

RESULTS

Thirteen of 18 selected case pharmacies (72.2%) participated in this study, of which 5 were categorized as high performers, 4 moderate performers, and 4 low performers. Eleven pharmacists, 11 technicians, and 3 student interns participated in interviews. Eight strategies were hypothesized as contributing to MTM performance: Strong pharmacy staff-provider relationships and trust, Inability to address patients' social determinants of health (negatively contributing), Technician involvement in MTM, Providing comprehensive medication reviews in person vs. phone alone, Placing high priority on MTM, Using available clinical information systems to identify eligible patients, Technicians using clinical information systems to collect/document information for pharmacists, Faxing prescribers adherence medication therapy problems (MTPs) and calling on indication MTPs.

CONCLUSIONS

Eight strategies were hypothesized as contributing to community pharmacies' performance on MTM quality measures. Findings from this work can inform MTM practice and Medicare Part D MTM policy changes to positively influence patient outcomes. Future research should test hypotheses in a larger representative sample of pharmacies.

Beyond the hospital infection control guidelines: a qualitative study using positive deviance to characterize gray areas and to achieve efficacy and clarity in the prevention of healthcare-associated infections

Background

The literature is replete with attempts to design and promote customized guidelines to reduce infections during the care continuum. Paradoxically, these efforts sometimes result in gray areas where many staff members are unaware of what is required of them, which then leads to confusion, frustration, and uncertainty.

We coined the phrase “gray areas” in this context to encompass the variety of situations on the care continuum that are not addressed in the accepted guidelines, and where staff members are unsure of how to proceed.

The purpose of the present study was to characterize the gray areas that were reported by staff and to identify the practices of Positive Deviance (PD) individuals. We define to PD individuals as people who independently develop creative solutions to solve problems not identified by the majority in their community.

Methods

A qualitative constructivist research methodology was used that included personal interviews, observations and video recordings of identified PD practices to enhance infection control. The study was conducted January through March 2018, in two Intensive Care Units (ICU) units at Hadassah Hospital, Jerusalem, Israel. Personal interviews were conducted with 82 staff members from the General ICU (GICU) and Medical ICU (MICU).

Results

The study confirmed that guidelines cannot cover all the different situations that arise during the care continuum and can paradoxically result in the increased spread of hospital infections. Our study found there are numerous individuals who independently develop and implement solutions for gray areas. The creative and practical solutions of PD individuals can address the barriers and difficulties on the care continuum that were encountered by the staff in their communities. For example, inserting a central venous line is a complex practice in the general guidelines, while the PDs provided clear situation-specific solutions not covered in the guidelines.

Conclusions

The recommendations of the present study are to encourage hospital personnel to create their own solutions for various situations on the care continuum, and to disseminate them within their units to achieve a bottom up change, in lieu of investing in new or specific written guidelines.

Electronic supplementary material

The online version of this article (10.1186/s13756-018-0418-x) contains supplementary material, which is available to authorized users.