Learning from what goes well: Improving the quality of general practice

Improving the quality of primary care is a global imperative, one only increasing in importance as health systems internationally move towards community-based models of care, and patients, tasks, technologies, practice environments and expectations get increasingly complex. Contemporary approaches to improvement, focused on learning from instances of poor performance, have not generated sustained improvement in quality and are likely insufficient to address the increasing complexities of delivering care in the general practice setting. Recently, new approaches to understanding quality and safety have been advocated, that emphasise learning from when things go well, or even exceptionally well. One such approach, the ‘positive deviance’ approach focuses learning on exceptionally high-performing individuals, teams or practices, and applications of the approach in primary care thus far have been promising. Given the increasingly complex healthcare landscape, applying strengths-based approaches like PD is an attractive strategy as it allows us to engage patients and staff to learn from positive deviations in care and attend to key systems and contextualising factors that impact the success of improvement efforts. The current thesis applied the principles of positive deviance and strengths-based learning to identify and disseminate the key factors and strategies that support the delivery of exceptional care in general practice to stimulate learning and improvement in this domain of healthcare.
University of Galway
Publisher DOI
Attribution-NonCommercial-NoDerivatives 4.0 International