Explore our growing collection of resources on improvement approaches, created with input from our Forum members.

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Improvement approaches

Positive deviance is an asset-based improvement approach. At its core is the belief that solutions to problems already exist within communities, and that identifying, understanding, and sharing these solutions enables improvements at scale. This article provides examples of how positive deviance has been used to support healthcare improvement.

Co-production sees patients as active contributors to their own health and explores how interactions with staff and services can best be supported. Co-design is a related but distinct creative process, where patients and staff work in partnership to improve services or develop interventions. Both approaches are promoted for their technocratic benefits (better experiences, more effective and safer services) and democratic rationales (enabling inclusivity and equity), but the evidence base remains limited.

Collaboration-based approaches to healthcare improvement attract much attention. Longstanding examples of collaborative approaches have been associated with some success in improving outcomes and reducing harm. The evidence for their effectiveness and cost-effectiveness, however, remains inconsistent and contingent on the circumstances in which they are deployed and how they are used for what purpose. The authors of this article focus on two approaches: quality improvement collaboratives and communities of practice. They explore evidence of their impact on health outcomes, and evidence about how best to organise and implement collaboration-based approaches.

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