Positive Deviants: What Health Departments Can Learn From Them

Apr 14, 2011, 8:34 PM

If a health department outperforms its peers in a crisis situation, what is the best way to draw key lessons from that performance and use them to help other communities respond better the next time a crisis strikes?

That’s the ultimate focus of new research by Tamar Klaiman, an Assistant Professor of Health Policy at the Jefferson School of Population Health in Philadelphia. Klaiman is working on evaluating why some local health departments had much more successful vaccination campaigns in the 2009 H1N1 crisis.

In scientific terms, Klaiman is investigating “positive deviants” – top performers - in the provision of the H1N1 vaccine, using in-depth case studies to identify the stand-outs, and then figuring out why they were able to operate at such a high level compared with their peers.

While still in the early stages, the research is producing some compelling early findings - for instance, validating the strategies of campaigns that focused on reaching children through schools.

Klaiman and her team also see promise for this approach to be applied more broadly in public health research - for instance, as a way to share the lessons of those health departments that are able to move the most smoothly through the accreditation process, or implement laws and policies to improve health. As she pointed out, while novel in public health, positive deviance is a tried method of finding and spreading best practices in health care and in other fields.

Weigh in: Thinking about the experience of your health department or others in a recent time of crisis – be it H1N1, a hurricane, or any other outbreak or calamity that threatened the health of people in your community – what are some other areas of performance you feel would benefit from this research?

This commentary originally appeared on the RWJF New Public Health blog.