Good ideas need champions and the New York Times is the champion of positive deviance. They followed up articles from 2008 and 2009 this week with a reminder on the power of the positive deviance approach. While some think of positive deviance as a community development strategy, through our lens it is a quality improvement and implementation strategy of nearly unlimited potential.
In this approach, look for where things are going right in places where lots of things aren't going right. Then, investigate to find out what people are doing differently there. Then, try to replicate. Tufts maintains a website on positive deviance. You can also check out the well-regarded article in F@st Company that helped spread the word.
From a QI perspective, you can use data monitoring to find positive deviance in your regularly collected data. Where are the consumers who are pleased with their service? What did they get that others don't? Is there a unit or team that does better at keeping their clients out of the hospital? What do they do differently there? You investigate. You see if you can replicate.
As an implementation strategy, you would look to see what teams or sites have been best able to mount and sustain an evidence supported intervention. Again, what are they doing differently that accounts for their success?