The use of the positive deviance approach for healthcare system service improvement: A scoping review protocol

Introduction Healthcare systems are currently facing challenges in enhancing access and improving the quality of healthcare services around the world, and one of the innovative strategies that have been utilized to address such challenges is the positive deviance (PD) approach. The approach assumes that identifying, examining, understanding, and disseminating solutions to problems that are already available within the community and organizations including the healthcare system can help in bringing improvements at scale. However, to the best of the researcher’s knowledge, there is no scoping review that is conducted to map and synthesize the available evidence on the use of the PD approach for healthcare system service improvements. Hence, this scoping review aims to map and synthesize resources on the methodologies and reported outcomes and identify gaps and potentials regarding the use of the PD approach in the healthcare system. Methods and analysis Articles will be searched and retrieved in research databases such as PubMed, Embase, and Scopus. Retrieved articles will be screened independently for inclusion through a title and, or abstract review. Then, articles that passed the title and abstract review will be screened by reading the full texts. A descriptive mapping and synthesis of the literature will be employed to present data using the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews checklist and data will be presented in text, figure, and table formats. Ethics and dissemination The results of this scoping review will be published in peer-reviewed reputable international journals. Furthermore, it will also be disseminated through conference presentations, and popular press to the wider community. However, formal ethical approval is not required as primary data will not be collected. Strength and limitations ❖ This scoping review is going to be conducted in line with the updated PRISMA-SCR guideline. ❖ However, this scoping review is focused on the supply side and will only address the application of positive deviance at the health system, health facility, and health worker levels. ❖ Therefore, only the articles that have measured the performance and behavior of those entities either directly or indirectly in their therapeutic relationships with patients and the community will be included.