#24 – Positive Deviance – Cherie Burke, DNP, CRNA

Cherie Burke, DNP, CRNA discusses the concept of positive deviance in healthcare.  Highlights include how to effect change as healthcare providers and the power of focusing quality improvement proactively on what goes right in an organization verses reacting to errors and negative outcomes.  Dr Burke is a practicing CRNA with nearly 30 years of clinical and teaching experience.  She holds a Doctorate of Nursing Practice from LaSalle University with her doctoral research focusing on patient safety.


Topics Discussed:

  • Positive deviance as a methodology of outcome analysis
  • Positive deviance as a professional behavior of healthcare providers
  • How to harness the power of positive deviance in anesthesia practice and education
  • The limitations and risks of positive deviance as a research tool and professional practice



“Positive deviance is really about… taking those things that people are doing right and sharing them with everyone so that everyone is doing things to improve our patient’s care, our patient’s outcome.”  Dr Cherie Burke

“We have to really encourage innovation.  We’re at a tipping point in healthcare.  We’re going to have to do major, major innovation to be successful and to survive in the healthcare arena…  Nurse anesthetists are going to have to be creative.  We’re going to have to figure out how can we continue doing high quality care with excellent outcomes, safety [and] efficiency.”  Dr Cherie Burke



Bradley, E. H., Curry, L. A., Ramanadhan, S., Rowe, L., Nembhard, I. M., & Krumholz, H. M. (2009). Research in action: using positive deviance to improve quality of health care. Implementation Science, 41-11. doi:10.1186/1748-5908-4-25\

Ford, K. (2013). Survey of Syringe and Needle Safety Among Student Registered Nurse Anesthetists: Are We Making Any Progress?. AANA Journal, 81(1), 37-42.

Gary, J. C. (2013). Exploring the concept and use of positive deviance in nursing. The American Journal Of Nursing, 113(8), 26. doi:10.1097/01.NAJ.0000432960.95762.5f

Lawton R., Taylor, N., Clay-Williams, R., & Braithwaite, J. (2014). Positive deviance: a different approach to achieving patient safety.  BMJ, 0:1–4. doi:10.1136/bmjqs-2014-003115

Prielipp, R. C., Magro, M., Morell, R. C., & Brull, S. J. (2010). THE OPEN MIND. The Normalization of Deviance: Do We (Un)Knowingly Accept Doing the Wrong Thing?. AANA Journal, 78(4), 284-287. doi:10.1213/ANE.0b013e3181d5adc5

Rosenberg, T. (2013, February 27).  When deviants do good.  The New York Times, Retrieved from http://opinionator.blogs.nytimes.com/2013/02/27/when-deviants-do-good/?_r=0

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One comment on “#24 – Positive Deviance – Cherie Burke, DNP, CRNA
  1. Rose says:

    Great podcast!!

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