Ositively deviant multidisciplinary ward teams who deliver secure patient care below specifically difficult situations.Routinely collected and valid measures should be employed to identify constructive deviants.Though a lot of routine measures of safety exist, couple of are readily available at ward level (eg, mortality statistics plus the NHS employees survey).The NHS Security Thermometer (ST) is published around the Well being and Social Care Info Centre (HSCIC) at trust (organisation), specialty and ward level.Information are collected month-to-month on all acute wards for four prevalent patient harms falls, pressure ulcers, venous thromboembolism (VTEs) and urinary infections in catheterised sufferers (UTIs).These are combined to make a composite measure of `harmfree care’.While issues exist in regards to the reliability and validity of ST information, this is the only routinely collected measure of all round safety, readily available at ward level, from all NHS trusts.Furthermore the measures included are particularly pertinent to our elderly patient population.The following main analysis inquiries will be addressed .Can NHS ST data be utilized for the valid and reputable identification of positively deviant elderly healthcare wards .What strategies and behaviours do multidisciplinary teams use to deliver exceptionally protected patient care on elderly health-related wards .How do team dynamics and culture differ among elderly medical wards that provide exceptionally protected and averagely protected patient care The following secondary Alsterpaullone References investigation query is going to be addressed .To what extent do organisational, situational and person things help or hinder the delivery of protected patient care on exceptional and averagely performing elderly healthcare wards Before addressing these investigation inquiries, preliminary perform outlined below was carried out to identify a PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/21444999 sample of positively deviant and comparison elderly medical wards with exceptional ( potentially positively deviant) and slightlyaboveaverage security performances.Final results of this analysis are going to be reported completely within a separate publication.BoxInclusion criteria for `elderly medical’ wardsDedicated care for patients more than the age of years Provision of h, acute, health-related care Common patient remain exceeds h (excluding assessment units) Dedicated medical care (excluding specialty wards, eg, stroke or rehabilitation) Devoted multidisciplinary ward teammost recent months).The trust level data sets accounted for patients becoming more than the age of years and cared for in acute settings.Data have been readily available for wards and trusts.Two wards, with months of information, were excluded.Crosssectional and temporal analyses have been performed to identify positively deviant elderly medical wards with exceptional safety performances.For the month period an average efficiency for `harmfree care’ was calculated and wards have been ranked to recognize the `best’ within the region.Offered that wards are the unit of evaluation, it was necessary to limit the extent to which organisational and specialtydirectorate level variables facilitate safety.A scatterplot consequently compared ward and trust level information to make sure ward efficiency was not just a function of their respective trusts’ exceptional safety record.To assess performance over time run charts compared the monthly functionality of every single ward together with the average month-to-month efficiency across the region.Run charts were visually assessed to identify wards that regularly outperformed the regional average over the month period.Wards with slightly aboveaverage harmfree care pe.