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Positive deviance is an asset-based improvement approach. At its core is the belief that solutions to problems already exist within communities, and that identifying, understanding, and sharing these solutions enables improvements at scale. Originating in the field of international public health in the 1960s, positive deviance is now, with some adaptations, seeing growing application in healthcare. We present examples of how positive deviance has been used to support healthcare improvement. We draw on an emerging view of safety, known as Safety II, to explain why positive deviance has drawn the interest of researchers and improvers alike. In doing so, we identify a set of fundamental values associated with the positive deviance approach and consider how far they align with current use. Throughout, we consider the untapped potential of the approach, reflect on its limitations, and offer insights into the possible challenges of using it in practice. This title is also available as Open Access on Cambridge Core.

Health services administration. --- Health administration --- Health care administration --- Health care management --- Health sciences administration --- Health services management --- Medical care --- Health planning --- Public health administration --- Administration --- Management

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Alcuin’s De Animae Ratione explains how the tripartite soul facilitates the perception of distant people and places. Perception is facilitated through mental images, built from experience of the bodily senses. Alcuin illustrates the differences between the perception of a known or unknown place with an analogy, using Rome and Jerusalem as examples. Texts that reflect the cityscape of Rome, and the people associated with the cityscape, would have been an important medium through which distant readers perceived Rome. Three such types of text are papal letters, pilgrim itineraries and syllogae collections of inscriptions. These were often composed in Rome but read elsewhere. The materiality of these texts would have had an influence on the perception of Rome that was possible for their readers. However, the extant historiography of these three types of text has rarely considered the message in the medium through which their earliest readers accessed them. This thesis focuses on the early manuscript witnesses of these texts to explore the perception of Rome possible for their readers. These early manuscript witnesses are interpreted via application of Alcuin’s explanation of perception of place in his De Aminae Ratione. Each chapter focuses on one or two core manuscripts. The first chapter will examine the dissemination of Alcuin’s De Animae Ratione, by conducting a detailed analysis of the ninth-century manuscript copies. Chapters 2, 3 and 4 each focus on one key manuscript containing an early copy of one or more of the topographical texts. Chapter 5 will examine how papal letters and epitaphs are displayed in the earliest surviving manuscripts of Bede’s Historia Ecclesiastica Gentis Anglorum. These manuscripts provide a route into understanding the circulation, reading experience and impact of these texts as they were accessed by their earliest readers in England and Francia.