Ositively deviant multidisciplinary ward teams who provide protected patient care under particularly difficult situations.Routinely collected and valid measures must be employed to recognize good deviants.Even though quite a few routine measures of safety exist, handful of are offered at ward level (eg, mortality statistics along with the NHS staff survey).The NHS Security Thermometer (ST) is published around the Wellness and Social Care Information Centre (HSCIC) at trust (organisation), specialty and ward level.Data are collected monthly on all acute wards for 4 frequent patient harms falls, pressure ulcers, venous thromboembolism (VTEs) and urinary infections in catheterised patients (UTIs).These are combined to make a composite measure of `harmfree care’.Though concerns exist about the reliability and validity of ST data, that is the only routinely collected measure of all round safety, accessible at ward level, from all NHS trusts.Additionally the measures included are especially pertinent to our elderly patient population.The following major study inquiries will be addressed .Can NHS ST data be used for the valid and reliable identification of positively deviant elderly Bax inhibitor peptide V5 Formula healthcare wards .What approaches and behaviours do multidisciplinary teams use to provide exceptionally secure patient care on elderly health-related wards .How do group dynamics and culture differ between elderly medical wards that deliver exceptionally safe and averagely secure patient care The following secondary investigation query will probably be addressed .To what extent do organisational, situational and person factors aid or hinder the delivery of protected patient care on exceptional and averagely performing elderly medical wards Prior to addressing these study inquiries, preliminary work outlined under was carried out to identify a PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/21444999 sample of positively deviant and comparison elderly healthcare wards with exceptional ( potentially positively deviant) and slightlyaboveaverage security performances.Results of this evaluation will be reported totally within a separate publication.BoxInclusion criteria for `elderly medical’ wardsDedicated care for individuals more than the age of years Provision of h, acute, medical care Typical patient remain exceeds h (excluding assessment units) Dedicated healthcare care (excluding specialty wards, eg, stroke or rehabilitation) Dedicated multidisciplinary ward teammost recent months).The trust level information sets accounted for individuals becoming more than the age of years and cared for in acute settings.Data had been obtainable for wards and trusts.Two wards, with months of information, were excluded.Crosssectional and temporal analyses have been performed to determine positively deviant elderly medical wards with exceptional safety performances.For the month period an typical functionality for `harmfree care’ was calculated and wards had been ranked to identify the `best’ within the region.Given that wards are the unit of evaluation, it was necessary to limit the extent to which organisational and specialtydirectorate level elements facilitate security.A scatterplot therefore compared ward and trust level data to ensure ward performance was not just a function of their respective trusts’ exceptional safety record.To assess efficiency over time run charts compared the month-to-month efficiency of every ward with the average monthly performance across the region.Run charts had been visually assessed to identify wards that consistently outperformed the regional typical more than the month period.Wards with slightly aboveaverage harmfree care pe.