Saturday, March 21, 2009

Positive Deviance.



I don't know whether you know about this already, but I read about Positive Deviance in a book by Atul Gawande.


(I was talking with a friend about how we don't ever think a original thought. We both agreed that it happens about once or twice a year, and it is soon forgotten out of apathy. But the good news is that there are lots and lots of people who do think original thoughts, and they do great things. We can learn a lot from them, even otherwise, it feels good that they are doing the thinking for us.)

Atul Gawande is a surgeon and he talks in the book, "Better- A Surgeon's Notes on Performance", about how difficult it is to get doctors and nurses to wash their hands. What with deadly MRSA (medicinenet.com), this is a big problem, and if the doctors and nurses keep their hands clean, lots of lives could be saved. But it does not happen.

Gawande writes about Pittsburgh Regional Health Care Initiative, where Paul O'Neill, the former secretary of the Treasury and CEO of Alcoa took up the challenge of making the medical professionals comply to regulations on cleanliness. Through some innovative strategies, he succeeded to some extent. But he did not succeed as well as he needed to. He quit frustrated, things went back to bad.

So, Jon Lloyd, a surgeon who had worked on the project, got thinking about this. He came to read an article about a Save the Children program to reduce malnutrition in Vietnam.  It detailed the antistarvation program run by Tufts University nutritionist Jerry Sternin and his wife Monique. Jon Lloyd thought the experience of the Sternins held a lesson for Pittsburgh.

What the Sternins found was that solutions from outsiders do not work. So they decided that the solutions have to be come from the inside. They took people to see homes where the children were healthy and well-nourished and let the people know what the more successful among them were doing. It worked. Within two years, in every village that the Sternins had been malnutrition had dropped by 65 to 85 per cent.

The Sternins called this, "Positive Deviance Approach". What they meant was that there were always people who did better than others in any group, and you could learn from these positive deviants.

So. Lloyd enrolled the Sternins to come into the Pittsburgh Program. They held discussions with small groups at every level. They did not give any directions or orders, but what they did was to ask for information what can be done. They were mining for solutions from people who were working at it. ""If we had any dogma going in," Jerry Sternin says, "it was Thou shalt not try to fix anything"."

The long and short of it is that ideas came pouring in, people learned from one another and at the end of it, the rate of MRSA infections dropped to zero.

This reads good, right? There is lots to know about this, so I am giving some links here:

(At the individual level I would like to think that if you are self-aware, and keep your eyes open, and learn from people who are doing well, chances are that you can do better- you have to be open in this, and the mindfulness part is most important, I feel).





This is the Wikipedia article on Positive Deviance.


This is the website of Pascale-Sternin, where they say the objectives of their website aims to document current applications of PD around the world, to encourage exploration of new applications though dialogue, and to help connect PD practitioners and other people interested in the Positive Deviance approach. It includes  case studies provided by the individuals and organizations using PD.


Here is a management perspective on 12 Manage The Executive Fast Track


You can find the seven characteristics of the positive deviant at The Positive Deviant Network (sampler:Passion, High Moral or Social Purpose, Seeing Holes vs. the Net, Moving Towards, Not Away, Rapid Cognition, Checking the Edges, Low Regard for Social Convention)


Excellent material is available on PDF at Harvard Business Review. It is titled "Your Company's Secret Change Agents" and is written by Richard Tanner Pascale and Jerry Sternin. It is worth exploring, I feel.

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