Darwin’s notion of “survival of the fittest” can apply to organizations as well as to species. A workforce may go through an evolutionary process driven by individuals with unusual but favorable behaviors. These successful outliers, or “positive deviants,” diverge from the norm, but their practices can result in positive outcomes and enable their survival in the workplace. Sometimes a “positive deviant” succeeds because of an intrinsic characteristic, such as an unusual strength or a particularly sharp memory. But more often, these individuals simply do things a bit differently—sometimes even bending the rules—to get work done better, faster, or cheaper.
Leaders can identify these “rebels with a cause” within an organization, figure out the specific behaviors that contribute to their success, and diffuse their wisdom across the entire workforce. The first step is to use measurable performance data to help identify outliers. Once an organization has found them, observational field studies and interviews can help uncover how they achieved success when their peers or neighbors did not. Finally, the organization can use carefully designed interventions and grassroots activities to transform positively deviant behaviors into standard operating procedures.
What Darwin can teach government
Charles Darwin challenged ancient beliefs about how we and other members of the animal kingdom came to exist. His ideas about natural selection are simple but significant—variation occurs naturally within any population, and nature will favor and spread characteristics that are advantageous within a specific environment. Over millions of years, the once unusual but beneficial traits and behaviors become common, and the evolved population improves its odds of survival.
Like a species, a workforce can go through a similar evolutionary process, driven by individuals with unusual but favorable behaviors. These successful outliers on the far right of the normal distribution, or “positive deviants,” diverge from the norm, but their practices result in positive outcomes and enable their survival in the workplace. Sometimes there is an intrinsic advantage that explains these individuals’ success, such as a special physical or mental capability. But more often they simply do things a bit differently—sometimes even bending the rules—to get work done better, faster, or cheaper.
Over time, organizations can nurture positively deviant behavior to overcome systemic challenges, and the way work is done can, in a sense, evolve. But like natural selection, this can be a slow process. The problem-solving methodology known as the positive deviance approach can offer a way to accelerate this process within your public sector organization by identifying your “rebels with a cause” and diffusing their wisdom across the workforce.
The approach is grounded in a systematic process that includes identifying positive deviants, teasing out specific behaviors that contribute to their success, and scaling them across the entire workforce. It can be especially useful when other efforts have failed to bring about the desired results, and it is more effective when the issue requires behavioral change instead of technical solutions.
This approach differs from more traditional problem-solving methods in that it is:
- Inside out—It seeks local solutions to local problems and looks to internal ideas instead of external leading practices.
- Upside down—It considers inputs from all levels of the hierarchy.
- Backwards—Unlike other problem-solving strategies, which often focus on what is broken, the positive deviance approach focuses on what is working.
The first step is pinpointing your positive deviants. This requires measurable performance data to help identify the outliers. The second step is teasing out the deviants’ replicable behaviors through structured observational field studies and interviews to discover how they achieve success when their peers or neighbors have not. Last, the positively deviant behaviors should be amplified across the workforce through carefully designed interventions and grassroots activities.
Stories of the positive deviance approach in action illuminate this method in facilitating change and show examples of how it has been used to combat a wide spectrum of vexing problems:
Focusing on the few: How careful observation of family life helped tackle child malnutrition in rural Vietnam
Jerry Sternin, a professor of nutrition at Tufts University, and his wife, Monique, embarked on a mission to end hunger in rural Vietnam in the early 1990s. Two-thirds of the children were sick and hungry, and the clock was ticking. The Sternins were given only six months to make an impact before their visas expired.
Because of these constraints, the Sternins were forced to get creative. They focused their limited time and resources on the healthy kids and, as a result, uncovered some unusual practices that explained why they were well-nourished when their neighbors were not. For example, the healthy children’s parents and grandparents were feeding them nutrient-rich sweet potato greens and tiny shrimps. These foods were accessible to everyone in the village, but it was taboo to feed them to kids. Upon discovering that such deviant behavior was contributing to better health outcomes, the Sternins spread these practices to families with sick kids. They gave them the tools and information, but did not impose the solution. Because of this assets-based, bottom-up approach, the malnutrition in the villages the Sternins visited decreased between 65 to 85 percent over a two-year period.1
The stubborn hospital “superbug”: How incidence of a deadly infection was addressed by ordinary employees innovating on the ground floor
Methicillin-resistant Staphylococcus aureus, commonly referred to as MRSA, is a dangerous infection that stubbornly resists antibiotics such as penicillin and amoxicillin. Unfortunately, the most severe and life-threatening cases of MRSA typically originate in a hospital setting. Despite efforts to reduce the infection and mortality rates of MRSA in the United States—including comprehensive educational campaigns and hygiene protocols—MRSA has been a seemingly intractable problem. Instead of decreasing, the infection rate actually increased 32-fold between 1976 and 2004.2
Figure 1. Positive deviants display unusual but favorable behaviors that can be replicated and disseminated across the general workforce.
Enter the positive deviance approach. Aided by non-profit organizations such as ‘the Plexus Institute’ and the Positive Deviance Initiative, trained researchers used infection data to track down outliers, ultimately leading them to small but effective deviations in protocol that contained the spread of MRSA. Examples include nurses disposing hospital gowns in new and unusual ways, male clinicians ditching their neckties, and priests gowning their Bibles. Once identified and scaled across the workforce, these unconventional but highly effective behavioral changes reduced infections by up to 75 percent.3
Reading between the lines: How reinterpretation of the rules helped reduce burnout and absenteeism among Danish prison workers
The prison environment, with its stressful conditions and psychological burdens, has historically resulted in high absenteeism and early retirement among Danish prison guards. In one facility, guards clocked 20 days of unannounced missed work days over the course of a year and retired at an average age of 48. Previous efforts, such as stricter sanctions for missing work or incentives that encouraged prison guards to seek mental health services, were unsuccessful.4
Danish prison system officials took this problem seriously and formed a positive deviance research team. They began by observing the behaviors of resilient guards—those with five or fewer days of missed work. They found that ambiguity in inmate intake protocol allowed for positive deviants to emerge. The rule called for guards to gather background information from new inmates, and the common approach was an interrogation-style interview. Deviant guards, on the other hand, offered inmates a tour around the prison facility and engaged them in a conversation to gather the information. This small but powerful difference gave rise to meaningful outcomes. Not only were these guards better equipped to deal with the stress and mental challenges of working inside a prison, but inmates under their supervision were also better behaved, as evidenced by fewer violent threats and greater enrollment in treatment programs.5
Call to action
As the case studies above make clear, rebels with a cause exist within the fabric of multiple types of communities and organizations. They are hiding in plain sight within your workforce today, silently and slowly helping your organization evolve. The hard part can be finding them and teasing out their unusual but beneficial behaviors.
The positive deviance approach is a tested strategy with effective applications in the areas of public health, nutrition, education, and business problems across the globe. As a government leader, you too can harness this technique to answer the question, “Who are the positive deviants in my agency, and how can I use them to help solve my most challenging problems?”
- Atul Gawande, “Better: A Surgeon’s Notes on Performance” (New York: Picador, 2008), pp. 249-258.
- Arvind Singhal and Karen Greiner, “‘When the task is accomplished, can we say we did it ourselves?’ A quest to eliminate MRSA at the Veterans Health Administration’s hospitals in Pittsburgh,” 2007, http://www.communicationforsocialchange.org/pdfs/Arvind-Greiner-Mazi12.pdf.
- Arvid Singhal, Keith McCandless, Prucia Buscell, and Curt Lindberg, “Spanning silos and spurring conversations: Positive deviance for reducing infection levels in hospitals,” 2009, http://www.positivedeviance.org/pdf/Singhal-McCandless-Buscell-Lindberg-MRSA-Performance%202009-Article-EandY-2.pdf.
- Lars Thuesen, “The secret behaviour of local heroes in the Danish Prison Service,” in Kriminal Forsorgen and Woodward Lewis, Radical problem solving approach delivers results for community and organisational issues—by revealing what is already working . . ., http://www.cambridgeshire.gov.uk/NR/rdonlyres/92567DFF-8BFA-4037-9B3A-29712E056AE2/0/PositiveDeviancecasestudies.pdf, accessed July 29, 2013.
- Lars Thuesen (Denmark Department of Prisons and Probation) interview, July 6, 2012.