Charles Darwin's revolutionary ideas about evolution are once again making waves, but this time in a way that offers governments and other organizations a tool for overcoming systemic challenges through the evolution of the way work is done.
This positive deviance approach is grounded in a systematic process that includes identifying outliers and the specific behaviors that contribute to their success, and then scaling those behaviors across the 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, looking to internal ideas instead of external leading practices.
• Upside-down: It considers inputs from all levels of the organization's hierarchy.
• Backwards: It focuses on what is working rather than on what is broken.
Two case studies of the positive deviance approach help illuminate its power in combating a wide spectrum of vexing problems:
A stubborn hospital "superbug": 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 increased 32-fold between 1976 and 2004.
Aided by nonprofit organizations such as the Plexus Institute and the Positive Deviance Initiative, trained positive deviance researchers used infection data to track down outliers, ultimately leading the researchers to small but effective deviations in protocol that contained the spread of MRSA at hospitals, including 153 Department of Veterans Affairs facilities. Examples include nurses disposing of 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 MRSA infections by as much as 75 percent.
Burned-out prison guards: The prison environment, with its stressful conditions and psychological burdens, has historically resulted in high absenteeism and early retirement among guards. In one Danish 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 to stem this problem, such as stricter sanctions for missing work or incentives that encouraged guards to seek mental-health services, were unsuccessful.
Danish prison-system officials looking to address this problem began by observing the behaviors of resilient guards, those with five or fewer days of missed work. They found that ambiguity in inmate-intake protocols 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. Instead, the deviant guards offered inmates a tour of the prison facility and engaged them in a conversation. This small but powerful difference not only better equipped the guards to deal with the stresses and mental challenges of their jobs but also improved behavior of the inmates under their supervision, as evidenced by fewer violent threats and greater enrollment in treatment programs.
As these examples make clear, rebels with a cause exist within the fabric of various kinds of organizations. They are hiding in plain sight within the workforce, silently and slowly helping their organizations evolve. They represent an untapped resource for government leaders to jumpstart the evolutionary process within their organizations and help them solve their most challenging problems.