The Power of Positive Deviance by Richard Pascale Jerry Sternin Monique Sternin & Jerry Sternin & Monique Sternin

Author:Richard Pascale, Jerry Sternin, Monique Sternin & Jerry Sternin & Monique Sternin [PASCALE, RICHARD]
Language: eng
Format: epub
ISBN: 9781422110669
Publisher: Harvard Business School Publishing Corp (Perseus)
Published: 2010-06-16T04:00:00+00:00

Making Change Stick

Grasping that something momentous was unfolding, yet aware that the PD MRSA initiative could rapidly dissipate as the “flavor of the month,” Dr. Lloyd sought to consolidate the beachheads of early success. Staff had seen many hospital campaigns ebb and flow. This time, making change stick could not be left to chance. Accordingly, ideas captured during the DAD sessions needed to be acted upon immediately, and feedback loops confirming results achieved needed to reach every corner of the hospital. Changing the emphasis of the sessions from discovery to action had this effect. Facilitators drilled down when ideas surfaced. “Great idea! What would it take to do that in this unit? Is there anyone who wants to volunteer to take those steps? Can you do it alone, or do you need help? Is there anyone who needs to be part of that decision who isn’t here in this group now? How do we get her to the table?” After a few tentative efforts, the facilitators mastered the “question as catalyst” technique. They came out of most sessions with milestones for future deliverables.

Evidence of action convinced people throughout the hospital that the PD initiative was not business as usual. The news spread rapidly. Elimination of MRSA became prominent in staff awareness. As mindfulness emerged, new solutions began to pop up in likely as well as unlikely places. Acting on these new practices quickly transformed initial discoveries into habit. This went a long way to sustaining the initial buzz.

Does the inclusion of “latent PD” blur the distinction between brain-storming, appreciative inquiry, and other participatory approaches? The simple answer is yes. But a fastidious or academic desire to differentiate the PD process must give way to pragmatic adaptation.

At the core, the distinguishing property of the PD approach is its focus on discovering positive variants in a community and mobilizing people to disseminate and integrate superior practices into the cultural DNA. PD interjects an internalization strategy into the traditional process of discovery. Clearly, reaching beyond preexisting variants and generating new approaches extend beyond the core concept. But essential aspects of the PD process (the community’s and individual’s decision to opt in or opt out, taking ownership of the process, investing sweat equity in mapping common practices and outcomes, discovering preexisting PDs, designing an action learning approach to spread discoveries to others) remain intact. Experience in Pittsburgh was taking on a life of its own. Ideas, previously held back, were put forward. Innovations became commonplace because people were paying more attention to the MRSA transmission problem and experiencing an idea-friendly climate, as the next four examples illustrate:

Fred, a reticent Hong Kong–born physical therapist, realized that both MRSA-infected and uninfected patients were using the same equipment without his department knowing who was who. This resulted in his request for a MRSA patient list and the creation of a new protocol for working with them and the equipment they used. This example captures how the PD focus on “solutions from within” leverages existing but underutilized resources.

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