How ‘positive deviants’ help a culture change itself

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Adoption of social business tools and practices is a recurrent issue. Here’s one theme we hear a lot: a company wants to roll out a new set of social tools and get everyone on board, so they hire an outside consulting firm to help in the transition. Nonetheless, after six months only 37% (or some other discouragingly small percentage) of the company are using the tools on a daily basis.

What’s gone wrong? Well, the backlash to major initiatives to impose large-scale change in many organizations is something like an immune response. The organism attempts to remain as it was before the infections, and will attack the outside agents that are destabilizing the existing homeostasis.

It turns out that this sort of rejection of outside influence is a widespread cultural phenomenon. However, some techniques have been developed that can counter this cultural rejection to behavioral change. One in particular, positive deviance, has been shown to work in many contexts.

The name suggests something sinister or unsavory, but it simply means looking for examples in a population that have already demonstrated adoption of the desired behavior, and having others learn from those ‘deviants’. In this approach, outsiders do not attempt to train members of the population in the new behaviors, or even stipulate exactly what the new behaviors are. It is outcome focused, rather than proscriptive.

In a recent article, Tina Rosenberg characterized the positive deviance approach:

Here’s how the positive deviance approach is different:

* Outsiders don’t bring in ideas to change a community’s culture. Instead, they ask the community to look for its own members who are having success. Those local ideas, by definition, are affordable and locally acceptable — at least to some people in the community. Since they spring from a community’s DNA, the community is less likely to feel threatened by these ideas and more likely to adopt them.

* The focus is not a community’s problems, but its strengths.

* Outsiders don’t design a communication or training strategy to teach the idea. Outsiders can bring people in the community into one room, but local people design a way to spread the new behaviors.

* Local leaders are not the ones who come up with solutions. That is the job of everyone on the front line dealing with the problem. The leaders’ job is to facilitate the process of finding and spreading these solutions.

* Outsiders don’t monitor success. They show people in the community how to do that.

Here’s an example: the Pittsburgh V.A. Hospital wanted to cut the rate of MRSA — the drug-resistant staph infection —  and older management techniques to do so, specifically, the Toyota Production System, had failed. John Lloyd, a Pittsburgh surgeon had read about positive deviance, and that led to a trial at the hospital, where those staff members who were positive deviants — people recognized by others as demonstrating behaviors that would decrease MRSA’s spread — were asked to brief others on what they did differently. This led to the unusual scene, in an extremely hierarchical culture, of a deviant housekeeper briefing doctors on anti-infection ideas.

Again, from Rosenberg’s article:

Six months later, the infection rate had fallen by more than half, and the gains did not go away. (Since this was not a randomized control trial, there’s no way to know how much of the gains came from the use of positive deviance.) The V.A. then adopted these changes in virtually all its hospitals, recommending that hospitals use the positive deviance approach and offering training in it. From October 2007 to June 2010, MRSA infections in intensive care units at the 153 V.A. hospitals in the program dropped by 65 percent; in nonintensive care units they dropped by 45 percent. (Again, we don’t know if the intervention can take credit, although it is significant that there had been no change in MRSA infection rates during the two years before the intervention.)

Pittsburgh’s experience, ultimately successful, also shows why positive deviance can fail. “It’s particularly difficult for donors who want to have a clear sense of what outcomes will be,” said Roger Swartz, the executive director of the Positive Deviance Initiative. Donors have solutions they like, and they will finance programs that use those solutions. But with positive deviance, you don’t know what the solution will be; it has to emerge as part of the process.

The approach can also be threatening to people at the top. They are used to being the experts, but with positive deviance, it’s the people in the field who are the experts. In hierarchical institutions like hospitals, housekeeping staff members do not usually brief physicians. But where managers can accept revolutionary new ways of doing business, positive deviance can succeed. “I don’t know how this is going to work,” the Pittsburgh V.A. chief Rajiv Jain told his workers when they began the program. “But I have total confidence that you as the front line staff will know.”

Incredibly valuable lesson here: a distant analogy applicable in all fields, not just hospitals or health care. The first point of failure is that people don’t want to change their own behavior. Doctors — those theoretically most well-trained — were the worse offenders. And the attempt to impose a new order from outside failed. What worked was finding those inside the culture that already were positive deviants, and having their methods shared and adopted.

The role of consultants and leaders is to channel this, to find the outliers with positive deviance, not to dictate behaviors. And the pushback to this approach is from management that wants a deterministic approach with predictable results, even if that leads to high rates of failure.

As Eric Bonabeau once said, management will continue to use techniques that don’t work, instead of adopting techniques that they don’t understand. But the evidence from the V.A. Hospital system and dozens of other examples is irrefutable.

So, in your social business adoption project, don’t tell people how to be more social specifically. Find the people who are naturally becoming more social, have them share what they are doing with others. Spread the lessons of the positive deviants, and the culture will change itself.