Dave Snowden

Being Smarter-The Plexus Institute Story

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Marian Zeitlin, Jerry Sternin and his wife, Monique are, without a doubt, true geniuses. I would urge all of you to read their stories: http://www.fastcompany.com/magazine/41/sternin.html They are stories of simple realizations that, once implemented, had massive nonlinear results. To anyone interested in understanding an “attractor” and how amplification of a positive attractor can have immense significance, read on.

A Tufts University nutritionist, Dr. Zeitlin used the term “positive deviant” in the book, “Positive Deviance in Child Nutrition”, authored with Hossein Ghassemi and Mohamed Mansour http://www.bvsde.paho.org/texcom/nutricion/posdev.pdf. While studying malnutrition in Africa, the authors were struck by the fact that some children seemed to be doing quite a bit better than others. These were the “positive deviants”. The adaptive child care and feeding behaviors of these children, as well as the social networks that supported them, were studied. Life in the village was a Complex Adaptive System, and these people had adapted very well. The genius of Zeitlin and the Sternins was to realize that the key was to identify what was going right for those children and amplify it, instead of focusing on what was going wrong with the rest of the community and trying to fix it: http://www.positivedeviance.org/about_pdi/history.html In other words, they understood the value of amplifying a positive attractor instead of trying to impose order!!

To quote from the Fast Company article:

“The traditional model for social and organizational change doesn’t work,” says Sternin, 62. “It never has. You can’t bring permanent solutions in from outside.” Maybe the problem is with the whole model for how change can actually happen. Maybe the problem is that you can’t import change from the outside in. Instead, you have to find small, successful but “deviant” practices that are already working in the organization and amplify them. Maybe, just maybe, the answer is already alive in the organization — and change comes when you find it.

Could this produce nonlinear results? You be the judge: The Sternins started the positive deviance program in 4 villages in Vietnam. After succeeding there, they took it to 14 more. Graduates of this “university” ultimately took it to 265 villages, reaching 2.2 million people. In the last decade, positive deviance has been applied to malnutrition in more than 20 countries through Save the Children. I’d say they are on to something there!

Although Jerry Sternin unfortunately passed away in 2008, the extremely positive effects of his work continue on. When he died, he had been working with the Plexus Institute under a grant from the Robert Wood Johnson Foundation on using positive deviance to decrease the transmission of healthcare associated MRSA (methicillin-resistant Staphylococcus aureus) infection. The final report can be downloaded from the Plexus Institute website: http://www.plexusinstitute.org/ideas/show_elibrary.cfm?id=1205

In a cooperative study using the positive deviance approach, the aggregate decline in healthcare associated MRSA rates at the institutions was 73%! The institutions were Albert Einstein Medical Center, Philadelphia, The Billings Clinic, Billings, Franklin Square Hospital Center, Baltimore, University of Louisville Hospital, Louisville, The Johns Hopkins Hospital, Baltimore and the VA Pittsburgh Healthcare System, Pittsburgh.

The messages of the study were: Guidelines to NOT change behavior. Attractors do. Order can not be imposed on a Complex Adaptive System. It must emerge. Nonlinear change is indeed possible. Being smart is good.

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