Meet Jasper Palmer – he’s positively deviant

"You are saying that within virtually every group there are individuals whose behavior enables them to get better-than-average results and that these individuals have discovered pathways to success for the rest of the group.

“That's contrary to a particularly potent and usually unquestioned assumption in the field of education - and perhaps in other fields as well – that the solution to problems must come from the outside because those on the inside either don't know enough to improve things or don't have the will to do the hard work of change.”

The long lead-in is from a conversation published in 2004 between Dennis Sparks director of the US teachers' National Staff Development Council and the late Jerry Sternin, originator of "positive deviance," the antidote to authoritarian problem-solving.

That year, Sternin and his wife Monique's work at Tufts University, Massachusetts, was being noticed for its usefulness in Vietnam in efforts by Save the Children and others to rescue the rural infant population from chronic malnutrition.

"Experts told us that malnutrition was caused by food distribution patterns, illiteracy, poor sanitation, the role of women in society, and so on," he told Sparks’s Journal of Staff Development [1]. But it turned out that in the lives of the “positive deviants” in those communities, none of the cultural factors made much impact. They and their families were relatively well nourished because they went against the grain of local custom by allowing their children to eat seafood.

The positive deviance view of the value of peripatetic scientific expertise (similar in some respects to the one inherent in “operating systems” such as Communities that Care) is that it should be an illuminating, facilitating force on the side of emergent properties [2].

By investigating unusual success, it brings to the light what is already known locally but unrecognized. UNICEF, Peace Corps, USAID, and the World Bank among others, have used it in their attempts to escape the post-colonial dilemmas that still bedevil their work.

Sternin told Sparks: "My experience in over 12 years of working with this particular approach and more than 30 years of experience in the development field is that improvement may occur when an external agent brings new resources and ideas to a community. But as soon as that external agent leaves, the problem returns because the recipients were essentially passive. This is why best-practices approaches usually fail."

Such problems are all too familiar to prevention science, witness the increasingly complicated arguments about fidelity and Type 2 translational research.

In the context of "positive deviance" projects, the paradoxes are similar: to empower a community and disable the authoritarian prejudices of the expert, you probably need … an expert trigger. Jerry Sternin died towards the end of last year just as his Tufts Positive Deviance Initiative [3] was being funded well enough by the Ford Foundation to be able to extend its activity.

One result of that posthumous expansion has been to bring positive deviance theory to the UK, where it is being trialled by Woodward Lewis [4], a consultancy working widely across the public service sector and specializing in team building.

Their engagement with a community safety partnership in Gosport, Hampshire, which earned coverage in The Guardian [5], last week, is looking for the "positive deviants" among families whose innate good practice may provide some answer to the antisocial behavior problems of the wider population

If they do it by the book, partner Jane Lewis’s team will determine - meaning identifying individuals in the community who already exhibit the desired behavior or status - and discover - learning the unique practices or behaviors that enable positive deviants to outperform or find better solutions to problems than others.

Capturing that restless, uneasy Honda effect

This descent into alliteration obscures something edgier in the underlying thinking. Sternin was a longtime collaborator with his friend, ex-McKinsey consultant turned management guru, Richard Pasquale, who was among the first to acknowledge and commend the achievement of positive deviance in Vietnam.

"Positive deviance does not impose a nutritional solution,” Pasquale wrote. “Rather, this model relies on scaling up a solution that is already working in the community. The design was aimed to discover what was already working against all odds, rather than engineering a solution based on an external formula."

Pasquale also has connections with Woodward Lewis in the UK and it is his reputation as a student of Japanese business management and as the identifier of the "Honda effect" that connects positive deviance to broader notions about the unusual dynamics operating inside genuinely creative organizations.

The Economist [6] said of him last December: “Much of his writing has addressed this idea of agility. Honda, he said, exists ‘in a sort of restless, uneasy state, which enables it to get a great deal out of its people.’”

In Surfing the Edge of Chaos: The laws of nature and the new laws of business Pasquale set out four “commonalities” which allowed a resemblance between large organizations and complex scientific systems:

• prolonged equilibrium in either is a precursor to death
• innovation occurs close to the edge of chaos
• all living things demonstrate a capacity for self-organization
• when you tamper with living things, you face the law of unintended consequences.

Complexity and chaos theories were all the rage when he wrote the book. Positive deviance has since succeeded in demonstrating something of the practical value of its implications, for instance in its efforts to tackle MRSA infections in US hospitals, reported in The New York Times magazine [7] last winter, shortly before Sternin’s death from cancer.

From whence, at last, comes the report of the case of Jasper Palmer:
“A nurse at the Albert Einstein Medical Center in Philadelphia noticed that an orderly named Jasper Palmer had choreographed a safe and ingenious method for removing an M.R.S.A.-exposed hospital gown and sealing it inside his latex gloves.

“Without the hospital’s positive deviance initiative, the Palmer Method, as it’s now known, might have been overlooked as eccentricity rather than innovation. It’s a modest bit of proof that we might do well to solve problems by thinking about how we act, Sternin remarks, rather than acting upon how we think.”