"Quand une douleur est complètement accueillie, elle se transforme."

Anne van Stappen

Identifyng positive deviants : Modeling successful outliers

In 1991, Jerry and Monique Sternin were hired by Save The Children to create a large-scale effective program to reduce child malnutrition in Vietnam. More than 65% of Vietnamese children were malnourished at the time. Traditional approaches led to short-term changes but were not sustained after aid workers departed.

Working with 4 communities and 2,000 children under the age of 3, the Sternins invited the community to identify poor families who had managed to avoid malnutrition despite all odds, facing the same challenges and obstacles as their neighbors and without access to any special resources. These families were the positive deviants. They were "positive" because they were doing things right, and "deviants" because they engaged in behaviors that most others did not.

The Sternins and the community discovered together that caregivers in the Positively Deviant families collected tiny shrimps and crabs from paddy fields, and added those, along with sweet potato greens, to their children’s meals. These foods were accessible to everyone, but most community members believed they were inappropriate for young children. The Positively Deviant families were also feeding their children three to four times a day, rather than twice a day, which was customary. But the children, malnourished as they were, could not take is such big meals.

After this discovery, the rest of the community was encouraged to change their behavior to match that of the positive deviants, resulting in a rapid decrease in malnutrition in that village. The new patterns rapidly spread throughout the country and persisted, unlike previous relief and change efforts.

The point : Discovering solutions that already exist in the context may lead to better implementation and longer-term adoption of the solution. It is not an imposed solution from outside the organization, but is native to the environment.

This leads to an experiment you might try that help you make changes in any organization of which you are a part.

1. Find people that are more effective in some way or have solved or avoided some problem you or others routinely encounter and haven’t done well with.

2. Study or model them to discover what you can extract from them.
When I was in a group private practice, most of us had problems collecting all the fees we were owed for our work. One of us, however, had close to 100% fee payment. I stationed myself near the receptionist/checkout desk and listened and watched what he did. I discovered that he consistently said a certain phrase as he handed the bill/chart to the receptionist/cashier. he turned to his client and asked : Would you like to pay by cash, check or credit card today ?

3. Spread the solution to others.
You could shoot a video of the person dealing with the situation or person ; you could make a checklist of effective or important steps or actions ; you could just initiate a discussion of the subject and the new possibility ; you could have someone "shadow" the person who does things well to model them. Use your imagination.

Of course, you could adapt this same idea to your own life or your relationships.

I am sure you can come up with other variations on this theme. Let me know and maybe I’ll try them or add them to this list.


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