This month, our featured PD Champion is Dr. Dirk Schroeder, co-founder of HolaDoctor. Dr. Schroeder is an expert in global health and a former tenured Associate Professor at Emory University’s Rollins School of Public Health. Dr. Schroeder has been working with Positive Deviance for over 15 years, including co-directing a large randomized trial of PD in Vietnam and, more recently, using the Positive Deviance approach with Hispanic diabetics in the U.S. During this interview, Dr. Schroeder discusses the PD proejcts he has been involved in and where he sees the future of PD and the obstacles that need to be overcome so that the full potential of PD may be realized.
Dr. Dirk Schroeder
Jerry Sternin Speaking at Glasgow Centre for Population Health in 2006
Length: 96 minutes
In November 2006, Jerry Sternin gave a presentation about Positive Deviance to the Glasgow Centre for Population Health in Scotland. We recently re-discovered the audio recording of this presentation, which includes Jerry describing the PD process, sharing four detailed stories about application of the approach, and explaining the concepts underpinning PD. The audio clip is over 90 minutes long, and captures Jerry’s vibrant way of telling PD stories and explaining the approach in a clear and engaging manner. A summary of the presentation, as well as a transcript, are available here: http://www.gcph.co.uk/events/30
Audio Interview with Dr. Arvind Singhal
Length: 23 minutes
I recently interviewed Dr. Arvind Singhal who describes himself as a sense maker and amplifier of positive deviance. Dr. Singhal is currently the Samuel Shirley and Edna Holt Marston Endowed Professor of Communication and Director of the Social Justice Initiative at the University of Texas, El Paso. Dr. Singhal has been involved with the in-depth documentation of the positive deviance approach in MRSA prevention and control at the VA hospital system in Pittsburgh and the Billings Clinic in Montana. Dr. Singhal has also co-created six PD Wisdom Series publications in collaboration with the PDI, as well as three short PD films which are featured on the PDI website. Dr. Singhal has served as a co-facilitator of numerous PD meetings, has guided several graduate theses on positive deviance, and has raised the "volume" on PD in his courses, lectures, and keynotes in the past six years. Dr. Singhal has also published a string of academic articles related to PD including the most recent article in Health Communication, Communicating What Works! Applying the Positive Deviance Approach in Health Communication. Singhal is co-author or editor of 11 books, including two books related to PD - Protecting Children from Exploitation and Trafficking: Using the Positive Deviance Approach (2009) and Inviting Everyone: Healing Healthcare through Positive Deviance which was published in 2010. Dr. Singhal will be a featured guest lecturer in the first PD Certificate course, "Positive Deviance: Theory, Method, and Process," which begins in January 2011. In this interview, Dr. Singhal discusses how he was introduced to PD, explains the PD projects that he has been (and is currently) involved in, and shares his ideas about the future of PD.”
Dr. Arvind Singhal
Using the PD approach to address hand hygiene compliance at Hospital Israelita Albert Einstein in São Paulo, Brazil
Date: December 2010
I recently interviewed a team from Hospital Israelita Albert Einstein in São Paulo, Brazil, including Jose Aparecido de Souza Junior “Junior” (physical therapist), Rita de Cassia Ribeiro de Macedo (nurse coordinator – 8th floor SDU), Luciana Reis Guastelli (nurse coordinator – 7th floor step-down unit), and Alexandre R. Marra (doctor). The team at Hospital Israelita Albert Einstein is currently using positive deviance as a strategy for improving hand hygiene compliance and reducing hospital acquired infections. In January 2010, the team published an article entitled, "Positive Deviance: A New Strategy for Improving Hand Hygiene Compliance" in Infection Control and Hospital Epidemiology, which showed that the positive deviance strategy yielded a significant improvement in hand hygiene, which was associated with a decrease in the overall incidence of HAIs.
I conducted this interview with the help of Luciana Perdiz, who helped to translate the Portuguese portions of the interview. I have separated the portions of the interview by individual questions. A full transcript of the interview in English is available here. During the interview the team shares how the project began, how the PD process has been useful in promoting hand hygiene compliance, and how the PD process is changing the dynamics of the hospital.
(English) Dr. Alexandre Marra explains how the hospital was introduced to the PD approach
Dr. Alexandre Marra explains how the hospital was introduced to the PD process and why they thought that the PD process should be implemented to address hand hygiene.
(English) Dr. Alexandre Marra summarizes the concept of “my 5 moments”
Dr. Alexandre Marra explains the concept of “My 5 moments for hand hygiene” which was developed by the World Health Organization (WHO), and explains that it is not enough to simply provide alcohol gel to hospitals around the world that may not have had access to it – the process also involves behavior change on behalf of the staff who will use the product, which is where PD comes in.
(English) Dr. Alexandre Marra explains why the PD approach is so useful
Dr. Alexandre Marra explains that the PD approach is useful because it increases the accountability of the healthcare workers and the staff members feel that it is a privilege to be considered a positive deviant. The healthcare workers are very proud to be able to contribute their ideas about hand hygiene compliance and the alternative ways to address the issue. Dr. Marra shares some examples of the ideas that the healthcare workers in the hospital have come up with.
(English) Junior explains the PD process
Junior, a physical therapist at Hospital Israelita Albert Einstein explains how the PD process works at the hospital and how valuable it is to have staff members from all departments involved in the process and contributing their own ideas.
(Portuguese) Rita describes the development of the project
Rita de Cassia Ribeiro de Macedo (nurse coordinator – 8th floor SDU) explains how the process of implementing PD began on the 7th floor step-down unit and eventually spread to the 8th floor team. Rita discusses the process of the teams developing ownership of the process and the great moment that the healthcare workers realized that the reduction in hospital infection rates was a result of their work.
(Portuguese) Rita shares how the PD approach has spread to other units in the hospital
Rita de Cassia Ribeiro de Macedo (nurse coordinator – 8th floor SDU) explains how the PD process has spread beyond just hand hygiene to include several infection control practices in the hospital. Rita also explains that other units in the hospital are interested in using PD and it is being widely disseminated. Rita also shares that healthcare workers are disseminating the PD idea through songs and plays.
(Portuguese) Luciana explains the ultimate goal of the project
Luciana Reis Guastelli (nurse coordinator – 7th floor step-down unit) explains why the project to implement PD began and the ultimate goal of the project.
(Portuguese) Luciana explains why she thinks the PD approach is so useful
Luciana Reis Guastelli (nurse coordinator – 7th floor step-down unit) explains why she thinks the PD approach is so useful and how the approach creates an environment that is conducive to discussion and awareness about hand hygiene.
(Portuguese) Luciana describes how the hospital staff maintains enthusiasm about the process
Luciana Reis Guastelli (nurse coordinator – 7th floor step-down unit) explains how the team keeps the PD process active and keeps people interested by celebrating successes, creating buttons and T-shirts with slogans like, “we wash our hands, do you?”
Audio Interview with Dr. Gretchen Berggren
Length: 37 minutes
Date: October 2010
This month I interviewed Gretchen Berggren M.D., M.Sc.Hyg , who along with her husband Warren Berggren, M.D., Dr.P.H, and many Haitian colleagues*, played a large role in developing the PD Hearth Model and the use of positive deviance in Haiti. In this interview, Dr. Berggren shares how the use of the PD Hearth model began in Haiti, how it continues to be used there today, and what she thinks make the PD approach so useful.
*The "we" which Gretchen refers to in this interview includes Warren Berggren M.D., Dr.P.H , Dr. William Larimer Mellon, Jr., founder of the Hopital Albert Schwetizer in Deschappelles, Haiti, as well as their Haitian colleagues: Dr William Fougere, head of Haiti's "Bureau de Nutrition", under the Haiti's Ministry of Health, and public health field workers including Dr. Jean Adrian Hilaire, Dr. Eddy Genece, Dr. Henry Menager, Dr. Jean Dieudonne, Dr. Bottex, Haitian sociologist Calixte Clerisme, and dietician/nutritionist Mireille Henry. With their help, all of their findings were first shared with the Ministry of Health of Haiti. Later, Michaelle Amadee-Gedeon,M.D., M.P.H., a Haitian nutritionist, co-authored a booklet with Dr. Berggren on the "Centres de Rehabilitation Nutritionelle d'Haiti", MIT Press. More recently, results were described in Chapter 7 ("People, Processes and Indicators") in a book entitled "Community Health Based Care: Lessons from Bangladesh to Boston", Jon Rohde & John Wyon, ed., published by Management Sciences for Health, in collaboration with the Harvard School of Public health, Boston, 2002.
Dr. Gretchen Berggren
Audio Interview with Dr. James Levinson
Length: 16 minutes
This month we interviewed James Levinson, Ph.D who has used the PD approach to address maternal health in Egypt and to address childhood malnutrition in Bihar, India. Dr. Levinson was introduced to the PD approach by Marian Zeitlin, and he played a large role in introducing Jerry and Monique Sternin to Tufts University, where they founded the Positive Deviance Initiative. In this interview Dr. Levinson talks about the PD projects that he has been involved in, and also discusses what makes the PD approach so unique and how the approach fits into the world of international development. Dr. Levinson describes the PD approach as “such a natural idea on so many fronts” and comments that “People who really are essentially opposed to top-down development gravitate immediately to PD and people who are simply looking for effective, quick answers to complicated problems turn to PD and get good answers and good information that they can really use.”
Positive Deviance project to reduce social isolation and the 25 year life span disparity among patients with severe mental illness
Length: 11 minutes
This audio clip features Paul Freund who has been working with Dr. Jon Lloyd on an application of Positive Deviance to the problem of social isolation and the life span disparity of 25 years for people with serious mental illnesses. The project, which began in the Fall of 2009, is based in the community McKees Rocks in Pittsburgh, PA. The project is being supported by the National Alliance on Mental Illness (NAMI). In this interview Paul discusses how the project began, what the expected outcome of the project is, and why Positive Deviance is the approach being used to tackle this issue.
Featured guest Richard Pascale, associate fellow of Said Business School at Oxford University and coauthor of The Power of Positive Deviance, is interviewed on the Harvard Business Review IdeaCast by Sarah Green.
Great Work Interview:Jerry Sternin
Michael Bungay Stanier interviews Jerry Sternin about his "Great Work"
Length: 28 minutes
Michael Bungay Stanier, founder and Senior Partner of Box of Crayons, conducts interviews with “great” people about their views on “great work.” The goal of Box of Crayons is to help organizations “do less Good Work and more Great Work.”
Michael conducted this interview with Jerry Sternin, co-founder of the Positive Deviance Initiative. During the interview Jerry and Michael discuss:
·the origins of PD in Vietnam in 1990 – and how a crisis gave birth to a new approach to change
·cover the broad principles of PD – simple and powerful
·dig down into some of the counter-intuitive genius of PD – including how you look for people least likely to succeed to findthe seeds of future success
·how accountability was a positive force for change and success
Positive Deviance: A Unique Approach to Behavior and Social Change
Alexandra Tung, host of Nutrition Talk, discusses the Positive Deviance approach and its applications with guests Monique Sternin, co-founder of the Positive Deviance Initiative (PDI) and Randa Wilkinson, Director of Training for the PDI.
Length: 55 minutes
Monique Sternin discusses the concept of Positive Deviance (PD) and shares her first experience using the PD approach in Vietnam to address the issue of childhood malnutrition. Randa Wilkinson discusses why PD has been described by others as "the cutting edge of common sense" and also shares her experiences using the PD approach to address goiter in West Java, Indonesia, as well as increasing access to healthcare for the Waria in Indonesia. How to be trained in using PD is also discussed. To access more Nutrition Talk Radio, click here.
This article, recently featured in Clinical Leader, discusses healthcare-associated infections and outlines the specific steps of the PD process that some pioneering hospitals are taking to reduce transmission.