Ideas drive action, attitudes and behavior, and there’s nothing like stories to unfurl ideas and let them flourish.

Aesop’s Fables , believed to have been written by a Greek slave sometime around the Sixth Century BCE, has been named one of the world’s most influential books by The New York Public Library and other scholarly sources that offer such opinions.  It’s a collection of stories meant to deliver cautionary tales and moral lessons. The enduring influence of these ancient fables on literature and life is illuminated by the expressions we still use today: “wolf is sheep’s clothing,”  “the boy who cried wolf,” the “goose that laid the golden eggs,” “sour grapes,” and “out of the frying pan into the fire,” among many others.

On the Origin of the Species, published in 1859, in which Charles Darwin detailed his extraordinary observations and discoveries in the Galapagos Islands, introduced Darwin’s visionary ideas of evolution and natural selection that continue to have profound reverberations in science, politics and religious discourse today. Stories from novels, essays and endless news cycles have an even greater influence today on the opinions and public policies on spending, healthcare, war, human rights, and the functioning of civil society.

Stories from the business world have impelled changes in corporate behavior and practices and the lives of working people.  Bill Gates and Warren Buffett have both said their favorite business book is Business Adventures by John Brooks, published 50 years ago.  Its relevance lives on in the vividly told stories of 12 of the most prominent businesses in Twentieth Century America, and the human lessons learned in their triumphs and struggles.

Stories Seen through a Complexity Lens

The idea of the clockwork universe arose with the Enlightenment and the Industrial Evolution. It supported the notion that humans and their organizations operate like mechanical clocks with identifiable parts, ticking away in regular rhythm in predictable ways governed by the laws of physics.  In businesses and organizations, the iterations of the clockwork view dominated for two centuries and remnants of those notions linger today.

The mechanistic metaphors could not address the systemic conditions that emerged from unpredictable change and what scientists began to identified as chaos.  Complexity science quickly established itself as s distinct scientific discipline, focused on a rigorous approach to how order and novelty emerge in the world. This new science was built on a different set of ideas and assumptions, which emphasized looking at human organizations as “systems” which are comprised of many interdependent and interacting parts that continually create new iterations when they interact. For organizations, the new ideas stressed the vital importance of relationships, the need for adaptation and the embrace of uncertainty.

As history has taught us, one of the most compelling ways to convey ideas is through illustrative stories that capture attention and inspire imagination.  Neuroscientists now know the human brain is hard wired for stories , and stories are an important element of complexity thinking and presentation.

Plexus Institute, in its early days, began collecting and studying stories of how complexity principles played out in organizations, communities, and among groups of people working together. A nonprofit founded in 2001, Plexus Institute has continued to collect and assemble complexity stories and complexity case studies that depict how complexity principles work in organizations and communities, and how complexity informed practices can foster new achievements of goals in many fields.

Many of these complexity stories are now available at Plexus Institute.  Early stories include narratives of achievement at hospitals, where pioneers in complexity thinking guided new approaches to such age-old issues as hand-hygiene among staff and aiding healthier outcomes for newly discharged patients.  One hospital, for example, used a complexity approach on medical reconciliation—the effort to help patients continue their medical regimes accurately after they have left the hospital.   Many such efforts produced improved relationships among staff, patients and communities. Some documented identifiable culture change.  There are also stories about experiences of individuals who learned and fostered complexity ideas and thinking in their work lives.

Complexity case stories explore projects and new models, practices and applications developed and led by Plexus Institute.  The Positive Deviance (PD) and Adaptive Positive Deviance (APD) models serve as early examples of how Plexus applied the principles of complexity to address specific difficult and previously intractable challenges in complex environments.

Early projects at Plexus focused on healthcare organizations, which have long struggled to combat spread of healthcare associated infections, resulting in unnecessary suffering and death and adding billions of dollars to healthcare costs. In 2006, The Robert Wood Johnson Foundation gave Plexus a $294,000 grant to use PD to eliminate spread of MRSA infections in healthcare organizations. The project began in six large hospitals in the US and two in Colombia, and successful practices eventually spread to 40 hospitals.  As Curt Lindberg, one of the founders of Plexus Institute and a pioneer of using PD in healthcare explained it, PD, a behavior change process, was a way to help all staff members establish the habit of following known infection control protocols at all times.  Using PD, staff members also discovered new practices and new ways of adhering to established protocols.  MRSA infections in all the pilot hospitals were dramatically reduced, and stories of individual hospitals tell how the gains were won, and how hurdles were confronted and overcome.   Complexity case stories also show how the use of PD helped in healthcare issue well beyond infection control.

In 2012, Plexus Institute received a $2.1 million grant from The Bill and Melinda Gates Foundation for a three years project in California’s Long Beach Unified School District, to use Adaptive Positive Deviance to help educators continually improve and foster better outcomes among their students.  STEP: The Supporting Teacher Effectiveness Project is the subject of a complexity case story, describes the work, and APD in education is the topic of other stories in Plexus manuals and educational publications.

Contributed by Prucia Buscell, a freelance writer and editor who was  formerly communications director at Plexus Institute. Before joining Plexus in 2001, she was a newspaper reporter and copy editor. Prucia can be contacted at prucia@gmail.com

Work with Adaptive Positive Deviance

APD & MRSA

Eliminating MRSA Infections Plexus MRSA Bundle: The HOW of Staff Engagement and Culture Change (ppt) or smaller pdf with notes.

Inviting Everyone: Healing Healthcare through Positive Deviance by Arvind Singhal PhD, Prucia Buscell, Curt Lindberg DMan

The MRSA Reduction blog – An Indiana Transforming Healthcare Research Initiative blog

RWJF Final report Plexus PD MRSA Project (pdf) – Curt Lindberg, Jon Lloyd, and Prucia Buscell, 2008

Positive Deviance and Hospital Acquired Infection (ppt) – Curt Lindberg, 2009

PD Informed Prevention: Hospital El Tunal, Bogota (pdf) – Curt Lindberg and Carlos Urrea, 2009

MRSA Issue of Emerging (pdf) – Prucia Buscell, 2006

More We Than Me: New Collaboration at Einstein Med (pdf) – Prucia Buscell, 2008

Learning to See and Stop MRSA at Billings Clinic (pdf) – Arvind Singhal and Prucia Buscell, 2009

STEP: The Supporting Teacher Effectiveness Project (pdf) Long Beach Unified School District

Plexus Institute received a $2.1 million grant from the Bill & Melinda Gates Foundation for a three year project in California’s Long Beach Unified School District (LBUSD) to discover, develop and promote methods that help K-12 educators continually improve so that their students achieve better outcomes. This case  reports the successes and challenges of the first year of the project from the perspective of teachers, administrators and district staff.