Adaptive Positive Deviance

Positive Deviance (PD) is an approach to social change that enables communities and organizations to discover the wisdom they already have, and then to act on it. The premise of PD is that in every community there are certain individuals or groups whose uncommon practices or strategies enable them to find better solutions to problems than neighbors and peers who have access to the same resources. PD is led by people in the community who help identify and spread the successful practices. Ideas for change are more likely to be accepted and adopted when they are based on existing local wisdom than they are when outside exports try to impose them.

“The Positive Deviance movement is changing the landscape of how we achieve transformation and change in systems.” Peter Block, Author, Community: The Structure of Belonging.

Plexus has been a leader in developing and applying the principles of APD in projects across the fields of education, healthcare and organizational resilience. The new Plexus book, Unexpected Gifts: Solve Tough Problems with Adaptive Positive Deviance, combines insights from complexity science theory and the understanding of systems with practical examples of how APD has been applied in multiple fields.  The cases and resources offered here are just a few examples of Plexus’ collaborative work with Adaptive Positive Deviance.

Healthcare: MRSA Initiative

A collaborative initiative involving six diverse institutions used Positive Deviance, adapted with other change processes, to prevent healthcare associated infections. The results: sustainable 35 % to 80 % reduction in infections, countless lives saved, and millions of dollars saved.

The Plexus Institute PD MRSA Prevention Partnership involved collaboration among a network of hospitals, PD facilitators, Positive Deviance Initiative, CDC, and Delmarva Foundation/Maryland Patient Safety Center. The Partnership is committed to pioneering the use Positive Deviance in MRSA prevention. Here you will find resources on PD and MRSA along with stories about the efforts in hospitals to eliminate MRSA transmissions through the active and genuine engagement of staff.

Fighting MRSA by Engaging a Whole Medical Center Community
The Einstein Healthcare Network uses a Positive Deviance Improvement Approach to reduce MRSA infections and save nearly $2 million a year.

“Do What You Can, With What You Have, Where You Are;” MRSA Prevention in Pittsburgh Veterans Hospitals
After initial success with the Toyota Production System (TPS), VA Pittsburgh Healthcare System added a Positive Deviance Improvement Approach to spread the success beyond the initial units. With PD, the hospital-wide MRSA rate dropped 64%.

Fighting Infection: Making the Invisible Vibrantly Visible
Billings Clinic staff discovered “seriously playful” ways to see the continual interplay between humans and their invisible bacterial adversaries and new practices emerged leading to an 80% decline in MRSA infections.


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.STEP: The Supporting Teacher Effectiveness Project (pdf)

During the 2013-2014 school year, Plexus Institute worked in two middle schools in the Long Beach Unified School District. STEP: The Supporting Teacher Effectiveness Project, reports the successes and challenges of the first year of the project from the perspective of teachers, administrators and district staff.

We have selected the following resources for further reading on APD projects.