Episode 139: Transforming Healthcare Teams Through Positive Deviance and Liberating Structures

Welcome to another episode of the Sustainable Clinical Medicine Podcast!

In this episode, Dr. Sarah Smith sits down with Dr. Jeff Cohn, a retired hematologist-oncologist whose journey took him from the patient bedside to the halls of hospital leadership and, ultimately, to coaching fellow physicians. Dr. Cohn shares deeply moving stories from his clinical days—like orchestrating a final, meaningful anniversary for two dying patients—as well as the challenges and motivations that led him to transition into healthcare quality improvement.

Through engaging anecdotes, Dr. Cohn reveals how he championed transformative approaches to organizational change, particularly the innovative use of “positive deviance” to tackle MRSA infections in the hospital. He explains how listening to frontline healthcare workers and drawing out internal best practices led to remarkable reductions in hospital-acquired infections—by 85%! Along the way, you'll learn about practical facilitative techniques, such as “liberating structures,” that empower teams and ensure every voice is heard.

The episode also delves into the realities of clinician burnout, the complexities of driving system-wide change, and Dr. Cohn’s current passion: coaching physicians in positive intelligence and mental fitness. Whether you’re a healthcare professional or simply interested in sustainable, people-centered medicine, this conversation offers inspiring perspectives and actionable insights on making systems—and ourselves—work better.

Here are 3 key takeaways from this episode:

1. Harnessing Frontline Wisdom: Dr. Cohn described the transformative power of inviting frontline staff to identify solutions—a process called “positive deviance.” By genuinely asking nurses, transporters, and other care team members for their ideas (and truly listening), his organization achieved an 85% reduction in MRSA infections, all through internally sourced solutions.
2. Liberating Structures Make Meetings Matter: Traditional hospital meetings too often drain energy and stifle creativity. Dr. Cohn’s team used “liberating structures”—simple yet structured facilitation tools—to ensure every voice was heard, which sparked engagement and uncovered innovative solutions.
3. Prioritizing Wellbeing for Sustainable Change: Through his coaching work, Dr. Cohn now helps physicians leverage mental fitness and positive psychology. He emphasizes that systemic change should support—not overwhelm—the clinical workforce, and that even within challenging systems, there are individuals and habits from which we can all learn.

Meet Dr. Jeff Cohn:

I'm a native Philadelphian, trained as a hematologist/medical oncologist. I practiced/taught/did clinical research full-time for the first 15 years of my career. I then was asked to assume various non-clinical roles (division head, interim Chair of Internal Medicine, Chief Quality Officer). The Chief Quality Officer role ultimately became a full-time role and I held that position for 12 years. Since then I've led a non-profit organization for three years (Plexus Institute) and worked with a couple of design teams as the medical director. I'm now working as a Mental Fitness and Leadership coach with physicians. Along the way I obtained a Masters in Healthcare Management from Harvard School of Public Health.

You can find Dr. Jeff Cohn on:

• Linked In: https://www.linkedin.com/in/jeff-cohn-2738b82b/
• Website: https://caretochangecoaching.com/

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