A Change Case Study: Part 1

A few weeks ago a friend of mine told that his hospital had implemented a great idea that really seemed to be working. Curious, I asked for the details. It turns out that this particular hospital had become siloed. Departments weren’t working together and employees in different departments rarely spoke to one another. In this particular case, patients and their family members were even picking up on the issue. Across the board, people reported feeling that the vibe in the hospital was cold and unfriendly.

Leaders at the hospital responded by engaging employees in all departments and all levels of people in a “friendliness campaign.” They put into place a “10/5 rule” which encouraged every employee to look up and make eye contact when they got within 10 feet of another person and to say “hello” or “what’s up” or “hey” when they got within 5 feet of another person.  The other essential element of this rule was that employees were encouraged to hold one another accountable for following it.  In other words, if someone were to brush by you in the hall without the eye contact or greeting, you might (smile) and say, “Hey .  . . 10/5 rule!”

My friend told me that the 10/5 rule has become deeply embedded in his hospital’s culture. He acknowledged that it can sometimes be annoying to be “called on it” when he forgets to say hello, but that overall the rule has helped people to create a friendlier environment.

To me, the 10/5 rule illustrates a number of important points about change and influence.  

First of all, the hospital utilized a key principal from the authors of the book, Influencer.  The Influencer authors (there are five of them so I won’t list them here) found that in successful change efforts, leaders identify vital behaviors. Vital behaviors are the few key actions that lead to other changes. In this example, the vital behavior was looking up and acknowledging one another. While this one action didn’t change the culture, it did create a cascade of other changes.   

Second, the 10/5 rule is an example of a principal we now call “stickiness.”  Author Malcolm Gladwell used the term sticky in his book The Tipping Point.  Researchers (and brothers) Chip and Dan Heath then picked up on the term in the title of their book, Made to Stick.  The Heath brothers argue that an idea needs to be “sticky” enough for people to first understand it and then communicate it to others in order to spread. The 10/5 rule is sticky because it is simple and concrete.  

So, the 10/5 rule appears to be a great example of a successful change effort.

But wait; there is a twist to this story!  Come back tomorrow for Part 2.

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