3 Steps to Making Changes Stick

Change is hard. Everybody says so. If you’ve ever tried to lose weight, you know it. You know that “change is hard” is not just a cliche when it comes to changing the way you eat.

Change is hard on a personal level, and it’s even harder at an organizational level.

That’s why so many major corporate change initiatives fail. Change is hard. People resist change. So what can you really do?

I’m reading a great book that actually answers that question, by Chip and Dan Heath (authors of Made to Stick): Switch: How to Change Things When Change Is Hard.

What I love about this book are the stories. The authors, both business school professors, use the power of stories to illustrate real people, real problems, and real changes that brought about real results.

Here’s a story from the book that really drove home for me an important concept: You don’t have to be in charge to affect change. Even if you don’t have the power to change the rules or laws, or to fire people, or to give them reward bonuses, you can be a catalyst for change.

In 2004, Don Berwick, a doctor and CEO of the Institute for Healthcare Improvement (IHI), analyzed patient care that revealed a shockingly high “defect” rate for hospitals that translated to tens of thousands of patients dying unnecessarily every year.

Berwick’s insight was that hospitals could benefit from the same kinds of rigorous process improvements that had worked in manufacturing industries. The data was indisputable, but Berwick had no ability to force any changes onto the other hospitals.

On December 14, 2004, he gave a speech to hospital administrators at a large convention.

“Here is what I think we should do. I think we should save 100,000 lives. And I think we should do that by June 14, 2006 – 18 months from today. Some is not a number; soon is not a time. Here’s the number: 100,000. Here’s the time: June 14, 2006 – 9 a.m.”

Berwick was determined. The audience was astonished. IHI proposed six very specific interventions that would save lives. Of course, everyone agreed. Who could not?

The path was full of obstacles. To agree to the plan was to admit the problem. Adopting the new plan required staff to overcome decades worth of habits and routines. Doctors perceived the new procedures as constricting.

The adopting hospitals starting seeing dramatic results. IHI provided conference calls and training and encouraged hospitals with early successes to become mentors to those just joining the campaign.

At the exact moment the campaign was over, June 14, 2006, at 9 a.m. Berwick took the stage to announce the results:

“Hospitals enrolled in the 100,000 Lives Campaign have collectively prevented an estimated 122,300 avoidable deaths and, as importantly, have begun to institutionalize new standards of care that will continue to save lives and improve health outcomes into the future.”

Big changes can happen. Dr. Berwick and his team catalyzed a dramatic life-saving campaign, yet he himself wielded no power. He couldn’t fire hospital leaders who didn’t agree with him. He couldn’t pay bonuses to those who accepted his proposals.

Here’s what he did do to affect a huge change:

  1. He was clear about the change needed: 100,000 lives saved. “Some is not a number; soon is not a time.” He was specific: 18 months.
  2. He appealed to the audience’s emotions. The numbers were clear, change was needed. But when he brought in a mother who’s girl died because of medical error, he galvanized people to get behind the plan.
  3. He provided a clear path toward action. All they had to do was sign a one page agreement to enroll in the campaign. They were provided with six steps that would bring results. Training and support was provided, much of it through peers.

If you think change is hard, try getting people over whom you have no power to join your plan.

What if you do have power? What if you’re the leader and you need people to do things differently?

It’s still hard, because we are entrenched in the comfort of our habits. Here are the 3 basic steps needed to make people change:

  • Be clear and specific about what needs to happen (appeal to rational brains)
  • Motivate people on an emotional level, connect with feelings
  • Provide a path. Don’t try to change everything, pick 3-6 clear steps that will bring results.

Here’s a quote from the authors, about their book Switch:

“In our research, we studied people trying to make difficult changes: People fighting to lose weight and keep it off. Managers trying to overhaul an entrenched bureaucracy. Activists combating seemingly intractable problems such as child malnutrition.

They succeeded–and, to our surprise, we found striking similarities in the strategies they used. They seemed to share a similar game plan. We wanted, in Switch, to make that game plan available to everyone, in hopes that we could show people how to make the hard changes in life a little bit easier.” –Chip and Dan Heath

What’s been your experience with change?

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