It can be difficult to change the culture of an entire organization, especially if it is large and spread out.  It is always helpful to review the strategies that other teams have found successful in the past.  One such story is that of Adventist Midwest Health. 

Adventist needed to start with straightforward, concrete steps that all 5,000 employees, spread over multiple facilities including hospitals, outpatient and support locations, could talk about and achieve.

The greatest objective was to shift the patient’s opinion of the level of care they were receiving.  While Adventist was committed to providing quality care, the staff was often so engaged in the task at hand that they appeared flustered and non-communicative to those they encountered.  Although not the case, this ultimately made patients question the level of care they were receiving. 

Adventist took on the challenge of becoming a more responsive organization that was committed to responsive communication with all parties, as it knew this was imperative to gaining the trust of patients and their families.  It is common in many organizations to attempt to change the employee’s behavior with a vague directive such as “be nice to people”, but Adventist knew it was important to define manageable actions that would help them to reach that goal. 

The 10/5 Rule was implemented by the leaders of Adventist and the suggestion of consultants from the Studer Group. Employees were directed to give direct eye contact to any staff member, patient or vendor they encountered within ten feet of them, and to greet them if within five feet.  

Suddenly everyone had a shared norm and a simple name for it. The employees would check each other on whether or not they were following the rule and kept each other accountable.  Most agreed they didn’t like to be corrected by a co-worker for failing to greet someone in passing, but acknowledged that the process resulted in a friendlier environment for staff and patients alike.

Since it was implemented, the 10/5 Rule has become a way of life at Adventist. It only took a month of using the rule before patients started commenting on the positive changes and employees began enjoying their work day more.

Lessons Learned

Adventist’s experience with the 10/5 rule brings up several points regarding change and influence. 

1.    Change should be tangible.

The authors of the book, Influencer found that in successful change efforts, leaders identify vital behaviors. These are the action steps needed to lead to other, less tangible change. At Adventist, the first vital behavior was to look up and acknowledge other people. While this one action didn’t change the culture, it did create a cascade of other changes.

2.    “Sticky” messages are effective.

In their book, Made to Stick, researchers (and brothers) Chip and Dan Heath argue that an idea needs to be “sticky” enough for people to first understand it and then communicate it to others in order for it to spread.  Adventist’s 10/5 rule was sticky – it was simple, concrete, catchy, and memorable enough to spread.

3.    Encourage shared accountability.

Finally, the accountability factor was critical to the successful outcome of Adventist’s campaign.  As we discussed, employees across the system were encouraged to remind each other of the 10/5 rule. This involved the entire staff in the success of the campaign. 

Culture by its very nature is abstract and hard to define. Yet Adventist’s story teaches us that rather than attempting to change culture, successful leaders focus on changing critical, concrete behaviors that will ultimately lead to the end goal.  

Vinnie Garufi is the Director of Organization and Leadership Development for Adventist Midwest Health.  Wendy Mack is a consultant, keynoter, and change catalyst who specializes in leading and communicating change.  For more information on mobilizing energy for change, visit www.WendyMack.com.

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