It is often tough to change the customs of a company or other concern, particularly when it consists of many members who may not all be in the same location.  To find out what works, you can always look to the success stories of organizations that have gone before you.  Adventist Midwest Health is just such a success story. 

With over 5,000 on the go health care workers engaged in numerous hospital, outpatient and support facilities, the first step for Adventist was to find manageble, definable steps that the entire staff could discuss and implement.

The greatest objective was to shift the patient’s opinion of the level of care they were receiving.  Adventist had always been focused on quality clinical care for its patients, but this commitment often caused employees to focus on the duties at hand and appear rushed and preoccupied to those passing them in the hallways.  Although not the case, this ultimately made patients question the level of care they were receiving. 

In order to capture the trust of the patients and their families, Adventist set out to become a more attentive staff dedicated to gracious interchange among those they encountered.  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. Staff were trained to look any patient, staff member or vendor in the eye who was within ten feet, and to say “hi” to them if they were 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.  While it was no fun to be corrected if they forgot to greet someone, all staff agreed that working together to create a friendlier environment was gratifying.

Adventist’s culture has changed significantly since the implementation of the 10/5 Rule. After about a month, patients and employees alike started giving positive feedback about how things seemed different and a better place to be.

Lessons Learned

Several important issues regarding change and influence are illustrated through the 10/5 rule. 

1.    Concrete steps to achieve change work best.

The authors of the book, Influencer found that in successful change efforts, leaders identify vital behaviors. These behaviors are the initial key actions that the members of the organization must achieve in order to lead to other changes. 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.    Messages should be “sticky”.

Chip and Dan Heath explain in their book Made to Stick that in order for an idea to spread, it has to be “sticky” so that those hearing it will understand it and then be able to pass the word about it.  Adventist’s 10/5 rule was sticky – it was simple, concrete, catchy, and memorable enough to spread.

3.    Encourage everyone involved to hold each other accountable.

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. Adventist’s experience teaches us that by changing specific, concrete behaviors, the culture of the organization will most likely also change as a result.  

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