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.  It is always helpful to review the strategies that other teams have found successful in the past.  For example, consider the story 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.  The organization had always been dedicated to providing great medical care, but it often happened that the staff’s focus on the task at hand caused the impression they were in a hurry and non-communicative to those they encountered during the day.  This often resulted in patients perceiving that the quality of care they received was substandard, although this was not the case. 

To gain the trust of patients and their family members, Adventist realized it needed to be a friendlier place, one that demonstrated respectful communication to all patients, family members, and staff.  And, while some organizations may have attempted to change the culture with a vague mandate such as “be friendly,” Adventist realized it needed to break the concept down into simple concrete actions. 

With the help of consultants from the Studer Group, Adventist leaders implemented the 10/5 Rule. 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.  

The result was a benchmark everyone shared and a name to identify it by. Staff could monitor co-worker’s adherence to the rule and would call them on it if they didn’t.  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.

Adventist’s culture has changed significantly since the implementation of the 10/5 Rule. Within a month of implementing the rule, patients began to remark that “something is different around here,” and employees starting saying, “this feels like a better place to work.

Lessons Learned

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

1.    Make change concrete.

The book Influencer explained that leaders who were able to make their change efforts successful identified crucial 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.    “Sticky” messages are effective.

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 discovered a sticky message in their 10/5 rule – it was concrete, creative, and easy to remember.

3.    Make it a priority for all members of the organization to share 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. 

Organizational culture is difficult to define because it is so abstract. 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 advisor, 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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