Switch - Chip Heath [63]
Because identities are central to the way people make decisions, any change effort that violates someone’s identity is likely doomed to failure. (That’s why it’s so clumsy when people instinctively reach for “incentives” to change other people’s behavior.) So the question is this: How can you make your change a matter of identity rather than a matter of consequences?
4.
Lovelace Hospital Systems in Albuquerque, New Mexico, was concerned about the rapid turnover among its nurses. Its turnover rate wasn’t any worse than the national average (between 18 and 30 percent per year), but that was small comfort. When nurses left, replacing them cost a lot of money, morale suffered, and patient care was put at risk during the transition period.
Kathleen Davis, a registered nurse and vice president of hospital operations, decided to try an unconventional approach to analyzing the turnover problem. She hired Susan Wood, a consultant who specialized in Appreciative Inquiry, a process for changing organizations by studying what’s working rather than what’s not (this is another example of the bright-spots focus that we discussed in Chapter 2).
Wood and Davis decided not to investigate why so many nurses were leaving. Instead, they began to explore why other nurses were staying. In a hospital with three hundred nurses, the team interviewed more than one hundred. Wood asked nurses what made their jobs satisfying. She recalled, “These nurses were beaten down and overworked, but as soon as we started them in a conversation about what they were good at, the tone changed.”
Davis and Wood found that the nurses who stayed at the hospital were fiercely loyal to the profession of nursing. In other words, their satisfaction was an identity thing—the nobility of the nursing profession gave meaning to their work. Once the hospital administrators realized this, they knew they’d have to do more to help the nurses cultivate their identity. For instance, they began to find ways to recognize people for extraordinary nursing performance. They developed a new orientation program that stressed the inherently admirable nature of nursing work. They created mentorship programs to help nurses improve their knowledge and skills.
The first hint that something had changed was evident on the annual employee satisfaction survey. Nursing satisfaction scores increased markedly in multiple categories, particularly “communication”—all those interviews and conversations about identity had an impact. But the impact went beyond the survey: Over the following year, turnover decreased by 30 percent. And then the success made an unexpected leap: On regional surveys, Davis and Wood started seeing improved ratings on patient satisfaction with Lovelace Hospital.
It’s critical to realize that these identity stories aren’t just special case situations, confined to scientists or nurses or St. Lucians. Identity is going to play a role in nearly every change situation. Even yours. When you think about the people whose behavior needs to change, ask yourself whether they would agree with this statement: “I aspire to be the kind of person who would make this change.” If their answer is yes, that’s an enormous factor in your favor. If their answer is no, then you’ll have to work hard to show them that they should aspire to a different self-image. And that’s exactly what Paul Butler