Making Change Happen - A Conversation with Dan Heath

Making Change Happen – A Conversation with AMCHP Keynote Speaker Dan Heath 

By Mike R. Fraser, PhD

Dan Heath
Author, Switch: How to Change Things When Change is Hard 

AMCHP is excited to welcome best-selling author Dan Heath to our conference. Dan will be sharing information from his most recent book, Switch: How to Change Things When Change Is Hard, which he co-authored with his brother Chip. Dan and I recently had the chance to talk about his work and what we can learn about change — both for ourselves and our organizations. 

Mike: Dan, thanks for taking some time to visit with me. As we get ready to welcome you to AMCHP I was interested in finding out what got you interested in the topic ofchange?” 

Dan: Thanks Mike, great question. All of us crave some kind of change — we want to change things at home or at work or in society. Not to mention our own self-improvement projects. But when you bring up the concept of “change” with people, they tend to shake their heads and say, “Change is hard.” No one seems to have a sense of HOW you go about changing things. We wanted to provide the “how” — to mine the insights of decades of research in psychology and make it practical for people who are fighting for real change. 

Mike: Yes, that “how” part is always elusive, isn’t it. AMCHP members come from a variety of positions in their organizations. Do you think someone has to be in a leadership position to create change? What can rank and file members of an organization do to un-stick their organizations?  

Dan: Our focus in Switch is on behavior change, because anyone is capable of creating behavior change. We were frustrated that so many organizational change books seem to be written for CEOs or top executives — the kind of people who have lots of structural power. They can sell off divisions, hire people, fire people, change incentive systems, merge teams, and so on. The rest of us don’t have these tools. Though, admittedly, it’d make life easier if we did: “Son, if you don’t take out the trash tonight, you’re fired.”  

Mike: Ha! Tempting to use such techniques at home isn’t it! You mention CEOs and business executives, which I read a lot about in the leadership and management literature. But many of our members work in state government. What’s different about change in government versus private organizations?  

Dan: There are plenty of differences, but to be honest, I see more similarities. For instance, I attended a conference for people who work in injury prevention in state governments. One tool they taught me was the “Haddon Matrix,” which is a way of thinking systematically about preventing injuries. So if you want to reduce car-crash injuries, you can think in three different ways: You can try to prevent accidents from ever happening (think lane markers and ample lights). You can try to prevent an accident from leading to an injury (think air bags). Or you can try to ensure that the harm from an injury, if sustained, is minimal (think quick emergency response). This is an incredibly useful framework for creating change in public safety. But notice that you could use it just as easily in a corporate environment, for example in minimizing data loss from computer crashes: You can prevent crashes, prevent a crash from leading to data loss, or ensure that data loss is as painless as possible. One of the reasons we wrote Switch was because we kept spotting patterns like these — the same tools used to create change in one environment could easily be used in another. 

Mike: Dan, what’s the “take home” point about change I should get to all of our members — not just those who will be with us in Washington next month? What do you think is the most important thing a leader can do to implement change in their organization?  

Dan: Look for bright spots. Here’s what I mean: Psychology tells us that people are wired to look at the negative. We like to analyze things that aren’t working and then try to fix them. But, in times of change, let’s face it, there are many things that aren’t working. It will feel overwhelming to try to fix everything. So don’t. Instead, ask yourself a question: What’s working well, today, and how can we do more of it? In the book, we tell the story of Jerry Sternin, a man who went to Vietnam to fight child malnutrition. And everyone thought that, to fight malnutrition, you’d have to fight the big, systemic forces responsible: poverty, lack of education, lack of clean water access, etc. But instead Sternin asked himself: What’s working well, today, despite the odds, and how can we do more of it? He went to a village and found the secrets of mothers whose kids were perfectly healthy, despite their poverty. Their secrets were things like serving four small meals per day rather than two big ones and using “non-traditional” foods like sweet potato greens, which added sorely needed vitamins to their kids’ diets. And once Sternin discovered these bright spots, he could scale them, spread them around. This “bright spots” philosophy is one that any change leader, in any domain, can use: What’s working now and how can we do more of it? 

Mike: Great example. I think our members can relate to finding those “bright spots.” As we wrap up, what advice would you give for organizations collaboratively to “switch” or create change as coalition partners? Lots of what our members do is work with other groups to “make change happen” for women, children, and families in the states. Any advice?  

Dan: Make sure you’re focused on the end goal of behavior change. Who do you want to behave differently, and how specifically should they behave? One mistake that I see a lot of coalitions or movements make is that they do a great job explaining the problem they’re fighting, but they aren’t as clear about the solution. I’ll give you an example of someone who handled this brilliantly: Don Berwick and his team at the Institute for Healthcare Improvement (IHI). Berwick was determined to fight medical errors in hospitals around the country. He set an outlandish goal: To save 100,000 lives in 18 months by eliminating the risky procedures that often led to patient death. The IHI had no ability to make this happen directly — it had a staff of about 75 people. It was only the alliance that could effect change. Berwick did many things right, but one of them was to stay laser-focused on the exact behaviors that hospitals needed to adopt to save lives. For instance, one of his recommendations called for a patient’s head to be elevated between 30 and 45 degrees, so that oral secretions couldn’t get into the windpipe, which was a big source of infection. When you get that clear about the change, you greatly improve your chances of success. And, in fact, Berwick’s 100,000 Lives campaign worked. It was a mind-blowing accomplishment. And it teaches the rest of us something: Often what we mistake for resistance is a lack of clarity. 

Mike: Dan, let’s get personal for a second as we conclude our time together. In the book, you discuss personal change — diets, relationships, parenting, etc. We are now at the point in the year when most people are giving up on their New Year’s Resolutions. Any advice for those struggling to live up to their 2010 goals? Not that I am one of them, but, you know… just looking out for our member’s here… 

Dan: Yeah, sure Mike. Look, if you’ve had some failures, then join the crowd. But before you decide to give up, you should know something: Failure is part of the deal. There’s an ad from the California Tobacco Control program that I love. It says: “It took you years to learn how to smoke. How come you thought you’d be able to quit the first time?” In fact, research shows that most people try to quit smoking five to seven times before they succeed. And if you think about any of the skills and qualities that you are most proud of — cooking, speaking another language, coaching Little League, driving, being a good parent or a good friend — none of them came quickly. You didn’t give up cooking because you incinerated a chicken breast in 1984. So if you’ve slipped on your diet, or your workout plan, or your self-improvement plan, then relax. It took you years to learn how to act the old way. What made you think you could change overnight? 

Mike: Great advice Dan. Thanks and we are so glad you will be joining us soon in Washington. 

For more information on Dan and Chip’s recent work, Switch, and their prior book Made to Stick, visit Copies of both of Dan’s books will be available on site for purchase before and after the Monday morning plenary session.