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It can be difficult to change the culture of an entire organization, especially if it is large and spread out. 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. Consisting of 5,000 very busy healthcare employees spread out over multiple hospitals, outpatient facilities, and support offices, Adventist started first with simple, concrete actions that could be implemented and talked about by every employee.

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. This often resulted in patients perceiving that the quality of care they received was substandard, although this was not the case.

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. While it might have been tempting to simply direct the employees to “be more polite,” Adventist saw the value in identifying straightforward actions that would help achieve the goal. With the help of consultants from the Studer Group, Adventist leaders implemented the 10/5 Rule.

They trained staff to make eye contact when approaching anyone (patients, coworkers and vendors) in the hallway within ten feet and to say “hello” at five feet. What resulted was that the entire staff had a model to strive for with a specific name.

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 LearnedAdventist's experience with the 10/5 rule brings up several points regarding change and influence. 1. Make change concrete. According to the book, Influencer, it is important for leaders who want to effect change to 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 action didn't change the culture in and of itself, it did create a ripple effect that resulted in other positive changes within the organization.
2. Messages should be “sticky”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 everyone involved to hold each other accountable. Lastly, accountability was a key element in the success of this initiative. As we discussed, employees across the system were encouraged to remind each other of the 10/5 rule. Everyone in the network became mutually accountable for their own behavior and for reinforcing the rule. Organizational culture is difficult to define because it is so abstract. However, the lessons learned from Adventist is that, rather than trying to force a certain culture on an organization, it is better to focus on changing specific key behaviors, which, when changed, will ultimately lead to a successful change in the overall culture.
Vinnie Garufi is the Director of Organization and Leadership Development for Adventist Midwest Health. Wendy Mack is a advisor, speaker, and change catalyst who specializes in leading and communicating change. Find more information on mobilizing energy for change, visit WendyMack.com .

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