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.

One challenge was to change patient's and their family's perception of the level of care they were given. 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. 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.

Consultants from the Studer Group helped the leaders of Adventist to implement the 10/5 Rule. 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.

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.

The 10/5 rule has become deeply embedded in Adventist's culture. 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 are the action steps needed to lead to other, less tangible change. In the Adventist example, the crucial behavior was requiring employees to acknowledge other people. While just doing that didn't completely change the culture of the organization, it did create a ripple effect that resulted in other positive change.

2. Make messages "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. The 10/5 rule adopted by Adventist was just such an idea in that it was easy, tangible, creative and easy to remember.

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

The final lesson learned is that shared accountability is a crucial factor to the positive outcome of the initiative. Adventist leadership encouraged employees and staff throughout the Adventist organization to hold each other accountable with respect to the use 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. Yet Adventist's story teaches us that rather than attempting to change culture, successful leaders focus on changing critical, concrete behaviors that will ultimately lead to the end goal.