I’m a medical doctor in a health clinic. Several years ago we set a goal to dramatically decrease the rate at which our staff contracted illnesses from patients. Using gloves and washing and sanitizing hands more frequently helped, but it didn’t give us the dramatic improvements we wanted. Bacteria and viruses can only make one sick by entering the body, which cannot typically happen through unbroken skin. The primary entry points for germs are the eyes, nose, and mouth. We were finally successful when, in addition to the standard procedures for keeping hands clean, we got people to stop touching their faces. Having people wash their hands and wear gloves is comparatively easy to do. The problem with touching our faces is that we all do it dozens of times a day, and ninety percent of the time we aren’t aware we are doing it.
To change people’s ingrained habits, we made giving feedback an expectation of every staff member. If you saw someone rubbing their chin, scratching their nose, or touching any other part of their face, you had to immediately bring it to their attention. No exceptions. That meant nurses and receptionists were required to give feedback not only to their peers but to the doctors
as well. This was difficult because most of the staff were uncomfortable giving feedback to doctors, and doctors were not traditionally open to criticism from non-doctors. It took time, but we persisted. Eventually, we changed the culture and infections dropped dramatically.
—General Practitioner, Intermountain Instacare
Immediate feedback is the key to unlearning old habits. If staff members had received monthly reports telling them how many times they had touched their faces in the previous 30 days, little would have changed, but this effort was successful because people received feedback the moment their hands and faces made contact. In time, people became more self-aware and could catch themselves in the act. Soon people started catching themselves before the act, and only then did new habits displace the old.
We can learn a lot from this clinic’s experience: entrenching a new value or behavior in your company’s culture means empowering individuals at every level to give feedback to people at any level whenever they see behavior that contradicts that value.
The health clinic in this study created a feedback culture. A feedback culture is one in which people feel safe giving candid feedback because those around them, especially their bosses, choose to receive it as a gift.
Any company serious about becoming and remaining a market leader, or improving safety, or implementing a new initiative, needs to champion a feedback culture to support that change. Those who call out their bosses need to be lauded, and any boss who punishes a direct report for speaking truth to power needs to be held accountable.