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PEAK Leadership Series: Dan Heath Discusses Change Management

by Published On: May 21, 2012


Dan Heath, co-author of the New York Times and Wall Street Journal best-selling book Switch, offered up a riveting, funny and practical keynote presentation and workshop at the LeadingAge PEAK Leadership Summit. Heath walked us through a straightforward framework to help attendees drive major change efforts back home, with particular emphasis on how to influence peoples’ hearts and minds to make change really work. 

In the following Q&A, Heath shares his insights as they relate to the field of aging.


Our entire field is in the midst of radical change: changing demographics, changing consumer preferences, changing regulatory environment. What can aging services leaders do to create organizational cultures that embrace change so that these variables are seen as opportunities rather than threats?

I think one of the keys is to be diligent about emphasizing the opportunities as well as the threats. Psychologists tell us that we’re wired to focus on the negative, but there are two mindsets: One is the promotion mindset and the other is called the prevention mindset. 

The promotion mindset is oriented around seizing opportunities – it’s when you’re excited about a new idea and you’re thinking about new ideas. The prevention mindset is about minimizing prevention or harm. 

So, when you’re feeling protective, or when you’re trying to avoid loss, you’re in the prevention mindset. In an economic climate like this a lot of people are trapped in the prevention mindset. They’re thinking, we have to cut the budget…we have to get leaner, and that makes them defensively minded. They think, “How can I do the least amount of harm while still cutting the budget?”

There was a study published in the Harvard Business Review that showed that if you look back over the past few recessions, and you study the way that organizations responded to the recessions, the ones that flourished the most were the ones that were able to combine the two mindsets. If times have made it necessary for you to cut the budget by say 5%, that’s a prevention mindset strategy. 

A way to add in a promotion mindset might be to say, “Let’s cut 9% instead of 5% and use that extra 4% to make an investment in the single most exciting thing that we think is an opportunity for us.” 

So, it’s important to create that sense of balance, not only trying to prevent harm but also to make sure you don’t lose sight of what could be better, what could put you in a better position five years from now.

What are the most important questions leaders should ask themselves and their team members when change efforts falter?

You almost have to expect failure with change. There’s a great quote from Rosabeth Moss Kanter who said that all change looks like failure in the middle. I saw a statistic recently that said that most smokers who quit successfully have tried between 5 and 7 times before finally succeeding. 

So, I think there’s just a certain amount of tolerance that we have to have going into a change effort that it probably isn’t going to work perfectly the first time out. Don’t panic if things aren’t going right, because that’s probably the norm rather than the exception.

More broadly, we have to learn to fight instinct when things aren’t going our way. Psychologists say that when it comes to the way we think, bad is stronger than good. We tend to focus on problems and how to solve them, or dramas and how to resolve them. (An interesting side note: 2/3 of the emotion words in the English language are bad emotions.) 

This is an artifact of the way we think so we have to be diligent to flip that and say even if a particular project failed, there were probably elements of it that worked. It will naturally come to us to wonder, what went wrong and how can we fix it in the future? 

But, what will not necessarily come to us is to say, what worked and how can we replicate it? It may be a piece of the project; it may be a couple of staff members that did particularly well. If you can understand what made even the small fragments successful, there’s hope that you can clone those in the future.

If you had to identify the most critical factor in creating lasting change, what would it be?

Motivation. Most people, when they think about change, think it’s about “The Plan” – the perfect plan will lead to the perfect change or the perfect innovation. And of course it’s not to say that the perfect plan, the perfect innovation is not important, but the important thing for long term change to succeed is that people are motivated to execute those plans and those innovations. 

In my keynote I mentioned something I love from John Kotter’s work: he talks about two models for thinking about change. He says we tend to think that change happens in 3 steps: 1) analyze, 2) think, 3) change. 

Meaning, we gather all the data in a situation and we analyze it carefully and then we think really hard to come up with the right answer and when we’ve got the right answer, change comes. But he says in his experience, it just doesn’t work that way. It’s not that rational. 

That in fact what happens is a different three step process that he describes as: 1) see, 2) feel, 3) change. People see something that makes them feel something – it may be fear, it may be optimism, it may be a competitive spark – but that feeling gives them the motivation to change and that’s what makes it happen. So my advice would be, for anyone looking to drive a change, think about that see, feel, change framework. What could you show your constituents to show them that your change vision is the right one?

SWITCHbookcoverIn the time since Switch was published, what are some new examples of Bright Spots (changes that worked on a small scale that were then scaled up to affect larger change) that you and Chip have encountered? Are there any that may be particularly relevant to the field of aging?

There are a couple things that I’ve been really excited about. One is that I got to know some people in the Department of Health and Human Services that are working on adoption of electronic health records, which had been really sluggish until the last few years when it has started to skyrocket…as of last fall, about 40% of all U.S. doctors now using them. 

One of the things they discovered to help to fuel this was that some of these doctors, especially some in rural environments, needed some handholding - doctors are not IT experts or project management experts. They’re doctors. And so they created Regional Extension Centers. A team will go in and handhold these doctors through the cycle of adopting electronic health records. 

They’ll help the doctors pick a vendor and pick a product; they’ll help to project manage getting it incorporated, getting the terminals set up and training staff. That’s been a big ingredient to their success – realizing that there is a human element here - so they’ve replicated that nationwide.

Another example is one that I’ve learned about from my brother, who’s done some work with Kaiser in California. He said they were working on encouraging women to get their mammograms on the prescribed schedule. 

They did an analysis to find the positive outliers. They found a couple of clinics that had an unusually good record for getting them done on time so they went to study what those clinics were doing differently. And they found that one location had learned to capture women who were in the clinic for any reason and after dealing with that specific issue they’d say, “Hey, we noticed you’re due for your mammogram; do you want to take care of that while you’re here?” 

Since it would save the women another trip, a lot of times they would do it. What I love about this example is that 1) they were looking for things that were already working. And 2) they found this very practical solution that they knew would work for Kaiser because it was already working for Kaiser. It was just a matter of exporting the intelligence that had been developed in that one location to a lot of other places. 

It’s not a trivial thing to do: operationally, they have to be ready at any moment to whisk someone in for a mammogram…that’s hard! But it’s also important, so it was worth the time and effort. They started with reframing that classic question: It’s not, “What’s broken and how do we fix it?” Rather, it’s “Who’s doing this right and how can we do more of that?”

When you’re not writing books with your brother or working with organizations like LeadingAge, what do you do? What’s your day job?

I’m a senior fellow at the Center for Advancement of Social Entrepreneurship (CASE) at Duke University. What I love most about my work is that I get to work with MBA students who are dreaming up ways of starting the next Teach for America or the next Toms Shoes…organizations that have an aspiration to create social good, not just profit. It’s an absolute blast and I’ll tell you, I think there is a wave of people who are thinking very differently about these things. 

Social Enterprise is becoming one of the most popular majors at many business schools. And the most popular club on campus at Duke is Net Impact, which is a social entrepreneurship organization. There’s a lot of enthusiasm for doing things in a different way. It’s fun to be part of that wave.

You can learn more about Dan and Chip Heath’s work by visiting their website.

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