Much of what we do as Lean and continuous improvement practitioners is related to change management: there must be some change in the way work is done or we have made no difference. With this in mind, I was struck by a piece on World Service a couple of weeks ago in the program Health Check (recording available until 12 October—listen to 19–27 min). They talked about a publication from Gaurav Suri and colleagues (thanks to Gaurav for sending me the paper) which purports that the reason many patients don’t take their medication is simply inertia. Patients know full well that they must take their medicine and understand the benefits but still don’t change their behaviour. And this goes beyond status quo bias, where people choose the default or existing option, so long as they consider it to be good enough—not taking life-saving medicine ought to be objectively much worse than taking it.

This phenomenon is of course recognizable from many aspects of life from: starting a new training regimen, maybe starting a new piece of work, learning a new computer program and of course making changes to processes and the way we operate at work. Very often, it turns out that it is easier just to keep doing things the old way, even though we understand fully, at least at an intellectual level, that the new way is better.

The researchers mimicked this situation in the lab by giving volunteers electric shocks in a series of trials and also gave them a button that reduced the probability of receiving that shock. You really would expect that everyone would press the button every time? The volunteers were split into two groups: in one, they were forced at the start of each trial to choose whether or not to press the button; the second group could choose freely whether and when to press the button. In the forced-choice group, volunteers pressed the button 85% of the time but in the free-choice group they did this only 52% of the time. Both researchers and participants were, perhaps not surprisingly, somewhat mystified as to why the volunteers had behaved this way. There was a clue in the data that showed that those who pressed the button in the first trials continued to do this later. In a follow-up experiment, one group was given two pre-trials and told they must press the button in one of them. In subsequent trials they pressed the button 78% of the time, almost as often as the forced-choice group.

fashion pills
Fashion pills: source Deanna Reesor

So, is this really new knowledge and how how does it inform how we work with change management? My take is that this highlights some difficult behavioural aspects, where understanding the benefits of change (as well as the consequences of not changing) is not enough. In the radio clip, the suggestions are essentially to make the change easier: take the first dose of the medicine at the doctor’s surgery, leave the drugs out rather than hidden away or put the running shoes in the hall rather than the cupboard. From my experience, this makes sense and fits in rather well with this adage:

It’s easier to act your way into a new way of thinking than think your way into a new way of acting

The conclusion from all of this seems to be that while we shouldn’t give up articulating the reasons for change, we also need to try to make the change as easy as possible, and make it easy to practice so that it becomes a habit. And that’s as true for changes in a key business process as when this author posts his first blog entry!


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