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Find Vital Behaviors

It is not enough to do your best; you must know what to do, and THEN do your best.

—W. Edwards Deming

As you do your best to increase your influence, if you’ve been following the path of effective influencers, you’ve already used the first key: you created clear, compelling, and measurable goals. You know exactly what you want, by when, and how to measure it. So you’re off to a good start.

Next you have to figure out what behaviors people need to change in order to achieve these results. Influencers are universally firm on this point. They don’t create methods for changing behavior until they’ve carefully identified the exact behaviors they want to change.

This can sound like an enormous task. On any given day, how many behaviors does one enact? Thousands? Fortunately, when it comes to creating change, you don’t have to identify thousands of behaviors. Not even a hundred or a dozen. Typically one or two vital behaviors, well executed, will yield a big difference. This is true because with almost any result you’re trying to achieve, there are moments of disproportionate influence. These are times when someone’s choices either lead toward great results or set up a cascade of negative behaviors that create and perpetuate problems.

And now for the really good news. These crucial moments are often easily spotted. For example, when Danny Meyer’s restaurant guest has a problem, it’s obvious that the actions of staff members in that moment will disproportionately affect that guest’s overall experience at Gramercy Tavern. A physician enters a patient’s room and doesn’t wash his hands as he enters. That is a crucial moment: his failure to practice one simple behavior creates the potential for many serious problems to follow. A person carrying a Guinea worm feels an uncontrollable urge to thrust his infected arm into the local water source. What follows makes a big difference in perpetuating Guinea worm disease in the village for another entire year.

Even the most pervasive problems will yield to changes if you spot these crucial moments and then identify the specific, high-leverage actions that will lead to the results you want. These actions make up what we call the vital behaviors in any change project. Find these vital few behaviors, and you’ve found the second key to influence.

Let’s see how this has been done by genuine influencers.

THE KING’S BIRTHDAY PRESENT

Meet Dr. Wiwat Rojanapithayakorn (or, as he mercifully permitted us to call him, Dr. Wiwat). He learned the value of focusing on a few high-leverage behaviors the hard way.

When King Rama IX of Thailand turned 60, he gave the country a gift. Unfortunately, the king’s well-intended present actually unleashed a horrendous plague on his people. Prior to the king’s birthday, AIDS in Thailand had been found only in the prison population, and it occurred there because the prisoners passed the disease from one to the other by sharing used needles. For several years the disease stayed incarcerated with its hosts. But in 1988, in a birthday-inspired act of compassion (in keeping with a national tradition for momentous occasions), the king granted amnesty to over 30,000 prisoners. Released from its confinement, the AIDS virus celebrated its new freedom by rampaging through a much larger community of intravenous (IV) drug users. In just a few months almost half the users nationwide were infected.

The country’s infectious disease experts watched in horror as month by month the disease spread from one community to another. Close on the heels of IV drug users, sex workers fell prey. Within only a year, as many as one-third of the sex workers in some provinces tested HIV positive. Next, married men carried the scourge home to their unsuspecting wives, who frequently passed it to newborn babies. By 1993 an estimated 1 million Thais were infected with HIV. Health experts worldwide predicted that in just a few years Thailand would lead the world in infections per capita—with as many as one in four adults carrying the virus.

But it never happened. Within two years the virus hit a wall, and then it retreated. By the late 1990s—largely because of a remarkable influence strategy implemented by Dr. Wiwat—new infections had been cut by 80 percent. The World Health Organization (WHO) has estimated that as of 2004, over 5 million people who should have been infected weren’t.

But the solution didn’t come easily, and it certainly didn’t come after the first attempt. While AIDS was taking Thailand by storm, Dr. Wiwat battled the plague alongside a handful of his colleagues in the Ratchaburi province. His training had taught him that the key to fighting the spread of any disease lay in making the public “aware” of the threat. The experts who were advising Wiwat (people who had thought about the transmission problem but who hadn’t actually solved it) argued that diseases thrive in ignorance; therefore, you have to spread the word.

With this idea in mind, Dr. Wiwat accepted a position with Thailand’s Ministry of Public Health. Specializing in venereal diseases, he approached the task of informing an ignorant public in much the same way corporate executives try to improve quality, customer service, or teamwork. Wiwat’s team distributed posters. They held education sessions. They convinced celebrities to broadcast television and radio spots.

Despite their best efforts, Wiwat and his teammates failed. After two exhausting, expensive, and deadly years, Thai researchers found that they had accomplished nothing. The problem had actually grown far worse. That’s when Wiwat threw out the handbook. Rather than accepting the word of people who had never actually succeeded in eliminating the rapid transmission of the disease, Dr. Wiwat decided to conduct a more intensive search for a strategy. He started by poring over data about the transmission cycle of AIDS through Thailand.

It didn’t take Wiwat long to realize that 97 percent of all new HIV infections were coming from heterosexual contact with sex workers. This statistic might seem a bit odd until you learn that Thailand has over 150,000 sex workers—about 1 for every 150 adult men. Wiwat’s concern was that, when induced by low prices and abundant supply, the vast majority of Thai men periodically visited brothels.

This statistic gave Dr. Wiwat the focus he needed. If contact with sex workers was causing the pandemic, he had no choice but to focus his attention there—despite the fact that the government refused to admit that the massive sex trade industry even existed. With over a million HIV infections in Thailand, Wiwat decided the time for political sensitivity and social niceties was long past. If the problem was born in a brothel, the solution would be found there as well.

After continuing his search for a solution, Wiwat surmised that there was a crucial moment—one that disproportionately affected the spread or the stopping of AIDS. It was when a sex worker chose—or did not choose—to demand the use of a condom. Wiwat had uncovered (1) the crucial moment (the point at which if you acted differently, you’d avoid the disease), and (2) the vital behavior that needed to follow. If he could influence 100 percent of the country’s sex workers to act differently in this moment, he could nearly stop the spread of HIV in Thailand. That became his primary strategy. He’d find a way to get every single sex worker to comply with the condom code. And much to the surprise of the world’s epidemiologists, Wiwat’s plan worked. He helped save millions of lives.

MIMI SHOWS THE WAY

The idea of finding but a few vital behaviors is an important and unlikely enough concept that it deserves a second example. After all, the idea of attacking but a few actions and then expecting enormous results flies in the face of years of tradition and “common sense.” To see how this might apply to something even more complex, let’s look into an example that demonstrates quite nicely how identifying, creating, and maintaining a couple of high-leverage actions can provide the perfect beginning to the most challenging of change programs. To do so, we’ll travel to San Francisco and meet Dr. Mimi Silbert. She’s the founder of Delancey Street, a one-of-a-kind organization with headquarters at an upscale address on San Francisco’s Embarcadero. Silbert’s company is part corporate conglomerate and part residential therapy. It consists of several dozen businesses.

What’s unique about Delancey is the employee population. In Silbert’s words, “They’re nasty, racist, violent, and greedy. They’re thieves, prostitutes, robbers, and murderers.” Then she adds: “When we started 30 years ago, most were gang members. Today, many are third-generation gang members.” According to Silbert, “These guys get letters from Grandma saying, ‘Get back here—the gang needs you!’ ” Dr. Silbert’s typical new hires have had multiple felony convictions. They’ve been homeless for years, and most are lifetime drug addicts.

But this doesn’t stop Dr. Silbert from asking a great deal from them. Within hours of joining Delancey, they are working in a restaurant, moving company, car repair shop, or one of the many other Delancey companies. And other than Silbert herself, these felons and addicts make up the entire population at Delancey. No therapists. No professional staff. No donations, no grants, no guards—just a remarkable influence strategy that has profoundly changed the lives of 16,000 employees over the past 30 years. Of those who join Delancey, over 90 percent never go back to drugs or crime. Instead they earn degrees, become professionals, and change their lives. Forever.

Meet James

One of the employees you might meet if you stop by the restaurant is a well-scrubbed, affable but steely-eyed fellow we’ll call James. James’s story is typical of Silbert’s staff. Like many of the 500 residents living on the San Francisco campus, James was a career criminal and drug addict before coming to Delancey. And like most, he started young. After four years as a regular runaway, criminal, and drug abuser, James turned 10. By that time Illinois was fed up with his shenanigans. The state officials had tracked down James’s father—who had abandoned him at age one. State justice authorities wished James good luck as they stood at a gate at the O’Hare airport while making sure he understood that he was no longer welcome in Chicago.

James flew to Oakland, California, where he took up residence with his father near the docks. The first lesson his dear old dad taught him was how to shoot heroin. The next 25 years consisted of an uninterrupted period of violent crime, drug abuse, and prison time. Six years ago he was convicted of yet another violent offense, and he was sentenced to 18 years with no hope of parole for 16 years. That’s when he asked to join Delancey rather than serve his full sentence.

James changed in ways that are hard to imagine. Should you run into him at Delancey, you’ll see that he is professionally dressed and has not used drugs or alcohol in years. To learn how Dr. Silbert influences this kind of change, we’ll touch base with her work throughout this book. She draws from the principles and practices of every one of the influencers we’ve studied to date.

To see exactly how only a few vital behaviors played an enormous role in both causing and solving profound problems with people such as James, let’s examine what Dr. Mimi Silbert does to help people turn their lives around. She learned early on that if you’re going to work with subjects whose lives are an undifferentiated bundle of dysfunctional behaviors, you have to limit your scope of influence by identifying only a couple of vital behaviors and then working on them. Otherwise you dilute your efforts and eventually fail. As you chat with Dr. Silbert, she’s quick to point out that if you want to help ex-cons change their lives, you need to focus on behavior, not values, homilies, or emotional appeals. Just imagine Mimi Silbert giving a value-laden lesson to James on his first day at Delancey.

James vividly describes what she’d be up against.

“When residents wake up in their nine-person dorm the first morning and you say, ‘Good morning’ to them, they say, ‘$%@^{^} you!’” A sermon on courtesy just isn’t going to cut it in this venue.

So Dr. Silbert focuses on changing behaviors, not on preaching homilies. And, once again, a few behaviors, not dozens. In Silbert’s words: “You can’t succeed by trying to change 20 things at the same time!” So Silbert made a study of the behaviors that needed changing, hoping to find a couple that would provide focus and leverage in transforming criminals into citizens. After working with over 16,000 felons, Silbert is now convinced that just two behaviors open the floodgates of change. If you focus on these two, a whole host of other behaviors, values, attitudes, and outcomes follow. Silbert explains how it works.

“The hardest thing we do here is try to get rid of the code of the street. It says: ‘Care only about yourself, and don’t rat on anyone.’ However, if you reverse those two behaviors, you can change everything else.”

James elaborates: “Helping residents learn to confront problems is essential. We’ve got Crips, Bloods, white supremacists, Mexican Mafia, and every other gang here, and they’re all bunking together. As you might imagine, the tension runs high. Everything we try to change in here is about getting rid of the gang culture.”

With this in mind, Silbert targets two high-leverage behaviors that help residents talk in ways that eventually destroy the gang culture. First, she requires each person to take responsibility for someone else’s success. Second, she demands that everyone confront everyone else about every single violation or concern.

To transform these ideals into realities, each resident is placed in charge of someone else the very first week. For instance, say you’re a resident who was homeless and strung out on crack a week ago. During the seven days since coming to Delancey, someone who had been a resident for only a little longer than you would take you under his or her wing and teach you to set a table in the restaurant. A week later when someone even newer than you comes in, you’re in charge of teaching that person to set the table. From that moment forward, people no longer talk to you about how you are doing. They ask you how your crew is doing. You are responsible for them.

Next, residents practice the second vital behavior: to speak up to people who are breaking rules, drifting off, becoming verbally aggressive, and otherwise behaving badly. For most excriminals, talking about these types of problems is like speaking a foreign language. Ultimately, Silbert helps residents change their values and attitudes—even their hearts—but she does so by focusing on two vital behaviors. Silbert has seen that if she can just get these two behaviors happening consistently among the 1,500 residents, everything changes.

Later we’ll explore how Dr. Silbert influences a reluctant group to actually adopt these behaviors. We’ll also see how Dr. Wiwat actually got sex workers to practice 100 percent condom use. Obviously, simply knowing the behaviors isn’t enough. But for now, let’s not miss this second key to influence. Most of us are in such a rush to influence others that we fail to stop and thoughtfully decide what behaviors we want to change. Influencers are scrupulously careful about identifying vital behaviors before setting off to create change.

Acting hastily can not only lead to failure but can also create costly side effects. With the spread of HIV/AIDS, the rush to action took the form of ineffective “awareness” campaigns that burned up resources and did nothing to stem the flow of a deadly disease. With convicted felons, the rush to action has led to so many failures that today’s penal institutions make no claim on rehabilitation whatsoever.

STAY FOCUSED

Wiwat’s and Silbert’s work provides us with a classic example of the Pareto Principle, the old 80-20 Rule. This rule suggests that for whatever your change topic may be, 80 percent of your results come from 20 percent of your efforts. This means that even for the most complicated problems, ones that are influenced by, say, 10 different behaviors, influencers should focus their efforts on the top 2—and only the top 2. If they spend time on the top 4 or 5 behaviors, or, worse still, on all 10 behaviors, they’ll spread themselves too thin.

Think of all the ways Wiwat could have lost his focus. In Thailand, the sex trade is a seamy underside that most would rather ignore, and in polite Thai society, people don’t discuss condoms. It would have been easy for Wiwat to have given in to pressure, to water down his approach by focusing on a whole array of positive social behaviors that are worth changing—like overturning sexual taboos, improving gender equality, or reducing the sex trade. Every one of these is a tremendously worthwhile thing to do. But Wiwat couldn’t do everything. He had to identify the behaviors that were most vital to the result he was trying to achieve. It was Wiwat’s laser focus on 100 percent condom use by sex workers that led to a disproportionate amount of change—saving millions of lives. Silbert’s focus has made her efforts not only successful but also the model for criminal rehabilitation worldwide.

Now, let’s see how this might apply to something even more local—say, your marriage or significant relationship. Let’s say you’re in a relationship that is good but not great. How do you improve it? Once again, there are dozens of behaviors and attributes you could say are keys to great relationships—spending time together, sharing interests, listening, sexual compatibility—to name a few. So here’s the big question. Could it be that only a couple of controllable actions make most of the difference in a relationship?

To answer this question, we visited marriage scholar Howard Markman’s Relationship Lab. After years of observation, Markman found that overcoming just four hurtful behaviors reduces the chances of divorce or unhappiness by over one-third. Markman and his colleagues can watch a couple interact for just 15 minutes and predict with 90 percent accuracy who will and who won’t be together and happy five years later—simply by watching how the couple behaves during one crucial moment. The moment of disagreement.

These researchers discovered that staying happily married isn’t about 50 things. Rather, they found that it primarily comes down to how people behave during the few minutes a day or week when they disagree. If a couple’s disagreements include significant amounts of four behaviors (blaming, escalation, invalidation, or withdrawal), then their future is bleak. If, on the other hand, they learn to take time out and communicate respectfully during these few minutes, then their entire future will be far brighter.

The 80-20 Rule has proven itself across problems in areas as different as improving student test scores, maintaining oilrig safety, and preventing medical errors. Across all these domains, we find the same hopeful, and yet counterintuitive principle. A handful of high-leverage behaviors drives most of the improvement in any successful change effort. Discover these vital behaviors and change them, and problems—no matter their size—topple like a house of cards.

FIND THE VITAL BEHAVIORS

Knowing that you need to find high-leverage behaviors and focus your efforts on them raises these questions: How do you find them? What if they aren’t obvious? If you’re not careful, you could easily focus all of your attention on the wrong behavior and achieve no results. For instance, a graduate student working with renowned psychologist Albert Bandura once went to the effort to teach alcoholics how to relax. Why? Because he thought it would be an important behavior in an alcoholic’s road to sobriety. After all, alcoholics experience a lot of stress in their lives, so the grad student concluded that teaching them relaxation skills might help them reduce their drinking.

It turned out that the alcoholics were excellent learners. In fact, they seemed exceptionally adept at developing relaxation techniques. But it didn’t reduce their drinking one iota. At the end of the study, the grad student was left with a bunch of very relaxed drunks. Getting people to relax was not a vital behavior for reducing drinking.

Successful influencers escape such debacles. They avoid spending time and effort on the wrong behaviors by drawing from the following four vital behavior search strategies:

• Notice the obvious. Recognize behaviors that are obvious (or at least obvious to experts) but underused.

• Look for crucial moments. Find times when behavior puts success at risk.

• Learn from positive deviants. Distinguish behaviors that set apart positive deviants— those who live in the same world but somehow produce much better results.

• Spot culture busters. Find behaviors that reverse stubborn cultural norms and taboos.

Search Strategy 1. Notice the Obvious

Back in the 1970s, one of the authors had a summer job with the Stanford Heart Disease Prevention Clinic. For this particular science project, researchers were trying to determine the behaviors that separated the healthy residents of San Jose, California, from their less healthy neighbors. This study was completed a long time ago, and you may have never visited San Jose, but can you guess what their findings were?

Hint: They’re pretty obvious.

Researchers found three behaviors that made nearly all of the difference in the subjects’ health. Healthy people exercise more, eat better, and don’t smoke. And what do we, as budding change agents, learn from this? Finding these vital behaviors isn’t exactly rocket science. Many vital behaviors are just this obvious.

So here’s the first strategy for finding those oh-so-valuable vital behaviors. Look for behaviors that are both obvious and underused. These are actions that lead directly to the desired results and often come with a big “Duhhh!” But they are also typically underused—not because we’re morons, but because the behaviors can be exceptionally difficult or unpleasant. You find these high-leverage actions either by simply applying what you already know or by doing a quick search of what experts say about the topic. If it’s easy for you to see the big-hitting actions or if you can find quick consensus from experts, you have a vital behavior.

Now, influencing this kind of vital behavior will take all six sources of influence— and using all of them is the third key to influence. But don’t underestimate the importance of getting the second key right. Even if the behaviors are obvious or they have already been discovered by experts, identifying and focusing on them are the keys to leveraging your influence efforts.

Here is a second example that looks at this obvious, but underused, category. Can you guess the three vital behaviors that drive success during students’ first year in college? The dropout rates for first-year students at some colleges are as high as 50 percent, so academic leaders worry endlessly about influencing these students to succeed during their first crucial year. Dropping out is disastrous for both the students and the schools.

This time, since it may not be obvious to your average citizen, we’ll rely on our second quick-search tool—experts. In this case, a quick Internet search put us in touch with researchers from a large Midwestern university who culled reams of data examining patterns of success and failure and identified three vital behaviors. If you want to make it past that first tremulous year: attend class, complete assignments (duh!), and make friends (really?). The first two sound pretty obvious, and they are clearly underused by the dropouts. But does making friends really separate the A’s from the F’s?

So we asked the experts why making friends was vital. They taught us about a rite-of-passage that often happens over the Thanksgiving holiday weekend. First-year students go home for their first real vacation from college, and many either break up with or get dumped by their high school sweethearts. These Thanksgiving breakups are so common that college counselors have given them a name: the “Turkey Drop.” And college counselors welcome these Turkey Drops. The students return from Thanksgiving serious and a little depressed. They dig into their studies, and they begin to make new college friends. They cut their ties with high school, and they begin to identify with their new role. Students who don’t make this transition to new friends and a new identity drop out at a much higher rate.

So, before you aim your efforts at the wrong behaviors, stop and look for candidates who are immediately obvious to you or have already been discovered by experts. Apply what you already know. Then, do an Internet search or talk with local experts, and see if you can find credible research that supports clear consensus on other high-leverage behaviors.

Search Strategy 2. Look for Crucial Moments

As you intensify your research for vital behaviors, you’ll need to become quite familiar with a concept we only alluded to earlier—crucial moments. Most of us are mostly successful most of the time. This means our problems typically boil down to a few perfect storms when everything lines up against us. The behaviors that help us succeed in these few crucial moments become vital.

For example, while we were working with Noble Drilling, a world leader in offshore oil drilling and a leader in workplace safety, internal experts described their safety challenge in the following way: “In our company 98 percent of our people do 98 percent of the right stuff 98 percent of the time. And that’s not good enough!”

Notice how this statement focuses the search for vital behaviors. If Noble Drilling could find the 2 percent of the times when 2 percent of their people did 2 percent of the wrong stuff, it would have tremendous leverage for improvement. And that’s what the company leaders did. They looked for crucial moments. They studied safety violations, and they documented the times, people, places, and circumstances when they occurred.

It turned out that their employees followed nearly every safety regulation nearly all the time, with a few exceptions. One exception was when the rig was down—not operating. When a rig is up, it brings in about a quarter of a million dollars a day. When it’s down, it brings in nothing, and as you might imagine, everyone goes into emergency overdrive. The sound of “We’re not making money!” rings through the rig, and people respond by taking shortcuts and skipping safety steps in order to get the rig back to making money. Nobody asks them to take shortcuts or turn a blind eye to safety protocols. They just do.

The other exception was similar, but it involves the weather. When a big storm is approaching and workers have to button up and evacuate the rig, they again feel entitled to take shortcuts and skip safety steps.

The third crucial moment stemmed from the fact that offshore oilrigs provide a vertical environment. They don’t have much of a footprint, but they soar hundreds of feet into the air. Thus the third crucial moment was whenever someone was working on or around ladders. The most common and hurtful injuries occur when people fall from ladders or drop things from ladders.

These three crucial moments suggested the vital behaviors the company needed to encourage and enable. Noble Drilling’s vital behaviors became the following:

• When a rig is down or it is behind schedule, or when a storm is approaching, hold a safety meeting, and take extra care to follow every safety precaution.

• Whenever you are climbing above the deck, tie off the ladder, use a safety harness, and never carry items in your hands.

These weren’t easy behaviors to implement, but Noble Drilling focused all of its efforts on these two. And focusing on these two vital behaviors saved dozens of lives.

Let’s now move away from the oilrigs and into an environment you might be more familiar with—a fast-food restaurant. After working closely with the leaders of a large chain of fast-food establishments, we learned a great deal about the following not-so-obvious vital behaviors.

Suppose you’re the owner of a burger joint, and you’re looking for ways to improve customer service. Your first effort takes you to a training course where you invest in training the restaurant managers and staff. On the whole, the managers are happy with the training, and they believe it was helpful. The only problem is that their customer service numbers haven’t improved.

Next you take steps to find your crucial moments and the resultant vital behaviors. First, you look for failure modes. In your case, customer service failures consist of ignoring a customer who is trying to order, taking too long to complete an order, and delivering a poor-quality order. Notice what your failures don’t look like. No one is yelling or cursing or being rude. Employees are nearly always nice, but that isn’t enough to create high customer satisfaction scores.

Next, you look for the times and circumstances (the crucial moments) when these particular failures happen. You do this systematically by mapping the problems by time of day, time of week, and restaurant conditions. Here’s what you find. More than 80 percent of the problems occur during one of three conditions: when the restaurant is shorthanded (down by at least two people); when one or more of the restaurant’s ovens is down; and when you have an unanticipated rush of customers that overwhelms the staff.

Then you look at your own and your staff’s behaviors during these crucial moments. You discover that you yourself often contribute to the problem. When the restaurant is overloaded or an oven is down, you often step into an employee role. You work the cash register or try to fix the oven. This takes you out of the quarterback role, and it results in poor customer service. Based on what you learned about your failure modes and crucial moments, when the restaurant is overwhelmed due to a staffing or equipment problem, you focus on two vital behaviors:

• You stop whatever you are doing and bring in your on-call team members.

• You become the quarterback and run a quick practice with the new staff configuration until the customers are served the right food the right way.

Finding and influencing vital behaviors for these crucial moments produce dramatic improvements in the customers’ satisfaction.

Search Strategy 3. Learn from Positive Deviants

Do you consider yourself a deviant? Hopefully you are, at least sometimes. Here’s why. A positive deviant is a person who, by all rights, ought to have a problem but for some reason doesn’t.

If you can find individuals who face the same challenges as your struggling group, yet have found a way to succeed, then you can learn from their solution.

Here’s an example. We once worked with a hospital team that transcribed physicians’ notes. Transcribers sat at computers wearing headphones, and they typed what they heard into files. But recently their jobs had been radically altered by technology when the hospital introduced a new voice-recognition system that did 80 percent of their previous work for them. Here was the dilemma. Despite the technological advances, their productivity had actually decreased, and their morale had nosedived along with it. These were proud and motivated employees who were doing their best to make the new system work, but they were growing impatient.

So where would you go to learn why results had deteriorated when they should have improved? The first step in any positive deviance study is to find individuals who have found a way to succeed despite the change in conditions. In short, see if you can locate positive deviants in your midst. The department manager did this and discovered three women whose productivity hadn’t decreased but had actually improved tenfold.

The second step is to ask members of the standard community and the positive deviants to observe each other’s behaviors to see what they might be doing differently—especially during crucial moments. A word to the wise is to ask the people themselves—in this case the members of the transcription team—to lead the observations. Evidence is more compelling when you discover it for yourself.

Here is what the transcription team discovered. The three outliers, their positive deviants, had each independently created keyboard shortcuts to make their jobs faster. These shortcuts were the vital behaviors that made all the difference.

The final step is to have these vital behaviors adopted across the population. In the case of the transcription team, the three positive deviants compared notes, picked the best of their shortcuts, and then created a short lesson for the others on the team. Within the week everyone’s productivity had improved by a factor of 10, and morale was as positive as it had ever been.

Search Strategy 4. Spot Culture Busters

As you search for vital behaviors, watch for crucial moments that call for behaviors that are currently taboo or punished or that challenge cultural norms. Many unhealthy behaviors continue for years within organizations because confronting them openly simply isn’t done. Speak honestly and you pay for it. For example, when Spectrum Health Grand Rapids worked to eradicate hospital-acquired infections, the company’s leaders learned that the vast majority of these infections are caused by inadequate hand hygiene on the part of the staff. Consequently, they set a goal of having everyone wash or use a disinfectant every time he or she entered or left a patient care area.

Washing in and out requires people to scrub their hands hundreds of times each day. If you’re at all normal, you’re likely to slip up now and then. Consequently, to no one’s surprise, in positive deviant units—those that had abnormally high levels of hand hygiene compliance—a tandem of vital behaviors was routinely optimized. First, whenever someone failed to wash his or her hands, a colleague reminded him or her to do so.

Here’s where norms come into play. Speaking up is generally taboo within healthcare, especially when it involves reminding people higher in the pecking order. For example, a housekeeper is cleaning a patient’s windows when he sees a surgeon rush in. He hasn’t seen her wash her hands, but he isn’t sure that she hasn’t. Will the housekeeper speak up? The weight of the culture says “No.” And if he tries this vital behavior once, what will predict whether he does it again and again—making it a new norm?

It depends on what happens after the next crucial moment. The instant the housekeeper issues the reminder, he feels incredibly vulnerable. But that vulnerability disappears if the surgeon enacts the second vital behavior by saying one simple thing: “Thank you.” If she utters this potent phrase, the housekeeper heaves a sigh of relief, and he decides that speaking up is not only helpful in ensuring success but it also won’t get him yelled at. Without this second vital behavior (thanking the person who reminds you to wash), the old norm will continue and hand hygiene problems will rage on at unacceptable levels.

Notice that these two behaviors are explicit reversals of the long-standing, yet unspoken, culture. They take an unwritten rule, and they turn it on its head with a written, trained, and practiced one. When these two new behaviors were first introduced at Spectrum Health, and later at the Yale New Haven Health System, they were so countercultural that many staff members doubted they would ever be adopted. In each case, it took all six sources of influence (our third key to influence), but they became the new norms. And when they did, hand hygiene improved dramatically.

By the way, if you’ve been paying attention, you may have noticed a pattern in some of the culture-busting vital behavior examples we’ve shared so far. In the hundreds of influence cases we’ve studied, one of the most consistent vital behaviors for driving change involves helping someone step up to some crucial conversation. In fact, our research into crucial conversation skills came from this consistent finding. Whether it’s reducing AIDS in Thailand, criminal recidivism at Delancey Street, Guinea worm disease in Burkina Faso, or error rates in software development, one of the most potent behaviors for driving change is influencing people to speak up about a previously emotionally or politically risky issue. Watch for these crucial cultural moments as you look for your own vital behaviors.

Collect Stories to Uncover Norms. As you look into your culture to determine if long-standing traditions are going to go head-to-head with proposed vital behaviors, you could be caught by surprise. After all, cultural norms are frequently invisible to the very influencers who need to deal with them. The concept that “fish discover water last” applies here. Culture so quietly and invisibly surrounds us that we often don’t recognize its unique norms, practices, and unwritten rules.

Of course, just because we don’t notice them doesn’t mean they aren’t exerting a powerful force. Consequently, influencers’ first job in seeking culture buster behaviors is to map their own culture, and the best way to accomplish this is by gathering stories. For instance, one of our projects had us working with truck drivers who drove for gold mines in Ghana and Indonesia. Our goal was to make the roads safer for both the drivers and their neighbors. The drivers knew the written rules of the road: the laws regarding speeding, passing, and leaving the scene of an accident. But everyone also knew that these laws were largely ignored. Consequently, to turn this around, we were more interested in the unwritten rules of the road: the norms and expectations that actually governed drivers’ actions.

We collected stories (as opposed to opinions or suggestions) from hundreds of the drivers. We asked for stories about accidents and near accidents. For this project, we used a networking tool that allowed us to collect stories in the drivers’ own words and languages. (You can also use traditional interviews and focus groups for this purpose.) Stories provide a window into the storytellers’ culture. In this case, the narrative accounts revealed the unwritten rules drivers actually followed on the road—rules such as, “Obey speed limits—unless you’re driving bosses who are in a hurry” and “Pedestrians never have the right of way.” These were the unwritten rules the gold mining company’s leaders would need to change. Once they surfaced these unwritten rules, they found vital behaviors to change them—and aimed all six sources of influence at nurturing these new vital behaviors. But none of this would have been possible if they hadn’t first taken the time to surface hidden but powerful cultural norms by collecting stories.

TEST YOUR RESULTS

The four methods we’ve discussed for finding vital behaviors provide a good starting point, but they aren’t foolproof. They often call for subjective judgments. All four help surface vital behaviors that are plausible, but they may still need to be rigorously proven. Fortunately, this search methodology provides enough information to take your project to the next level. When stakes are high enough and resources are available, you can start a genuine research project of your own. That is, you can track both the vital behaviors and the results you care about to see if an increase in behavior leads to an increase in the result. Then, as appropriate, you can make changes and continue to conduct similar mini experiments until you’ve located the vital behaviors that yield the results you want. While it’s true that you might not have the resources to complete such a study, it’s nice to know that it can and has been done, even within traditional corporations.

Meet Ethna Reid

To see how the search for vital behaviors is key to a rigorous influence project, consider the efforts of learning expert Dr. Ethna Reid. She has spent over 50 years doggedly observing teachers in order to identify the vital behaviors that separate the best from the rest. She has codified, gathered, and studied data on virtually every type of teaching behavior, compared these behaviors to the desired results, and discovered a handful of high-leverage actions that make all the difference.

One of the vital behaviors Dr. Reid has unearthed concerns the use of praise versus the use of punishment. (For some, this appears to be a no-brainer.) The best teachers reward positive performance far more frequently than their counterparts. A second vital behavior is that teachers rapidly alternate between teaching and testing. Then, when required, they make immediate corrections. Poor performers drone on for a long time and then let students struggle, often allowing them to repeat errors. By watching positive deviants (those teaching similarly challenged students who get substantially better learning) and discovering the actions they took that separated them from the pack, Dr. Reid has been routinely successful in uncovering the vital behaviors leading to improvements in everything from reading comprehension to vocabulary acquisition.

Of course, the real test of a vital behavior comes when scholars take newly discovered vital behaviors and teach them to experimental groups. If they have indeed found the right behaviors, experimental subjects show far greater improvement in the desired outcome than do control subjects who fail to implement the vital behaviors.

This is where Ethna Reid reigns supreme. Studies she has conducted in Maine, Massachusetts, Michigan, Tennessee, Texas, North Carolina, South Carolina, Nebraska, Washington, Virginia, Hawaii, Alabama, and California have shown that, independent of the topic, pupils, school size, budget, or demography, changes in the vital behaviors Reid has discovered improve performance outcomes that influence the entire lifetime of a student.

From this best-practice research we learn two important concepts. First, careful research is sometimes needed to weed out “good” behaviors from the vital few. And second, in many of the areas in which you’d like to exert influence, the vital behaviors research has already been completed for you. For example, if you want friends, children, or loved ones to live healthily with type 1 diabetes, you’ll need to find a way to motivate and enable them to complete two vital behaviors that have already been found: they should test their blood sugar four to seven times a day, and they should adjust their insulin appropriately to keep their blood glucose in control. These two behaviors substantially increase the likelihood of a normal, healthy life. If you search carefully, you’ll find that good scholars have already found the vital behaviors that solve most challenges that affect a large number of people.

SUMMARY

Master influencers know that it takes only a few behaviors to create big changes in the results they care about. To do so, they look vigilantly for one or two actions that create a cascade of change. They move through this phase by using a combination of four search techniques. They look for obvious but often underutilized actions. They then seek confirmation of what seems obvious to them by examining the advice of experts. When tailoring their own change program and trying to see what will work for them (given their unique circumstance), they look not at the 98 percent of the time they’re successful but the 2 percent of the time when they fail. They then use these crucial moments to inform the actions that need to follow. Often successful influencers surface these high-leverage actions by studying individuals within their organization or circumstances who face similar problems and yet have found a way to succeed. Finally, they watch for behaviors that might be needed to break free of a culture that sustains past problems.

So, you’ve identified the results you want. You’ve found the vital behaviors that should get you there, and now all that’s left is to help people to adopt those behaviors. This, of course, is akin to saying, now all you need is a miracle. Because, of course, if it were a simple matter to get people to do what they should, persistent and resistant problems would have been resolved years ago. That’s why we’ll now devote the next half dozen chapters to creating methods that both enable and encourage people to enact those precious vital behaviors.