This short post is about how new practices spread from person to person.
High-performance work systems and effective ways of organising are more likely than not to lead to outcomes that are good for workforces, customers and businesses. But so much of this research and good practice is overlooked in practice – and this frustrates the life out of me. My mantra has been that I could think of no other knowledge discipline where so much accumulated insight was so consistently ignored in practice.
But I was wrong about that. Dr Atul Gawande, in an article in The New Yorker, compares the rapid spread of anesthesia to the slow diffusion of antiseptics. Despite Edinburgh surgeon Joseph Lister publishing his evidence in The Lancet in 1867, it was not until the end of the 19th century that things began to change:
“A few pioneering Germans, however, seized on the idea of the surgeon as scientist. They traded in their (blood-slick, viscera-encrusted) black coats for pristine laboratory whites, refashioned their operating rooms to achieve the exacting sterility of a bacteriological lab, and embraced anatomic precision over speed.
The key message to teach surgeons, it turned out, was not how to stop germs but how to think like a laboratory scientist.”
The article is about why simple, life-saving childbirth practices are even today so slow to disseminate. He tells the story of how a junior nurse managed to change the practice of a more senior nurse. It took time, explaining, showing – and it involved swapping personal details about their children and their lives over shared cups of chai.
Here’s a bit from the article where the senior nurse is asked about the experience:
“Why did you listen to her?” I asked. “She had only a fraction of your experience.”
In the beginning, she didn’t, the nurse admitted. “The first day she came, I felt the workload on my head was increasing.” From the second time, however, the nurse began feeling better about the visits. She even began looking forward to them.
“Why?” I asked.
All the nurse could think to say was “She was nice.”
“She was nice?”
“She smiled a lot.”
“That was it?”
“It wasn’t like talking to someone who was trying to find mistakes,” she said. “It was like talking to a friend.”
That, I think, was the answer.
Dr Gawande concludes that diffusion is a social process. Big changes can happen from a groundswell of hundreds, thousands and millions of people connecting personally and emotionally, and influencing each other to do things differently.
Look over the wall
But hold on a minute. I argued in an old post, Social business, it’s catching – or is it?, that although knowledge is transmitted in a social process – passed on person to person as in an epidemic – we continue to learn in silos or tribes. What I said then was:
“If we are not careful though, our allegiance to tribes – workplace, HR, IT, OD (organisational design) etc will be our undoing. Specialisation, a feature of the Taylorist approach, is a strong feature in how we have all been educated. I think we need to make strenuous efforts to look outside the boundaries of our own specialist knowledge – and the tribes that develop around it.
So what are we waiting for? Let’s break out of our knowledge silos and cliques. Let’s get connecting, chatting, re-framing and seeing things differently, seeing things afresh, challenging our stale, fixed thinking, encouraging each other, discovering what has worked for others, trying things out, seeing what happens and trying again when we fail.
I sometimes think we make things more complicated than they really are. Guilty as charged, m’lud!