Leading change that lasts: Sticky strategies for healthcare leaders

As healthcare leaders, we constantly strive to improve patient care, operational efficiency and staff engagement. Yet, affecting meaningful change requires more than good ideas. It requires communicating those ideas in a way that “sticks” with the people who need to implement them. Good communication is vital in healthcare. In addition to improving patient outcomes,¹ good communication helps organizations by:  

1. Reducing workplace stress: About 50% of American employees experience workplace stress due to inadequate organizational communication.² Clear and effective communication can alleviate this stress, leading to a more productive and harmonious work environment.
2. Enhancing employee engagement: 85% of employees are most motivated when they are updated on corporate news and information.³ Communicating effectively increases employee engagement, satisfaction and retention, leading to less turnover.
3. Boosting organizational efficiency: Inefficient communication costs organizations substantial amounts annually. Even in smaller companies with 100 employees, miscommunication costs an average of $420,000 per year.⁴ Improving communication strategies can significantly reduce these costs and improve organizational efficiency.

Chip and Dan Heath’s New York Times best-selling book Made to Stick offers invaluable insights into communicating memorable and impactful ideas. Here’s how healthcare leaders can apply the six Made to Stick principles to drive change effectively.

Principle 1: Keep it simple

Sticky messages are often short. Try to sum up your point in a single sentence or phrase to compel others to follow it. An example of this principle is the Golden Rule: “Treat others like you want to be treated.” It originates from the Bible as a rule of conduct summarizing a person’s duty to their neighbor.⁵ This message is so sticky that it has appeared worldwide throughout history.

In healthcare, simplicity often translates to clear, concise communication that avoids unnecessary complexity. One example is using SBAR (Situation, Background, Assessment, Recommendation). SBAR is a verbal or written communication tool that helps provide essential, concise information, usually during crucial situations. The United States military introduced it in the 1940s and later targeted specifically nuclear submarines where concise and relevant information was essential for safety. Since then, the SBAR communication tool has been used in various industries, and its ability to improve safety is well documented.⁶  

• Tip: Next time you launch a new initiative, create a one-sentence summary or acronym that captures the core message. Make sure every team member understands this summary and can articulate it clearly.

Principle 2: Make it surprising

Jane McGonigal is a world-renowned author, game designer and researcher. In her TED Talk “The Game That Can Give You 10 Extra Years of Life,” she begins by stating:

I’m a gamer, so I like to have goals. I like special missions and secret objectives. So, here’s my special mission for this talk: I’m going to try to increase the lifespan of every single person in this room by seven and a half minutes. Literally, you will live seven and a half minutes longer than you would have otherwise just because you watched this talk.⁷  

McGonigal used that talk to discuss her own health journey, four types of resilience — physical, mental, emotional and social — and how regularly boosting those forms of resilience can help you live 10 years longer. [You can watch the full video to discover how she arrives at the seven-and-a-half-minute figure.]

Healthcare professionals are bombarded with information daily. To capture their attention, your message must break through the noise. During the COVID-19 pandemic, we asked an infectious disease doctor in our medical group to educate the staff on ways to reduce the spread of COVID and other respiratory illnesses. He began his presentation by asking, “Did you know that the average person touches their face 50 times per hour?”⁸ His question piqued everyone’s interest and encouraged attendees to lean into the discussion. He went on to emphasize the importance of handwashing and limited facial touching to curb the spread of viruses. 

• Tip: Start your communications by opening with a surprising fact, a provocative statement, a confession or a question that challenges assumptions and piques curiosity.

Principle 3: Make it concrete

Concrete details make abstract concepts easier to understand. For example, this approach is used by financial advisors to help their clients understand the best ways to save money. Rather than giving vague advice like, “Just to put money away,” advisors tend to recommend to, “Set aside 10% of your monthly income into a high-interest savings account to build an emergency fund.” This specific, actionable advice clearly explains the specific step to take and its benefits.

In healthcare, the PDSA cycle — Plan (develop improvement ideas), Do (implement the plan), Study (analyze the results) and Act (make necessary adjustments based on the findings) — is a practical method for implementing and evaluating process changes.⁹ PDSA graphs are commonly seen on visual boards throughout high-performing healthcare organizations. This approach helps to ensure that changes are concrete, effective and sustainable.    

• Tip: Use specific, tangible examples and actions in your communications. Whenever possible, try to demonstrate procedures visually or through hands-on training.

Principle 4: Be credible

Achieving the appropriate level of credibility encourages people to listen to and embrace your ideas. We are more inclined to value information from a trusted source rather than from a stranger, a principle of which advertising agencies take full advantage through celebrity endorsements. A notable example is Under Armour’s partnership with NBA star Steph Curry, who designs his signature basketball shoe line, resulting in significant success for the brand.¹⁰  

Credibility in healthcare often comes from trusted authorities and evidence-based practices. For example, the ABIM Foundation’s “Choosing Wisely” campaign encourages conversations about unnecessary tests and treatments between doctors and patients, gaining credibility from the endorsements of more than 80 medical specialty societies. These endorsements ensure that the guidelines are trusted and adopted widely.¹¹ 

• Tip: Leverage the credibility of experts and peer leaders within your organization to champion new initiatives. Share evidence-based results to support your proposals.

Principle 5: Appeal to emotions

Appeal to the emotional side by connecting your message to values and beliefs. Growing up in Texas, I witnessed the immense pride Texans have in their identity. In 1986, The Texas Department of Transportation tapped into this sentiment by launching an anti-littering campaign called, “Don’t Mess with Texas.” The campaign featured bumper stickers, radio ads and television commercials featuring famous Texans from movies, music and sports declaring they don’t litter, ending with the popular slogan. The campaign successfully reduced littering by 29% in its first year and saw a 72% decrease in roadside litter over the first five years.¹²   

The Cleveland Clinic’s video, “Empathy: The Human Connection to Patient Care,” with more than 7 million views on YouTube, appeals to viewers’ emotions about healthcare. It encourages viewers to envision thought bubbles floating over the heads of patients, family members and healthcare personnel, highlighting the oft unnoticed hardships people face in their lives. It stresses how empathizing with others’ lived experiences can improve patient care, making it more compassionate and effective.¹³ 

• Tip: Incorporate personal stories and testimonials that highlight the human impact of your initiatives. Target emotions that resonate with your team’s values and experiences. 

Principle 6: Driving action through storytelling

A story that people can relate to because of their lived experiences will be recalled, retold and leveraged to spread ideas. Take the story of Wilma Rudolph. Rudolph was born prematurely and contracted polio at a young age — leaving her with a paralyzed leg — and was told she would never walk again. After years of rigorous physical therapy, she not only walked again but went on to become an Olympic athlete. Rudolph made history at the 1960 Rome Olympics, where she became the first American woman to win three gold medals in track and field in a single Olympics. Her performance earned her the title of “the fastest woman in the world.” Rudolph’s story is a powerful example of never giving up and having unwavering faith in oneself, even in the face of overwhelming challenges.¹⁴  

Stories like these are excellent tools for illustrating ideas and can help drive change in healthcare. Dr. Susan Moffatt-Bruce led an initiative at The Ohio State University Wexner Medical Center (OSUWMC) to enhance surgical safety by mandating surgeons mark surgical sites before entering the operating room. Some of the surgeons initially resisted, believing they should delegate this task to residents. To emphasize the importance of this change, Dr. Moffatt-Bruce arranged for surgeons to meet a patient who had undergone a wrong-site surgery, which made the issue more tangible and relatable. This led the surgeons to accept and implement the new protocol, significantly improving patient safety and reducing surgical errors.¹⁵ 

• Tip: Collect and share stories from within your organization that exemplify the success of past initiatives. Use these stories to illustrate key points and motivate your team.

Conclusion

By applying the six principles outlined in “Made to Stick,” healthcare leaders can communicate better and introduce change more effectively. By keeping messages simple, unexpected, concrete, credible, emotional and narrative-driven, you can ensure that your ideas resonate with your team, leading to improved patient outcomes and a more efficient healthcare system. 

Notes:

1. Sharkiya SH. “Quality communication can improve patient-centered health outcomes among older patients: a rapid review.” BMC Health Serv Res 23, 886 (2023). https://doi.org/10.1186/s12913-023-09869-8 .
2. Interact/Harris Poll. 2024 State of Business Communication Report. 
3. NorthStar Leadership Training. “Statistics on why effective communication is important in the workplace.” LinkedIn. June 20, 2022. Available from: https://bit.ly/3BrPop5 .
4. Hamilton D. “Top Ten Email Blunders That Cost Companies Money,” Creative Communications & Training, 2010.
5. “Golden Rule.” Encyclopedia Britannica, Updated Aug. 14, 2024, Available from: https://bit.ly/3Y0Y0vM .
6. American Society for Quality. “SBAR Quality Glossary Definition.” Available from: https://bit.ly/3YdFX5L .
7. McGonigal J. “The Game That Can Give You 10 Extra Years of Life.” TEDGlobal. June 2012. Available from: https://bit.ly/4eKvpQD .
8. Rahman J, Mumin J, Fakhruddin B. “How Frequently Do We Touch Facial T-Zone: A Systematic Review.” Ann Glob Health. 2020 Jul 6;86(1):75. doi: 10.5334/aogh.2956.
9. AHRQ. Health Literacy Universal Precautions Toolkit, 3rd Edition. Available from: https://bit.ly/3ZKiF8z .
10. Sports Business Journal. “Curry, Under Armour looking to continue off-court growth of brand.” Feb. 27, 2024. Available from: https://bit.ly/3XZ9gbT . 
11. ABIM Foundation. Choosing Wisely. Available from: https://www.choosingwisely.org .
12. McClure T, Spence R. Don’t Mess With Texas: The Story Behind the Legend. Idea City Press. September 2006.
13. Cleveland Clinic. “Empathy: The Human Connection to Patient Care.” Feb. 27, 2013. Available from: https://www.bit.ly/3bMHlBe .
14. Norwood A. “Wilma Rudolph.” National Women’s History Museum. National Women’s History Museum, 2017. Accessed July 12, 2024.
15. Baumer C, Finnegan A. Personal Stories in Healthcare and Public Health Leadership.