4. ‘Witty and instructive’ Wall
Street Journal
‘A fantastic book’ Wired.
‘A must read’ Forbes.
‘Any leader looking to
create change in his
organization need not
look beyond this little
book’ Business Week.
Flipkart, Amazon
31. Carrot or Cookie Experiment
Carrot Group Cookie Group
Image: Ashley
32. Carrot or Cookie Experiment
Carrot Group Cookie Group
Image: Ashley
Puzzle image: Patafisik
33. Carrot or Cookie Experiment
Carrot Group Cookie Group
Played puzzle for 8 Played puzzle for 19
minutes an average minutes an average
Attempted 19 solutions Attempted 34 solutions
Image: Ashley
34. Carrot or Cookie Experiment
Carrot Group Cookie Group
Played puzzle for 8 Played puzzle for 19
minutes an average minutes an average
Attempted 19 solutions Attempted 34 solutions
Exhausted! Image: Ashley
35.
36. Lesson 2
What is usually viewed as
laziness problem
is often a
Exhaustion problem.
37. Eat healthy Case study
• Two health researchers
from West Virginia
• Persuade people to ‘eat
healthy’
• Number of ways to eat
healthy
45. Three Surprises & Lessons
• Resistance - Lack of clarity
• Laziness - Exhaustion
• People Problem - Situation
46. Three Surprises & Lessons
• Resistance - Lack of clarity
–Direct the Rider
• Laziness - Exhaustion
–Motivate the Elephant
• People Problem - Situation
–Shape the Path
54. Hip arthritis Case study
Hip arthritis patients
slotted for Hip Surgery
1 NSAID yet 2 NSAIDs yet
not tried not tried
55. Hip arthritis Case study
Hip arthritis patients
slotted for Hip Surgery
1 NSAID yet 2 NSAIDs yet
not tried not tried
43% doctors 28% doctors
gave a trial of gave a trial of
the drug either of drug
56. Free to taste Jam at a mall
10 X more tasters when there were 6 variety
of jams to taste
58. Script the Critical Moves
• Don’t give a Big Picture
• Ambiguity is enemy of Change
• Don’t assume it to be Obvious
59. Script the Critical Moves
• Don’t give a Big Picture
– Give precise Goals
• Ambiguity is enemy of Change
– Make plans crystal clear
• Don’t assume it to be Obvious
– SMART goals is the cure
61. Re-Mission Case study
Children treated for cancer
Post chemotherapy compliance is
crucial for remission. Skipping 20%
medication, ups relapse by 200%.
Pam Omidyar had conviction that a
game, which makes children feel in
control, will increase the compliance.
75. St Lucia Parrot
Exists only in
Caribbean island
of St Lucia
In 1977, only 100
were left
Estimates
indicated species
will to be extinct
by 2000
76. Paul Butler, a 21 year
fresh graduate, into
the scene as
Conservation advisor.
Instead of
conventional action-
plan, he focused on
means to make
people rally for the
parrot and to get
public support
78. People embraced
St. Lucia Parrot
Parrot became their
National identity
Species came back
from the brink
Poaching stopped
completely
Now about 700-800
birds live
80. Medication errors Case study
• Kaiser South San Francisco Hospital
• Nurses administer 800 medications a
day
• Impressive accuracy, only 1/1000
errors
82. A Simple Solution
• Wear ‘Medication Vests’, a bright
colored vest, while administering
medication.
• In six months, 46% drop in
medication errors.
86. Simple solution
• Dr Peter Pronovost compiled a 5-point
checklist.
• Put into practice, over a period of 18
months, it saved hospital and patient an
estimated $175 million
• Saved 1500 lives
87. Simple solution
• Dr Peter Pronovost compiled a 5-point
checklist.
• Put into practice, over a period of 18
months, it saved hospital and patient an
estimated $175 million
• Saved 1500 lives
A Humble Check-list
92. Thank You
Hope you enjoyed
this presentation.
You can get
transcript of this
presentation from
surinderkumar.com.
Hinweis der Redaktion
Heraclites said, ‘You can’t step into the same river twice’. Change is law of nature.
But Change is hard. It needs patience, perseverance, and above all, a blue-print.
Most important point to realize is – things do not change; we change, Henry Thoreau
Movie goers in Chicago. Two groups at random. Both groups were given free popcorn buckets with soft drink. Popcorns were stale, difficult to chew. Quantity in buckets were too much to be finished. Conclusions are: 1. People ate not only for pleasure, they ate because of availability – popcorns were stale. 2. If something is available freely, people will use it.
Conclusions are: 1. People ate not only for pleasure, they ate because of availability – popcorns were stale. 2. If something is available freely, people will use it.
Surprisingly, group I has consumed 153% more popcorns than group II.
What is general impression – there are gluttons in group I! People problem.
People in group I was given bigger buckets.
Situation Problem
People do strange, mostly stupid, things when trapped in a bad situation.
People, caught up in bad situations, do stupid things – cheat, focus on short-term solutions.
Clocky alarm clock by Gauri Nanda.
The moment is goes off, Clocky start moving around in the room. So that one needs to chase it to catch and shut it off.
Changing situations helps, but only temporarily. Making manager shadow representative; supervising your child’s homework, everyday; do bring required results,
Changing situations helps, but only temporarily. Making manager shadow representative; supervising your child’s homework, everyday; do bring required results, But, it works only temporarily. Being very energy-intensive , it exhausts the supervisor.
Therefore, to bring a lasting effect, one needs to change both, heart and mind.
To bring in a change, to reach a destination, both rider and the elephant need to work in harmony. Rider is mind, elephant is heart. Bringing a change is like rider guiding an elephant. Can also be called conscious and subconscious, mind and heart
Rider is reflective, analytic, rational and planning. Rider is ego of Freud, intellect in Bhaghwad geeta
Elephant is emotional, instinctive and impulsive. Elephant is id of Freud, Horses of Geeta.
In case of conflict…..Rider has his say, temporarily, but in the long run elephant wins. A 70 kg rider is no match for a 7000 kg elephant. Elephant is very powerful. Smoking, new year resolutions, over eating. Numerous failed attempts like these is an example that it is elephant which has his way – knowledge, till sinks in, is useless.
Riders role is to provide planning, direction and perseverance to the elephant. Only he can to sacrifice short-term benefits for long-term gains.
Elephant has energy, strength and passion. It the strength of elephant that brings change.
Rider has his weaknesses – over-analysis, over thinking and indecisiveness.
Elephant’s weakness is emotional, instinctive, instant gratification, falls for quick payoffs, lazy.
Most Change-efforts fail because rider is not able to keep elephant on the road long-enough
Most Change-efforts fail because rider is not able to keep elephant on the road long-enough
Most Change-efforts fail because rider is not able to keep elephant on the road long-enough
College students. Two groups. Left alone in room. Carrot group stick to carrot group, and cookie to cookie group. None cheated. Will power at work.
Once the experiment was over, another set of experimenters entered asked them to solve geometrical puzzles, grouping remained the same.
College students. Two groups. Left alone in room. Carrot group stick to carrot group, and cookie to cookie group. None cheated. Will power at work. Is group a Lazy?
No they are exhausted of self control. People are at nadir to take initiatives, make right decisions, etc. after exhausting shopping, watching a sad movie, etc.
Two health researchers, Steve Booth-Butterfield and Bill Reger, professors at West Virginia university brain stormed on how to make people stick to healthy diet. They knew that people will change only if behavior expected of them is crystal clear. if the choices are many, rider will spin his wheels, analyzing and agonizing, never moving forward.
If people stick to 1% milk, saturated fat intake will fall to normal.
1% milk campaign for 2 weeks. 1 glass of whole milk equals 5 strips of bacon in saturated fat contents.
and even 6 months, it remained 35%
Confused rider due to his failure to provide clarity (he makes elephant go in circles), and unmotivated elephant (due to exhaustion, situation) doom all change efforts.
Confused rider due to his failure to provide clarity (he makes elephant go in circles), and unmotivated elephant (due to exhaustion, situation) doom all change efforts.
Confused rider due to his failure to provide clarity (he makes elephant go in circles), and unmotivated elephant (due to exhaustion, situation) doom all change efforts.
What looks like resistance is often a lack of clarity. Force exhausts, what is usually viewed as laziness problem is often a Exhaustion problem. What is usually viewed as People Problem, is in fact a Situation Problem
What looks like resistance is often a lack of clarity. Force exhausts, what is usually viewed as laziness problem is often a Exhaustion problem. What is usually viewed as People Problem, is in fact a Situation Problem
In 1990, Jerry Sternin, a staff at Save the Children, a US non-gov organization, is sent to Vietnam to suggest solution to solve problem of malnutrition amongst children. Vietnam, poor due to recently lifted US sanction was hostile to his coming. He was perhaps 12 american in Hnoi. He was given 6 months time. Minimal staff, meagre salaries and hostile gov.
Tackling malnutrition is very simple .. But all this is True but Useless knowledge. This will never happen.
Tackling malnutrition is very simple .. But all this is True but Useless knowledge. This will never happen.
He finds healthy children’s parents make them eat tiny shrimps and crabs and sweet potato greens – which were considered ‘low class’ and not fit for children, though adults take these regularly. After knowledge what ? Simply passing the knowledge will not work. People are anyway reluctant to adopt. Knowledge does not serve well. Crazy shrinks, obese/smoking doctors, divorced marriage counselors and sinful priests. He organized groups, who practice cooking and feeding children, the needed crabs, shrimps and sweet-potato greens, as group activity. Over 2 weeks nutrition sessions, 40% (of 300) kids became normally -nourished status, another 205 migrated from severely- to mod-malnourished. His visa was extended for another six months, and he end up spending 6 more years in Vietnam.
Many times there is a big diff between the scale of the problem and scale of the solution. When rider analyze a problem he seeks a solution to complement the scale. Rider is problem focused rather than solution focused. Don’t teach new knowledge, encourage new behavior. Let the deviant spread the word.
In 2001. Post chemotherapy compliance is crucial for remission. Skipping 20% medication, ups relapse by 200%. Pam Omidyar had conviction that a game, which makes children feel in control, will increase the compliance. Post chemotherapy compliance: report for fever, take medications, low dose chemotherapy and antibiotics, for two years.
She founded Hopelabs, and developed Re-mission. Main character is Roxxi, a nano-robot, who zaps the tumor cells. In between another character Smitty shows up and give clues. Study was published in Pediatrics, 2008. Game had 20 levels. Even the children who played only two levels had significantly benefit.
To motivate the elephant, find the feeling. Give feeling that change can be done. It is with in their reach.
Partly finished journey appears easier than a journey that is yet to start. Make them feel as they are already closer. Shrink milestones, one milestone at a time. one step at a time. encouragement at each step. Small rewards. And elephant keep on moving
Conventional Advice- Increase punishment for capturing or killing the parrot. Establish a ‘Parrot sanctuary’. Raise more money for conservatory efforts
1988, Gov gave Butler full citizenship and later St Lucia Medal of Merit, one of the country’s highest honor.
Every human being want to grow. He wants to be part of a big cause. People join political parties, sects, religion, and for that sake, companies too, for their deep desire to be part of a big-show. Leader has to give them a cause-they are ready to jump. Elephant has to believe that he is capable. He needs training.
Richards, director of clinical services investigated. Errors were due to distraction & multitasking. Noisy hospital wards. Nurses, doctors, ward boys, patients talking. Since administering medication was considered to be a easy job, nurse who were administering medication were usually the first ones to be interfered and called in case of any help by others, usually by doctors whom they could not refuse.
To make the journey easier.
To make the journey easier.
In ICU all patients have iv line. If line gets infected, it follows serious complications, and, many times, takes life.
How did you behave? You behaved exactly how other were behaving! Create a good work-environment. Create a motivated team.