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Doctor’s Orders: What Compliance in Medicine Can Teach Us About Leadership

Categories: Behavior change, Conference, Leadership, One on One Coaching, Reinforcement, TrainingTags: , , , , , Author:

This blog post is a summary of a talk that I gave at our last BMT for Leaders conference titled, “Doctor’s Orders”. Watch the edited video here.

Why should we as business leaders be talking about compliance in medicine? A lot of research has been done in the medical field on adherence and compliance, and there are a lot of parallels between compliance in medicine and compliance in business and safety that we could learn from.
What is compliance? Compliance means taking medications in the way they were prescribed, complying with diet and lifestyle advice, and being honest with your doctor. In business, we can think of it as completing tasks on time and in the manner they were meant to be done, behaving in appropriate ways in the workplace (professionally, safely, etc), and being honest with supervisors and leaders.

5 factors that impact compliance:
Complexity
The more complex a demand is, the less chance of compliance. A patient is much less likely to take a pill 5 times a day correctly than a pill once a day.
Reinforcement
Compliance is better in medicine when the patient is experiencing some discomfort that is made better by complying with advice. It’s harder when the disease isn’t as obvious (hypertension), and especially when the impact of the drug or advice is hard to feel/perceive/measure. You have to provide other reinforcers in order to maintain behavior when the performer doesn’t perceive any consequences.
Side Effects
When a patient experiences negative side effects because of a medication, compliance rates drop dramatically. It’s important to minimize the impact of side effects as much as possible.
Understanding
Having an understanding of why you’re being asked to comply with medical advice dramatically increases the chances that you’ll do it.
Relationships
Surprisingly or not, the relationship between the patient and the practitioner has a large impact on compliance. The more you like your doctor, the more likely you are to comply with their advice/requests. In fact, the more a doctor interrupts a patient in the exam room the less likely it is that the patient will comply with the doctor’s advice.

In medicine, compliance starts with the doctors in the exam room. In business, it has to start with leaders. Keeping things simple, explaining why, and focusing on relationships are the first steps to creating the conditions where people comply with your requests because they want to, not because they have to.

BBS and BMT … What’s the Difference?

Categories: Behavior change, BMT Courses, Employee Engagement, Leadership, Safety, TrainingAuthor:

bbsandbmt

By Nicole Gravina and Lisa Kazbour

Both Behavior Based Safety (BBS) and Behavior Management Techniques (BMT) are based in the science of behavior.  Behaviors provide a leading measure of safety and measuring them creates the opportunity to provide feedback and deliver reinforcement on a more regular basis, which can have a positive impact on safety.

BBS is a set of techniques developed by behavioral psychologists that are applied similarly in organizations.  Although applications of BBS may vary slightly, they all use a checklist to observe behaviors (and sometimes conditions) and provide feedback either at the individual level, the group level, or both.  The fact that BBS is a set of techniques makes implementation fairly straightforward and doesn’t require people within the organization to have a deep understanding of behavioral science.

The downside of not needing to have a deep understanding of behavioral science to implement BBS techniques is that it is easy for these techniques to be misapplied just slightly, resulting in the process not having the intended impact or even making things worse.  Unfortunately, this happens so often that many labor unions and other groups strongly oppose the use of BBS, calling it a “Blame the Worker” system.

In contrast, BMT is a more comprehensive and flexible approach that teaches people behavior science blended with project management.  By teaching behavioral science, BMT provides a skill set and knowledge base to apply the science to any of a number of problems in business and safety.

Behavioral science tells us that the current environment influences our behavior.  Shifts in the current environment can help create new behaviors, including safer ones.  If BBS, or any safety initiative, is applied without an understanding of how the environment is currently impacting behavior, we cannot be sure that the new initiative will be a positive influence, regardless of the intended impact.  For example, if we ask people to observe each other’s behaviors in an environment that is low on trust and with poor relationships, the observation process will feel punishing and people will avoid it.  If we give behavioral data to leaders who aren’t well versed in how to use that knowledge to have a positive impact, the data is likely to be used in a way that inadvertently demoralizes the workforce.  If there is low engagement, people will probably not conduct observations without a significant amount of coercion.  Having to coerce people to engage with safety (by using either a “do this or else” approach OR with incentives) does not advance the safety culture.  These situations occur all too often but can easily be addressed with an understanding of behavioral science.

Because people trained in BMT gain a deep understanding of behavioral science, they are able to apply the many tools, including observation and feedback, in a way that fits each unique situation in their business and has a positive impact.  BMT empowers people, improves relationships, and develops great leaders.  Understanding the current environment, and the way shifts in the environment impact behavior, dramatically increases the likelihood that any initiative, BBS or otherwise, will succeed.

The success of your various initiatives depends on a deep understanding of behavior and fluent application of behavioral science techniques by leaders throughout the organization.

Download a pdf of this article here:  BBS and BMT … What’s the Difference?

Controlling Your Inner Micromanager

Categories: Behavior change, Conference, Leadership, One on One Coaching, ReinforcementAuthor:

At our BMT Conference in Chicago last September, I gave a talk called, “Controlling Your Inner Micromanager”.  I have found that most people feel the urge to micromanage in at least some situations at work or home.

I define micromanagement as providing more management than necessary.  In other words, the task would get done and the results would be fine with less direction and oversight than you are currently providing.  Receiving too much direction and oversight is generally punishing for most people.

Micromanaging is highly reinforcing for the micromanager in the short term because we know what is happening and we get to control the direction.   However, it often creates long term damage.  People who are micromanaged feel frustrated, don’t get the opportunity to learn, don’t feel empowered or engaged, are afraid of making decisions, and they generally don’t like the micromanager.  It’s a recipe for mediocre effort and poor relationships in the long term.

The alternative, thoughtful and strategic leadership, produces less immediate reinforcement.  When things are chugging along smoothly, direct reports don’t often feel compelled to compliment their boss on their more hands-off leadership approach.  In fact, they are probably crediting themselves for their success.  Thoughtful, strategic leaders must learn to derive reinforcement indirectly by seeing their people be successful.

How do you know if you are micromanaging?  Here are a few telltale signs:

  • You devote a lot of time to other people’s projects
  • You get aggravated when people don’t run things by you
  • You feel frustrated when people do things “their way”
  • You know many details about other people’s projects or feel anxious if you don’t have all of the details
  • You feel like you are busier than everyone else
  • You have hundreds of emails in your inbox and most of them are your people ccing you

If you are afraid you might be micromanaging, here are some steps you can take to move in the other direction.

  1. Tell your people you are guilty of micromanaging, apologize, and tell them you want to do better and need their help.
  2. Ask your people to tell you when you are micromanaging, send anonymous surveys to get some honest responses, and ask them each time you speak about a task if you micromanaged.
  3. Arrange your environment so that you can’t get into the weeds.  Don’t attend the meetings of other people’s projects, ask for a high level summary instead of seeing the whole report, etc.
  4. Book time into your schedule to be thoughtful and strategic.
  5. Leave more choices up to your direct reports.
  6. Back off the amount of direction you give, delegate more, and see what happens.
  7. Spend time with your people developing the relationship and asking them how you can help them.
  8. If you aren’t sure if something might be micromanagement, don’t do it.  Wait and see what happens.  If the situation arises again and you are still unhappy, you can do something then.

Of course, I am not suggesting that you shouldn’t spend time leading and coaching your people.  I am just suggesting that when you do spend time with them, you spend it on things that add value for both of you and strengthen the relationship.

You can listen to an edited down version of my talk on micromanagement here.