11/27/2012

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The Rules of Engagement

Pat Teske, RN, MHA

Bricklayer #1“Putting a brick on top of another... Isn’t that obvious?”

Bricklayer #1“Putting a brick on top of another... Isn’t that obvious?”

Bricklayer #2

“Building a wall for the west side of a church”

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Bricklayer #3

“Creating a cathedral that will stand for centuries and inspire people to do great deeds”

What percentage of the people you are trying to engage are: 

• Putting one brick on top of another?

• Building a wall for a church?

• Creating a cathedral?

• Putting one brick on top of another?

• Building a wall for a church?

• Creating a cathedral?

The Four Myths of Engagement

1. Showing the Evidence is Sufficient

2. Everyone Engages at the Same Time

3. The Same Message Works with Everyone

4. Every Intervention is 

Equally Easy/Hard to Implement

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The Four Rules of Engagement

1. Connect to the Core

2. Engage the Engaged

3. Customize Communication

4. Align and Segment

Myth #1: Showing the evidence is sufficient

9

39 38

3228

20 19

3 3

0

10

20

30

40

50

60

1950's 1959 1961 1963 1965 1972 1974 ‐1977

1980's 1990 ‐1991

2007

% of Physicians that Smoke

First detailed data showing higher % of smokers among lung CA patients (1928)

First Surgeon General report linking smoking and lung cancer

(1957)

Congress mandates health warnings on

cigarette packs (1965)

Arizona passes first law designating separate

smoking areas in public (1973)

Congress bans smoking on all

domestic flights (1989)

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Rule #1: Connect to the Core

Being Part of Something BIG

Contribution

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Examples: Connect to the Core

• Setting a statewide AIM… Being part of something BIG

• The Banners… Everyone’s on Board

• Exploring the topic of LEGACY… Begin with the End in Mind

• Find a story about the impact of meaningful improvement ‐ "SEE‐FEEL‐CHANGE" 

“Connect to the Core”Worksheet

Myth #2: Everyone Engages at the Same Time

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Engagement is Non‐linearA Core Concept

Innovation Adoption S‐Curve

Rule #2: Engage the Engaged

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Looking for Bright Spots

Examples: Engage the Engaged

• Every state has a Jimmy Kimmel

• Harvest stories constantly

• Create a “critical mass”

• Use early adopter peers as spokesperson

• CAUTION: Beware of the “swagger effect”

“Engaged the Engaged”Worksheet

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Myth #3: The Same Message Works With Everyone

The messenger matters

The Message Also MattersMake It Stick

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How Ready is Ready?

Not thinking about it

Thinking about it

Getting ready to do something about it

Taking action

Holding the gains

Modified Prochaska’s Model

Adapted from Ashkenas, 1995

SHAREINFORMATION

SHAPE BEHAVIOR

GeneralPublications

flyersnewslettersvideosarticlesposters

PersonalTouch

letterscardspostcards

InteractiveActivities

telephoneemailvisitsseminarslearning setsmodeling

Face‐to‐face

one‐to‐onementoringsecondingshadowing

Customize the WAY You Communicate

(C) 2001, Sarah W. Fraser

PublicEvents

Road showsFairsConferencesExhibitionsMass meetings

Examples: Customize Communication

• 8 times, 8 ways – understand your audience(s)

• Plan your communication for the stage of implementation part of the organization– Getting started – Team, PDSA, Data entry

– Hitting barriers – Ideas, Network, Coaching

• Data – from charismatic nagging to meaningful results

• Local “open house”

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“Customize Communication”Worksheet

Myth #4: Every Intervention is Equally Easy to Implement

Diffusion Checklist – iPod

Key Factor Likelihood (1‐5)

Relative Advantage 5

Complexity 4

Observability 5

Compatibility 5

Trial‐ability 3‐5

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Segmentation

Alignment

Rule #4: Align and Segment

M  I CRO

M ESO

M  A CRO

VAP

SSI

HAPU• Executive Leadership• Organization wide AIM• Cooperation across business

units

• Executive Monitoring• Effective “Teaming”• Role clarification and effective

handoffs

• Executive Support• Local champions• Multi-disciplinary care

Examples: Segment & Align

• Creating a portfolio of improvement projects

• Align within and across levels of the organization

• Adapt implementation approaches to the specifics and challenges of each intervention

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“Align and Segment”Worksheet

Conclusion

Myths of Engagement

Showing Data is Sufficient to Change Behavior

Everyone Engages at the Same Time

The Same Message Works with Everyone

Every Intervention is Equally Easy/Hard to Implement

Rules of Engagement

Connect to the Core

Engage the Engaged

Customize Communication

Align and Segment