02 Jan Lessons in change saving ships and babies
A few days ago I was enjoying a pleasant boat trip with friends when a white line painted on the ship passing us reminded me of a book I had just finished reading and a fundamental principle of managing change that all of us change professionals need to give more attention and thought.
Making ships safe
Every boat or ship these days has a line painted on its side, and that line has a name: the Plimsoll Line, named after its inventor, Samuel Plimsoll.
In the mid-1800’s, the overloading of cargo ships was routine and this led to numerous sinkings. Despite calls for regulation, the ship operators insisted on loading ships with as much trade cargo as possible. Samuel Plimsoll led a campaign requiring that vessels display a clearly visible line indicating when they had reached the limits of a safe load, hence ensuring the safety of crew and cargo.
Needless to say the change met resistance! In fact ship owners started a series of legal battles against Plimsoll. It was not until 1890 that the Board of Trade effectively applied the regulations that Plimsoll had outlined.
Now, an obvious relevance for change managers is the admirable persistence of Mr. Plimsoll, and the effective way that he marshalled the considerable power of public opinion, and influenced those in a position of Government to make the right decisions. Another is the need for persistence and reinforcing behaviours to make the change ‘stick’.
However, in this blog I want to focus on another crucial aspect of his innovation that has much in common with another life-saving breakthrough in 1953, which teaches us a valuable lesson about planning, delivering and sustaining beneficial change.
Saving newborn babies
My niece, a General Practitioner in Scotland, recently recommended a book called Better: A Surgeon’s Notes on Performance. One chapter is about Dr. Virginia Apgar, who in 1953 published a new procedure that saved countless new-born babies. At the time one in 30 babies in the US died at birth.
The procedure consisted of measuring five vital signs one minute after birth and again five minutes after birth: skin colour, pulse rate, movement of limbs, breathing and reaction to stimulation. Each reading could be scored a 0, 1 or 2 resulting in a combined maximum score out of ten.
After this scoring procedure caught on, neonatal survival rates rapidly improved (the mortality rate in the US is now down to about one in 500).
The Apgar score became standard procedure in birth wards here in the United Kingdom and worldwide.
Those of us born after 1953 should probably acknowledge its contribution to ensuring that we made it past the first five minutes of life!
Lessons in change
What have these two got in common? They were able to provide easy-to-interpret data that provided timely and relevant information.
The Plimsoll Line is easy to read, and tells you exactly what you needed to know – is this ship buoyant, or is it overloaded and likely to sink? There is no ambiguity – you simply need to look at the line: is it above or below the water level?
Similarly, Dr. Apgar’s innovation was a simple scoring mechanism, based mainly on a midwife’s observation and with minimum technical input, to measure the relative health and survival chances of a newborn baby.
Lesson 1: we need to be able to assess the chances of our change being successfully implemented through the simple, unambiguous, and relatively non-technical measures. We should not confuse collecting masses of data with gaining an unambiguous understanding what the likely success of our change initiatives – simple, checks based on evidence directly related to key performance indicators (KPIs) is worth more than analysis of all other available data combined. And for these KPIs to be effective, they must be understood by all, open to wide scrutiny, and demonstrably sensible, reasonable and visible to everyone who has a stake in the change.
Another lesson from these stories: how KPIs for change need to be thought about from another perspective, that is in helping to trigger and then reinforce changes in organisational behaviours.
If you would like to learn more about how CITI Limited could help you as partners to plan, deliver and sustain beneficial change, then please feel free to contact Richard Bateman on 01908 283600, email RBateman@citi.co.uk.