• Stephen Harden

Changing Culture with the Power of Rewards

Updated: Aug 7



Brushing our teeth can teach organizations about changing a culture.


Did you brush your teeth this morning? Did you use Pepsodent? Probably not, as Pepsodent is not nearly as popular as it once was. However, in the 1920s and 30s Pepsodent was the most widely-used toothpaste in the world, with a market value of over a billion dollars. No other toothpaste maker has ever come close to the world domination the brand once had.


How did the makers of Pepsodent dominate the world market? By harnessing the power of habit... using toothpaste to clean their teeth.


They realized that if they could encourage people to make it a habit to use Pepsodent toothpaste to brush their teeth, that consumers everywhere would reach for Pepsodent in their local store when they needed to buy a tube of toothpaste. Creating and/or changing habits drive the changing of culture in organizations.


It takes three things to make a habit: a cue, a routine, and a reward.


For Pepsodent, the Cue was the film that covers your teeth while sleeping. All of Pepsodent’s marketing encouraged people to run their tongues over their teeth to see if the film was there. If so, the response to that Cue, the Routine, was the act of brushing your teeth with Pepsodent. To get people to use that Routine the Reward offered was the feeling of having clean teeth.


To ensure the “feeling of clean teeth” was present after brushing with Pepsodent, the company included oil of mint in their ingredients to give users that “tingling” sensation in their mouth. This was the genius in their marketing; at the time they were the only toothpaste maker to include that oil. (Now, everyone does it.) The tingle provided instant proof and feedback that the routine of brushing with Pepsodent was worth it.


The result was that hundreds of millions of people all over the world reached for Pepsodent when they felt their mouth was dirty. They craved the tingling sensation they received, and in return, reaching for Pepsodent became a habit in their daily lives. The reward (tingling) drove the habit (using Pepsodent).


Leaders must harness the power of reward in creating habits to drive changing the culture around safety and quality initiatives.


Have you thought about the equivalent “reward tingle” your staff should receive when they use the new routine - the new process, bundle, practice, or checklist - you need them to use to make your initiative a success?



If not, here are two suggestions for you...


1. Leadership Rounding: On the day that you implement a new routine (e.g. a new process, bundle, protocol, or procedure, etc.) ensure that a member of the leadership team will be Rounding on the staff who are using the new routine. The interest your leadership shows in the new tool, and the people who are making the effort to use it, is part of the reward your staff craves and an essential part of creating new habits. As your leaders round, they should not only observe, they should also ask the staff three questions:

1. What’s working well?

2. What can be improved?

3. Who should be recognized for their support of the initiative?


Lastly, they should verbalize a simple and sincere “Thank you” for the effort the staff is making. The presence and support of your leaders is the “tingle” your staff needs, and it answers the craving for recognition everyone seeks. Rounding is absolutely critical to making the new routine a habit. The new habits will drive the changing culture. At LifeWings we feel so strongly about this, that we insist our partners prepare a Rounding schedule in advance of the implementation of a new routine. Typically this rounding schedule covers a minimum 21-day period and includes the name of a specific leader and the exact day, time, and place they should Round. In our experience, if a very detailed schedule is not prepared, leaders will forget to Round due to the everyday crush of operations. Left to chance, Rounding will not happen and you lose a powerful component of making new routines a habit.


2. Data Feedback: All staff want to know that the effort they are making to adopt a new routine is making a difference. One of the best ways to reward their effort and assist the creation of new habits is to share with them the data you are collecting that proves the new routine is a better way to do business. As I travel around the country helping hospitals implement new tools, I am always surprised at how few facilities do this data sharing well. The best practice is to share your data with your physicians and staff every month through four channels of communication:

1. General Publications: Flyers, newsletters, videos, articles, or posters, etc.

2. Personal Touch: Letters, cards, postcards, or email, etc.

3. Interactive Activities: telephone calls, one-on-one visits, personal office visits, or shift briefings, etc.

4. Public Events: Conferences, Grand Rounds, monthly staff meetings, or education events, etc.


These are just two of many ways you can provide a Reward to the Routine you need to become part of changing culture. Other Rewards include Thank You notes, Letters of Recognition, awards, lapel pins, mentions in local newsletters, banners, flyers, and posters, just to name a few.


Either you are intentionally creating and changing culture, or your culture is managing you.




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