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From Conviction to Volition

Apr 20, 2020

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Austrian physician Ignaz Semmelweis discovered in the 1850’s that hand washing
was the number one means of preventing the spread of infection between care
providers and their patients. The Centers for Disease Control and Prevention,
Centers for Disease Control and Prevention Foundation reports 160 years later, in
the United States, nearly 100,000 patient deaths occur annually as a result of
hospital-acquired infection. Private organizations, advocates, and public health
entities spend countless hours and dollars to provide training and literature on the
benefits of hand washing. Yet, many health care professionals continue to disregard
these hand washing protocols. In fact, recent studies indicate that health care
providers, when they do wash their hands, are more likely to do so leaving a
patient’s room rather than entering the patient’s room. This variance reflects that
health care workers are more concerned about transmission of infection from the
patient to themselves than they are about transmitting infection to the patient.

hand washing

The simple practice of hand washing indicates that knowledge alone does not
compel people to change behavior, even when it really matters and even when they
have been educated repeatedly about what to do and how to do it. Innovative
thinking alone does not compel people into new practices. People must behave their
way into a new way of thinking. It is action innovation, not thinking innovation that
makes the difference to improving patient care outcomes in safety, quality and the
service experience of care.

So what makes people who possess knowledge about what they need to do actually
change their behavior? The answer is volition- a purposeful, intentional choice.
People choose to change their behavior when they have a compelling interest to do
so. Sometimes the reason for such a decision boils down to dissatisfaction or
unhappiness with the status quo; the consequences of not changing are too hurtful
or unpalatable. Richard Beckhard and Rubin Harris offer this classic equation
regarding change resistance:

Resistance to Change

Dissatisfaction is an emotional reaction that is so negative it prevents a person from
continuing routine or usual functioning. Although it is a negative experience,
dissatisfaction provides a motivation to change. Desirability is the emotional
reward for making a change. It is the “what is in it for me” driver. Practicality is the
realistic, attainable, and emotional acceptance of the change.
Keep in mind that when it comes to behavior and brain we are talking biology not
psychology. f-MRI studies show beliefs are generated by complex recurrent firing of
patterns of neurons accompanied by subtle but very specific changes in hormones and neurotransmitters.

This brain activity is developed by experience and linked to
the feelings that experience engenders. In other words, our brains are hardwired by
experience and feelings about dissatisfaction, desirability, and practicality. The
stronger the positive or negative feeling and the more frequent the experience, the
more we become hardwired to behave the way we do. To change behavior you must
first use experience to change beliefs. A person must be convinced that the change
will improve performance, outcomes, and workplace satisfaction.




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