The red vest

One of the behaviour change examples I’ve referenced a lot when talking about the need to consider the wider environment comes from Switch. In it, the Heath Brothers describe the efforts used by Becky Richards, the Adult Clinical Services Director at Kaiser South San Francisco hospital.

Nurses who were distributing medication had a higher then average error rate. Rather then assuming this was a training or attitude issue with the nurses (it wasn’t), Richards observed that during the administration of medication, nurses were being distracted by doctors and others who would ask for their help.

So her solution focused not on the nurses, but those around them. In a pilot project, nurses administering the drugs were asked to wear a red vest, while at the same time, others within the hospital were instructed not to interrupt nurses when they were wearing the vest. At the end of the 6 month trial, error rates had dropped by 47%. It was adopted as a permanent process across the entire hospital – and in the 1st month, error rates dropped by 20% overall.

It’s a simple yet inspiring story that drove real behaviour change. To me, it’s a great reminder of how clearing a path to change can come from looking up and out, rather than simply at the individual.


3 thoughts on “The red vest

  1. Pingback: White-coat syndrome and the influence of environment | age of change

  2. This reminds me a great deal of positive deviance initiatives at places like the Billings Clinic – where MRSA-related infections were nearly eradicated simply by looking towards the “outliers” who were doing things right – regardless of their standing in the organization.

  3. Thanks Fisher for the comment and information – and sorry for the delay responding. I’m going to check out the Billings Clinic for sure – sounds like a smart approach in targeting those outliers. Thanks again for sharing.


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