Nursing Code

Driving Change with Artificial Scarcity

Have you ever wondered how to get people to adopt a new practice? I'm guessing that if you've worked in health for any length, the answer would be yes.

Think about that change. How did it go? Was it accepted to universal acclaim, or was subject to resistance and derision?

I'm not exactly going out on a limb by saying that it was probably met with a reasonable amount of resistance.

The truth about change

We might think that when an innovation is presented that the acceptance of the change would be based around the merit of the innovation, we'd likely be wrong. Much of the acceptance is driven by vanity and fashion!

Rogers talks about varying personality types and their engagement with change, identifying several categories of individual and the percentage of the population they represent.

Early adopters13.5%
Early majority34%
Late majority34%

So what can we do with this information? Well, we can use a bit of psychology to make change more attractive.

In order to target the innovators all we need is something shiny and new, they take little convincing and are prepared to take a risk, so we only need to show them the change and they will leap on it.

Early adopters tend to follow the innovators quickly, they are major opinion leaders and will deliver you the early majority through their support of the change.

With these three groups you've got 50% of your workforce on board with a change, the late majority will follow eventually leaving only 16% to deal with.

How to get the easy wins

How amazing would it be if people queued up to change like they when a new iPhone is released, or there is a sale at Myer?

Lets consider why people are queuing up and getting exited. It's not because they need the product it because they NEED to not miss out on it! To wait would be pain beyond belief. Fear of missing out is such a powerful driver that Apple and Myer actually sell out intentionally.

There is no truly good reason that the Myer boxing day sale couldn't have massive amounts of stock so that everyone who came could buy the item they were looking for, but if they did that there would be no fear of missing out. Apple could quite easily manufacture enough iPhones for launch day so that no one missed out, but where's the exclusivity in that? If there was no risk of missing out, then there is no need to sleep outside the shop.

Welcome to the concept of artificial scarcity. Deliberately manipulating the truth to create some buzz. You're subject to it every time you buy that limited edition (album / picture / car / dress ). You know that concert you went to? The one that only had 200 tickets, so you paid a huge premium - guess what, they could have hired a bigger venue and sold more tickets at a lower price, but you had to have them because there were only 200 seats, so they didn't need to.

It's a great and simple trick that could come in useful

Artificial scarcity in healthcare

Imagine you need to get your staff using a much better hand hygeine product in your operating theatres. You know right from the start there's going to be uproar. You will have people with scientific reason why it doesn't work, sensitivities to the the product, impassioned pleas not to change... You get the picture.

Now imagine announcing the product to your team and telling them that they can't have it! Because it's new, only the people in theatre 1 can have it. Imagine the faces of the people in the other 5 theatres!

"Why are they putting it in theatre 1?, we've got more cases in theatre 5"
"We've got orthopaedics in theatre 3"
"Yeah, but we're doing cardiac in theatre 6"
"Sorry team, it's only available in theatre 1"

I'm confident that you'll find yourself needing to replace the bottles within a very short space of time. Keep stocking them up in theatre 1 and soon they will have migrated to all of your theatres with minimal effort.

You can readily apply this strategies to other changes, but it's not a panacea for all ills! Pick your situations carefully and you'll be thrilled with the results.

1 Rogers E. Diffusion of innovations. 4 ed. New York: Free Press; 2003.