For the medical informatics unit of a major health services organization, the vision was clear and compelling: assure that the most advanced current knowledge about medical informatics be incorporated into the company’s clinical information systems. Despite strong corporate support, the unit faced multiple problems, including trying to convince a loosely knit confederation of hospitals to implement its ideas, making commitments to these hospitals and then failing to deliver high-quality systems on time, and burning out its staff in the process. Simply put, people were overcommitted and under-delivering.

Senior staff talked about the need for change and actually learned new skills such as how to make more reliable commitments, but they had an uncomfortable feeling that they were not addressing the really critical issues.

This situation is all too common in organizational life:

• We have noble aspirations for what we want to achieve.
• The costs of conducting business as usual are high and growing.
• We make changes that should work but don’t seem to get at the core issues.
• We can’t get traction on making the most important changes.

It raises two questions:

1. Why do1people persist in making seemingly superficial changes?
2. What would motivate them to make the changes that would best enable them to accomplish what they want?

We’ll answer both in turn.

A Perfectly Designed System

One of the premises of systems thinking is that systems are perfectly designed to achieve the results they are producing. At first glance, when we look at how dysfunctional our existing systems can be, this premise seems absurd. For example, why would people create a system that produces low-quality products delivered late at the expense of their own personal health and well-being?

However, on closer observation the premise leads to some important insights:

1. People experience payoffs from the system as it is currently designed.

For example, the senior managers of the medical informatics group came to recognize that the existing system acknowledged them for their ambitious vision and commitment, motivated them to work hard in service of this vision, and averted the need to challenge their clients’ own unrealistic expectations.

2. One of the most common payoffs is that the current system allows people to avoid “paying the price” of changing their behavior.

For example, for the senior managers of the medical informatics group, many of whom are doctors themselves, making more reliable commitments would require them to plan their work more carefully. However, the physicians in charge did not have strong planning skills. Developing these skills would have required them to acknowledge their weakness in this area and take time away from delivering on their current commitments.

In addition to evading paying the price of change, there are several other typical benefits to conducting business as usual. These include:

3. The solutions that people have employed so far work well enough in the short term.

For example, when the senior managers in the medical informatics group make promises to their clients, the very act of making a commitment temporarily removes external pressure from them to perform. Because they are people of high integrity, they believe that their commitment means that they will deliver the result. Moreover, they experience the act of making a promise as motivation to work as hard as they can to succeed.

4. These short-term benefits reinforce the belief that people are doing the best they can. They do not have to consider the longer-term consequences of their actions that often undermine their effectiveness.

For example, the medical informatics managers take comfort in the belief that their noble aspiration, innate intelligence, and hard work are sufficient to achieve their vision. Belief in the power of one’s passion and persistence is perfectly understandable, even though these qualities might be necessary but not sufficient to achieve great results. The managers fail to recognize that making commitments without realistically thinking through the time, resources, and focus required to be successful is a quick fix that leads over time to delivery shortfalls, quality problems, and reduced credibility with clients.

5. The short-term benefits people experience tend to meet normal human needs for competence and acknowledgement of their good intentions and effort. Experiencing these immediate payoffs also enables people to blind themselves to their responsibility for subsequent problems with execution. Rather than take ownership for these problems, they convince themselves that they are doing the best they can and others are to blame when things do not work out as expected over time.

For example, the medical informatics group prides itself on working extremely hard to achieve a significant vision, and staff members can easily point to external obstacles, such as the corporate culture or clients’ unrealistic expectations, as preventing them from being as successful as they could be.

“Cost Benefit Analysis of Change vs. No Change” can help people expand their awareness of the benefits and costs involved in changing. It helps people explicate not only the more obvious benefits of changing and costs of not changing, but also the frequently hidden benefits of not changing and costs of changing.

COST BENEFIT ANALYSIS OF CHANGE VS. NO CHANGE

In order for change to occur, the product of cells 1 and 2 must exceed the product of cells 3 and 4.

Five Steps to Achieving More of What You Want

There are five steps you can take to increase your ability to achieve more of what you really want:

1. Reinforce the case for the desired outcome, i.e., make your vision (the benefits of changing) and costs of not changing as visceral as possible.

2. Acknowledge that the status quo, however overtly dysfunctional, also produces benefits you value.

3. Clarify how your current actions actually undermine the vision you want to achieve. Systems maps can assist this process by tracing the long-term unintended negative consequences of people’s well-intentioned behavior. Illuminating these consequences:

• Reduces your attachment to your current behavior and the accompanying benefits of maintaining the status quo;
• Increases the perceived costs of not changing because you can now see how your actions lead to worse rather than better performance.

4. Look for ways to achieve the benefits of both the status quo and the desired state. It makes sense to look for both/and solutions that maximize benefits of both the status quo and the desired state, and to implement these solutions where they exist. However, given a system’s tendencies toward better before-worse behavior (i.e., “there’s no free lunch”) and worse-before-better behavior (i.e., “pain before gain” or the need to make upfront investments for long-term success), finding these both/and solutions is not so easy.

5. Choose consciously. Where tradeoffs between short and long-term payoffs are required, you need to make a deliberate choice in favor of those actions that are likely to produce the longer-term result you say you really want. Alternatively, you can accept that the benefits of the status quo are more important than your espoused vision—and consciously choose to maintain the status quo.

David Peter Stroh (dstroh@bridgewaypartners.com) is a founder and principal of Bridgeway Partners and an expert in applying systems thinking to organizational and social change.