The following article appeared in
Best Practice Measurement Strategies, February 2001
Melcrum Publishing, Ltd., London

Communicating for change

By Angela D. Sinickas, ABC

Problem:  I've talked with a number of communicators who are perplexed at how to find measurable behavioral changes to chart against their communications. The problem is often that they started in the wrong place, determining messages independently of identifying behavior changes aligned with company goals. Instead, you need to make messaging and channel selection the last steps in developing your communication strategy instead of the first.

Solution:  The box below shows 10 steps to follow to connect your work with changes in your audience's actions. This strategy is also illustrated by the diagrams at the end of this article.

10 steps to connect your work with changes in your audience's actions:   1. Identify which bottom-line organizational goals, initiatives or programs communication could impact the most. (see illustration) 2. For a particular goal, determine which groups of stakeholders could take different types of actions that would better lead to the goal.(see illustration) 3. For each stakeholder group, interview the relevant supervisors and managers to understand what actions those stakeholders are currently taking and what they should be doing ideally. Probe for the types of measurements that the operation is already conducting relative to those behaviors. (see illustration) 4. Conduct focus groups with members of each stakeholder group. Discuss with them several topics: (see illustration) a. Why they do what they do currently. b. What it would take for them to start taking the new actions identified through your supervisor and manager interviews. c. What types of knowledge or information they would need to be able to change their behavior. d. The best way for them to receive this information. e. What attitudes might affect their behavior. Ask this in terms of: "If you had all this new information, is there anything else that would still keep you from taking the new actions?" At this point, you'd be probing for "belief blockages" that could inhibit their behavior. For example, they might say: "If I do what they're asking, it would create problems for our customers (or for another department)," or "Why bother? Next month management will want me to do something else." f. What would it take to change their existing negative beliefs on the topic, if anything. 5. Conduct a survey of your key stakeholder groups to identify the current baseline levels of their existing knowledge and attitudes you identified in focus groups as being critical to the desired behavior change. 6. Start collecting operational management's measures on the current levels of the behaviors, both desired and actual. 7. Design your communication campaign to integrate the knowledge and belief messages you identified as critical to the behavior change. Use the ideal communication approaches the focus groups listed as the best ways to gain the needed knowledge and change their beliefs. 8. Do mini-surveys of your stakeholders' knowledge and attitude levels on the key messages, timed to coincide with your communication interventions. 9. Chart for management the changes in the stakeholder behaviors versus changes in their knowledge and attitudes, indicating the timing of your communication interventions. You might also measure desired behaviors that were fine to start with to make sure they haven't accidentally been negatively affected. 10. Quantify the financial value of the change in behaviors, and take full credit for it!

Case study

Here's an example from a home IV therapy company in the U.S. that wanted to change nurses' behavior when the health care system underwent a dramatic change. In the past, every time a nurse went to a patient's home, the company received a payment from the patient's insurance company.  When many insurance companies adopted a "managed care" approach to reimbursement, the company received payments of a fixed amount for a particular period of time to treat a patient, regardless of how many nursing visits were required.

Under the old approach, more visits meant more revenue. Under the new approach, each visit was a cost item.

The company's desired behavior change for nurses was to have them eliminate any unnecessary visits to patients' homes. The traditional approach to this type of communication would be a lengthy explanation of the company's business strategy, the changes in the marketplace that managed care had ushered in, capped by an exhortation to nurses to stop making unnecessary visits.

The only problem with this approach was that nurses are not generally motivated by the desire to help their employers make more money, but to provide excellent care for their patients. Fewer visits would have sounded like substandard care. The traditional approach appealing only to the head (the knowledge messages about strategy and marketplace) would not have resulted in behavior change. They could have actually alienated the nurses from wanting to work at this company.

The actual communication approach that was used mentioned the strategy and marketplace issues only in passing. The main focus appealed to the nurses' existing attitudes of patient care first, last and always. The behavior change requested in the communication campaign was very simple. Each day, before they began driving to their patient's homes, they were asked to call each one for two reasons.

• Confirm that the patient will be at home. (This was critical because many times nurses arrived at a patient's home after a two-hour drive only to discover that the patient's physician had admitted the patient back into a hospital or that the patient had forgotten the nurse was coming and wasn't there.)
• Ask the patient if he or she needs additional supplies, like gauze or needle disposal units. Often, a nurse wouldn't identify this need until arriving at the patient's home, which would then necessitate a second (unreimbursed) visit.

Both of these requested actions were crystal-clear knowledge messages of what was expected.  They also appealed to nurses' existing attitudes about patient care. Clearly, there was no value to patients in having a nurse visit their doorsteps when they weren't home themselves. Plus, patients benefited from having any needed supplies arrive in the first available visit.

Lessons learned

In order to connect the work we do with operational outcomes, we need to know the business dynamics of our organizations, understand our audiences and work closely with operational management.

When we do this effectively, we become more valuable communicators whose work is aligned with business goals. We create a seat for ourselves at the business table instead of waiting to be invited in.

Angela Sinickas, ABC, is president of Sinickas Communications, Inc., a communication consultancy specializing in helping corporations achieve business results through targeted diagnostics and practical solutions. You can visit her new website, CommToolbox.com, to see the automated planning, measurement, and benchmarking tools she has developed based on her manual, How to Measure Your Communication Programs.