I recently finished reading The Power of Habit: Why We Do What We Do In Life and Business by Charles Duhigg. The book covers a number of areas of interest to EMS providers, students, and educators. Here are three things I learned from it:
1. The cue-routine-reward habit loop.
Much of what we do is subconsciously driven by a cue that we may not notice, followed by a behavior that we engage in based on the cue, which is followed by a reward that perpetuates the cycle. This applies to both good habits, such as exercise, and bad habits, such as smoking. To build good habits and break bad ones, the cue-routine-reward cycle needs to be altered.Of course this is not easy. Breaking or starting the cue-routine-reward cycle takes practice, and there will inevitably be relapses.
My vice is sugar, and I resolve to consume less of it 2017. First I will track when I get sugar cravings – such as at work when I want to avoid doing something, and substitute it with another routine, such as making a cup of coffee or mint tea (which is less of a vice), and reward myself with 10 minutes or so of mindless computer time after completing the task I wanted to avoid.
2. One good habit bleeds into other areas.
Duhigg writes about Paul O’Neal’s tenure as CEO of Alcoa, where he preached about workplace safety above all else. He set seemingly unrealistic safety expectations for a aluminum manufacturing plants, and opened communication lines among employees and managers across all factories worldwide. Not only were injuries drastically reduced, this opened channels to share information about how to improve the company and built discipline.
The safety lesson resonates with EMS. A culture of safe driving, safe lifting, and scene vigilance, as well as open channels to constantly improve safety also lead to better clinical care.
3. It takes faith to apply good habits at critical moments.
Duhigg describes how Tony Dungee’s football teams practiced the system he developed, but during close games, particularly pivotal playoff games, players would break those habits and the team will lose. An interview with Dungee revealed that players believed in his system until pivotal moments, then they started thinking instead of relying on good habits. To executing good habits in time of stress, people must strongly believe that those habits will work, which Dungee’s Colts accomplished the year of their Superbowl win.
This concept applies to EMS in areas such as airway checklists and medication cross-checks. They may work with stable patients, but it takes extra discipline to take the few extra seconds and apply them with critically ill patients.
The Power of Habit is worth reading for personal health, productivity and patient care as well as to build good EMS workplace culture.