Right away, when talking with Sonja Graham, I heard her passion for understanding how people behave and how their behaviour can be influenced for the good of society and the environment. For the last 7 years, Sonja has been one of the driving forces of Global Action Plan (GAP) UK as managing partner.

GAP UK is an environmental charity on a mission to “tackle our throwaway society by building a better living movement”. GAP UK is part of a global network of organisations driving behaviour change towards more sustainable lifestyles based on a common methodology rooted in empowering for change. Since 1993 GAP UK achieved many impressive milestones and through numerous programs for household, students, young people and employees achieved a reach of over 392 million across the world and trained over 51,000 people. Through their programs, GAP UK empowered people to improve their health and well-being, while saving 66,000 tonnes CO2eq since their founding.

Their work has been recognised through numerous awards. They have long-term corporate partnerships with companies such as Sainsbury’s Supermarkets, are supported by charitable funders including The Mark Leonard Trust and the KR Foundation and collaborate with many organisations.

2’600 Tons of carbon saved in a year by a hospital through 3 simple behaviour changes

Majka: During the last years you ran many impactful behaviour change programs. What is a program you felt really happy about?

Sonja: A good example is the work we have done is our Operation TLC programme – a programme that has helped hospital staff save energy and also make hospitals better healing environments for patients. The TLC programme focuses on three simple behaviours: Turning off machinery, Lights off and Closing doors (to better regulate heat). We have replicated the programme at a number of hospitals but the real showcase project was with Barts NHS Trust – the largest health trust in England – which saved over £500k a year and 2600T CO2 whilst also achieving up to ⅓ fewer sleep disruptions for patients hopefully helping them to get a better night’s sleep and recover more quickly!

Majka: How did you achieve this impressive results in a hospital?

Sonja: We followed a 10 step behaviour change process we use at GAP UK that was created based on the Social Marketing model. During the process we understand a problem – in this case energy being wasted, identify the behaviours that can change this and select a few based on how easy they are to change – in this case machinery, lights, doors, create the intervention based on our research on what motivates the audience we are working with – in this case great patient care, test the interventions to make sure they work well and roll the best ones out.

The first things we usually try to work out in a situation are:

  • What are the most impactful behaviours to tackle? Some may be very impactful but it would be very difficult to change them – for example how appointments are scheduled, some maybe be less impactful for example turning off lights – but much easier to change.
  • Which people are the most important in changing these behaviours in a given environment and what motivates them? These could be a few people who can control systems (e.g. surgeons and equipment) or loads of people who can change everyday behaviours (e.g. Nurses)

Who can have which impact?

Sonja: In the hospital for example, we identified three groups, as having the ability to bring big change over specific things: the facility managers taking care of the utilities within the buildings; the cleaners who are often the last ones leaving rooms at night time and so could turn many things off if they had the knowledge/permission; and the Consultants that have the influence and prestige to be able to set new norms. In terms of people who can influence everyday change, we identified Matrons – nurses in charge of parts of the hospital who have a lot of control over their Wards.

Graph showing hospital stakeholders grouped by their potential impact on energy savings. There are a few people that can have a very large impact and many people that can have a small impact, but that take decisions daily. Patient care is their main motivator.

Sonja: Next, we identified what the people we were addressing cared about, as there is no point in starting an environmental campaign if you don’t understand what motivates the group you work with. So we did a “motivational analysis”.

What do people care about?

Sonja: People working in hospitals care about the patients first. So all of our campaigns were focussed on things that could really help the patients during the healing process. With that in mind, we worked with the matrons to identify things in the hospital environment that would improve the life of the patients, while as well saving energy.

For example, we looked at noise and access to the patient rooms. Stress levels of patients were really high because of the continuous activity at the hospital, but research shows how patients heal better when they are in a calm environment. We explored how to change this. A very small intervention we identified was to introduce a couple of calm hours during the day that was called “quiet time”. There were no visitors, the light was turned off, machinery was turned off, and this was about creating a nice environment for the patient and at the same time lead to energy savings.

These are the kind of interventions we looked at and they were all based on: what could we do that would help a situation, motivate the people involved, but also achieve the environmental benefit.

Keep it simple and find the sweet spot

Sonja: Finally, we called the program “Operation TLC”, which in English means Tender Love and Care, but also Turn off machines, Lights off and Close doors.

We kept the program very simple: we just focused on three behaviours. We implemented it throughout the entire hospital: we trained Ward Matrons, to teach their staff about it, and also do checks and audits. We worked with the influencers, the Consultants, they were role models. But we also made sure that everyone felt they could do the actions and had permission to do them.

It was a quite specific program, but it was incredibly successful. We were working in one location, with one culture, understanding the benefits, and then create interventions that are simple but also motivate everyone that is in the building.

Majka: Do you think that a program like this can be scalable?

Sonja: It’s definitely scalable, it is not complicated to run and we created all necessary materials which are available to any hospital in Europe to use.

Majka: What are the challenges of scaling a program like that?

Local ownership is necessary for scaling and replication

Sonja: The challenge to make this happen is that you need local ownership.

You need the decision makers to decide that they want the program and another tricky thing in a hospital environment is to make sure that people are making the connection between patient care and energy.

But finding internal leaders that support the program and bring in the message inside the organisation is the real challenge. You need somebody having the motivation to make sure the program happens. You need someone that is sort of your hospital green champion, a very motivated financial director for example. It could be anyone. You need someone that is going to make it happen and get people excited about it.

Everything is there (we know how it works, it saves a lot of money, it makes patients sleep better and saves energy and carbon). So it is all about finding somebody that has the passion to make it happen.

The big learning: stop assuming and start asking

Majka: What was a learning that you got out of this program?

Sonja: I suppose that the big learning was to realize how much doesn’t happen just because no one considers it. Like in the hospital we found things like entire wings, that when the hospital was originally designed were commissioned, but then were not used. And everything was on including the machinery. But nobody had really questioned this.

There are a lot of things that happen just because people don’t question it. That can be solved very quickly. For example – a myth that all equipment had to be left on 24/7 to update. That was a really interesting learning for us. How do you help people to challenge the norm and ask the question about whether it is this really right? Does this need to be on? Do we need to do this? Who is in charge of this? Often everyone thinks that someone else has the responsibility to do something. It’s about helping people to be confident that they should be able to ask that question and to do that. And not to feel stupid in asking questions like “why is that on?” “what is that for?”. That was one big learning.

Majka: How sustainable are programs like this on the long-term? What happens when you, the initiator of the program, leaves the organisation?

Sonja: To be real lasting successes these programs need to be owned internally. It cannot be someone from the outside that just comes in and runs it. If you leave then it stops. For real behaviour change you need the program to be part of a real cultural change.

That is why, when after the success of this program we received many requests from other hospitals, for us it was really important to work with organisations with very motivated people internally, that don’t want us just to come in and fix the problem, but are committed to make a real change happen.

Majka: Do you think that it is possible to change the culture inside a company so that a program like that keeps running even if you leave?

Good structures are the base for sustainable culture change

Sonja: Yes, I think it is possible and there are real benefits looking at it when stepping back. It is really just about very good structures. If it is part of someone’s role to support a culture change it will happen.

For example in the hospital some of the interventions we ran were about recognising the amazing teams in the hospital that engaged in saving energy. We took some pictures of people doing amazing jobs and gave boxes of biscuits. A small effort but the effect was huge, because nobody was used to others recognise their work and just saying thank you. In this case the teams were making the changes already it was just having someone recognise them and support them that was important.

The new job is to support champions

Sonja: If there is a passionate group of changemakers in an organisation, but if there is not someone who is given the permission to spend the time coordinating these change makers, working with them, or simply giving them the tools, permission or the budget needed, very often they struggle to make an impact. Usually there is already someone inside the organisation that is very relevant, like in HR, that is motivated to drive change of the culture and who could take on this role.

It’s about making sure that these people have the remit to look at environmental behaviour within the organisation and support the champions within their work. Because otherwise it’s very very hard for change makers to really make a difference.

 

The insightful interview with Sonja Graham continues in a blog coming soon, where she will reveal how GAP UK is planning to challenge the mainstream culture of “buying, buying, buying” their way to happiness.

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