A friend of mine just had heart valve surgery at the Cleveland Clinic. He raved about the customer service aspects of the experience (well, as much as you can rave about a medical procedure) and noted that many of the staff wore buttons with the saying, "Patients First." I immediately wondered how much of the patient-centered behavior that he noticed came from what people actually did and how much came from the buttons suggesting that the hospital was patient focused, influencing him to notice patient-centric actions. I also wondered about the healthcare providers wearing the buttons--how much did the reminder about the priority of patient welfare affect their behavior?
The fact is that visual cues do affect perceptions and behavior, and some organizations have enough sense to act on that insight. Sutter Health's medical facilities in San Francisco now feature many patient pictures, and staff identification badges have messages emphasizing patient service. In a physical therapy treatment room in one Sutter facility where a physical therapist named Michael worked on my frozen shoulder last year, there was, in a very visible place, a laminated patient satisfaction questionnaire. This could remind Michael of the focus on patient satisfaction, and also signaled to me the importance of patient feedback. In factories, initiatives to improve manufacturing quality often begin by cleaning and painting the buildings, because orderliness sends a visual message consistent with an emphasis on avoiding defects.
Nonetheless, many organizations do not make use of their physical spaces to cue desired behaviors and attitudes. Most office buildings, including the one I work in at Stanford, are completely nondescript. Although the buildings may be architecturally attractive and nicely decorated, you can't tell anything about the work or mission of the organizations that occupy these spaces from looking around at the dÃ©cor.
It's not just the occasional anecdote that confirms the importance of visual cues in shaping behavior. Stanford marketing professor Christian Wheeler and some colleagues studied the impact of people's voting places on their support for schools. Voting is sometimes held in churches, other times in firehouses, and often in schools. A field study using data from a 2000 Arizona election found that voters were more likely to support raising taxes that would benefit education if they cast their ballots in schools rather than other polling places. This effect persisted even when voter demographics, political preferences, and other individual characteristics were statistically controlled.
In the same paper, an experiment showed that people who saw church-related, school-related, or generic images of buildings expressed different preferences for various spending initiatives, such as supporting stem cell research. Other research by Wheeler and colleagues showed that visual exposure to objects common in business settings--board tables, briefcases-Increased the likelihood that an ambiguous social interaction would be perceived as more competitive. It also increased the amount of money participants kept for themselves in a game in which they unilaterally decided how much to offer a partner.
You can use these findings about visual cues to help make yourself more effective. When bestselling author and Arizona State social psychologist Robert Cialdini wants to write prose accessible to a mass audience, he writes at home because, as he told me, when he writes in his academic office, the language is more academic. The message: try to surround yourself with visual reminders of what you want to be and do and how you want to act.
Meanwhile, companies need to be much more thoughtful about how they design and decorate their workspaces, because visual cues influence attitudes and behaviors. Companies should think about what employee behaviors and what customer reactions they desire and then experiment with cues that are likely to invoke them. Casinos learned this lesson long ago, and it's nice to see that some health care organizations are implementing these lessons.