When a young Paul O’Neill was working for the government and creating a framework for analyzing federal spending on health care, one of the foremost issues concerning officials was infant mortality. The United States, at the time, was one of the wealthiest countries on earth. Yet it had a higher infant mortality rate than most of Europe and some parts of South America. Rural areas, in particular, saw a staggering number of babies die before their first birthdays.

O’Neill was tasked with figuring out why. He asked other federal agencies to start analyzing infant mortality data, and each time someone came back with an answer, he’d ask another question, trying to get deeper, to understand the problem’s root causes. Whenever someone came into O’Neill’s office with some discovery, O’Neill would start interrogating them with new inquiries. He drove people crazy with his never-ending push to learn more, to understand what was really going on. (“I love Paul O’Neill, but you could not pay me enough to work for him again,” one official told me. “The man has never encountered an answer he can’t turn into another twenty hours of work.”)

Some research, for instance, suggested that the biggest cause of infant deaths was premature births. And the reason babies were born too early was that mothers suffered from malnourishment during pregnancy. So to lower infant mortality, improve mothers’ diets. Simple, right? But to stop malnourishment, women had to improve their diets before they became pregnant. Which meant the government had to start educating women about nutrition before they became sexually active. Which meant officials had to create nutrition curriculums inside high schools.

However, when O’Neill began asking about how to create those curriculums, he discovered that many high school teachers in rural areas didn’t know enough basic biology to teach nutrition. So the government had to remake how teachers were getting educated in college, and give them a stronger grounding in biology so they could eventually teach nutrition to teenage girls, so those teenagers would eat better before they started having sex, and, eventually, be sufficiently nourished when they had children.

Poor teacher training, the officials working with O’Neill finally figured out, was a root cause of high infant mortality. If you asked doctors or public health officials for a plan to fight infant deaths, none of them would have suggested changing how teachers are trained. They wouldn’t have known there was a link. However, by teaching college students about biology, you made it possible for them to eventually pass on that knowledge to teenagers, who started eating healthier, and years later give birth to stronger babies. Today, the U.S. infant mortality rate is 68 percent lower than when O’Neill started the job.

O’Neill’s experiences with infant mortality illustrate the second way that keystone habits encourage change: by creating structures that help other habits to flourish. In the case of premature deaths, changing collegiate curriculums for teachers started a chain reaction that eventually trickled down to how girls were educated in rural areas, and whether they were sufficiently nourished when they became pregnant. And O’Neill’s habit of constantly pushing other bureaucrats to continue researching until they found a problem’s root causes overhauled how the government thought about problems like infant mortality.

The same thing can happen in people’s lives. For example, until about twenty years ago, conventional wisdom held that the best way for people to lose weight was to radically alter their lives. Doctors would give obese patients strict diets and tell them to join a gym, attend regular counseling sessions— sometimes as often as every day—and shift their daily routines by walking up stairs, for instance, instead of taking the elevator. Only by completely shaking up someone’s life, the thinking went, could their bad habits be reformed.

But when researchers studied the effectiveness of these methods over prolonged periods, they discovered they were failures. Patients would use the stairs for a few weeks, but by the end of the month, it was too much hassle. They began diets and joined gyms, but after the initial burst of enthusiasm wore off, they slid back into their old eating and TV-watching habits. Piling on so much change at once made it impossible for any of it to stick.

Then, in 2009 a group of researchers funded by the National Institutes of Health published a study of a different approach to weight loss. They had assembled a group of sixteen hundred obese people and asked them to concentrate on writing down everything they ate at least one day per week.

It was hard at first. The subjects forgot to carry their food journals, or would snack and not note it. Slowly, however, people started recording their meals once a week—and sometimes, more often. Many participants started keeping a daily food log. Eventually, it became a habit. Then, something unexpected happened. The participants started looking at their entries and finding patterns they didn’t know existed. Some noticed they always seemed to snack at about 10 A.M., so they began keeping an apple or banana on their desks for midmorning munchies. Others started using their journals to plan future menus, and when dinner rolled around, they ate the healthy meal they had written down, rather than junk food from the fridge.

The researchers hadn’t suggested any of these behaviors. They had simply asked everyone to write down what they ate once a week. But this keystone habit—food journaling—created a structure that helped other habits to flourish. Six months into the study, people who kept daily food records had lost twice as much weight as everyone else.

“After a while, the journal got inside my head,” one person told me. “I started thinking about meals differently. It gave me a system for thinking about food without becoming depressed.”

Something similar happened at Alcoa after O’Neill took over. Just as food journals provided a structure for other habits to flourish, O’Neill’s safety habits created an atmosphere in which other behaviors emerged. Early on, O’Neill took the unusual step of ordering Alcoa’s offices around the world to link up in an electronic network. This was in the early 1980s, when large, international networks weren’t usually connected to people’s desktop computers. O’Neill justified his order by arguing that it was essential to create a real-time safety data system that managers could use to share suggestions. As a result, Alcoa developed one of the first genuinely worldwide corporate email systems.

O’Neill logged on every morning and sent messages to make sure everyone else was logged on as well. At first, people used the network primarily to discuss safety issues. Then, as email habits became more ingrained and comfortable, they started posting information on all kinds of other topics, such as local market conditions, sales quotas, and business problems. High-ranking executives were required to send in a report every Friday, which anyone in the company could read. A manager in Brazil used the network to send a colleague in New York data on changes in the price of steel. The New Yorker took that information and turned a quick profit for the company on Wall Street. Pretty soon, everyone was using the system to communicate about everything. “I would send in my accident report, and I knew everyone else read it, so I figured, why not send pricing information, or intelligence on other companies?” one manager told me. “It was like we had discovered a secret weapon. The competition couldn’t figure out how we were doing it.”

When the Web blossomed, Alcoa was perfectly positioned to take advantage. O’Neill’s keystone habit—worker safety—had created a platform that encouraged another practice—email—years ahead of competitors.

By 1996, Paul O’Neill had been at Alcoa for almost a decade. His leadership had been studied by the Harvard Business School and the Kennedy School of Government. He was regularly mentioned as a potential commerce secretary or secretary of defense. His employees and the unions gave him high marks. Under his watch, Alcoa’s stock price had risen more than 200 percent. He was, at last, a universally acknowledged success.

In May of that year, at a shareholder meeting in downtown Pittsburgh, a Benedictine nun stood up during the question-and-answer session and accused O’Neill of lying. Sister Mary Margaret represented a social advocacy group concerned about wages and conditions inside an Alcoa plant in Ciudad Acuña, Mexico. She said that while O’Neill extolled Alcoa’s safety measures, workers in Mexico were becoming sick because of dangerous fumes.

“It’s untrue,” O’Neill told the room. On his laptop, he pulled up the safety records from the Mexican plant. “See?” he said, showing the room its high scores on safety, environmental compliance, and employee satisfaction surveys. The executive in charge of the facility, Robert Barton, was one of Alcoa’s most senior managers. He had been with the company for decades and was responsible for some of their largest partnerships. The nun said that the audience shouldn’t trust O’Neill. She sat down.

After the meeting, O’Neill asked her to come to his office. The nun’s religious order owned fifty Alcoa shares, and for months they had been asking for a shareholder vote on a resolution to review the company’s Mexican operations. O’Neill asked Sister Mary if she had been to any of the plants herself. No, she told him. To be safe, O’Neill asked the company’s head of human resources and general counsel to fly to Mexico to see what was going on.

When the executives arrived, they poked through the Acuña plant’s records, and found reports of an incident that had never been sent to headquarters. A few months earlier, there had been a buildup of fumes within a building. It was a relatively minor event. The plant’s executive, Barton, had installed ventilators to remove the gases. The people who had become ill had fully recovered within a day or two.

But Barton had never reported the illnesses.

When the executives returned to Pittsburgh and presented their findings, O’Neill had a question.

“Did Bob Barton knowthat people had gotten sick?”

“We didn’t meet with him,” they answered. “But, yeah, it’s pretty clear he knew.”

Two days later, Barton was fired.

The exit shocked outsiders. Barton had been mentioned in articles as one of the company’s most valuable executives. His departure was a blow to important joint ventures.

Within Alcoa, however, no one was surprised. It was seen as an inevitable extension of the culture that O’Neill had built.

“Barton fired himself,” one of his colleagues told me. “There wasn’t even a choice there.”

This is the final way that keystone habits encourage widespread change: by creating cultures where new values become ingrained. Keystone habits make tough choices—such as firing a top executive—easier, because when that person violates the culture, it’s clear they have to go. Sometimes these cultures manifest themselves in special vocabularies, the use of which becomes, itself, a habit that defines an organization. At Alcoa, for instance, there were “Core Programs” and “Safety Philosophies,” phrases that acted like suitcases, containing whole conversations about priorities, goals, and ways of thinking.

“It might have been hard at another company to fire someone who had been there so long,” O’Neill told me. “It wasn’t hard for me. It was clear what our values dictated. He got fired because he didn’t report the incident, and so no one else had the opportunity to learn from it. Not sharing an opportunity to learn is a cardinal sin.”

Cultures grow out of the keystone habits in every organization, whether leaders are aware of them or not. For instance, when researchers studied an incoming class of cadets at West Point, they measured their grade point averages, physical aptitude, military abilities, and self-discipline. When they correlated those factors with whether students dropped out or graduated, however, they found that all of them mattered less than a factor researchers referred to as “grit,” which they defined as the tendency to work “strenuously toward challenges, maintaining effort and interest over years despite failure, adversity, and plateaus in progress.

What’s most interesting about grit is how it emerges. It grows out of a culture that cadets create for themselves, and that culture often emerges because of keystone habits they adopt at West Point. “There’s so much about this school that’s hard,” one cadet told me. “They call the first summer ‘Beast Barracks,’ because they want to grind you down. Tons of people quit before the school year starts.

“But I found this group of guys in the first couple of days here, and we started this thing where, every morning, we get together to make sure everyone is feeling strong. I go to them if I’m feeling worried or down, and I know they’ll pump me back up. There’s only nine of us, and we call ourselves the musketeers. Without them, I don’t think I would have lasted a month here.”

Cadets who are successful at West Point arrive at the school armed with habits of mental and physical discipline. Those assets, however, only carry you so far. To succeed, they need a keystone habit that creates a culture—such as a daily gathering of like-minded friends—to help find the strength to overcome obstacles. Keystone habits transform us by creating cultures that make clear the values that, in the heat of a difficult decision or a moment of uncertainty, we might otherwise forget.

In 2000, O’Neill retired from Alcoa, and at the request of the newly elected president George W. Bush, became secretary of the treasury. 1 He left that post two years later, and today spends most of his time teaching hospitals how to focus on worker safety and keystone habits that can lower medical error rates, as well as serving on various corporate boards.

Companies and organizations across America, in the meantime, have embraced the idea of using keystone habits to remake workplaces. At IBM, for instance, Lou Gerstner rebuilt the firm by initially concentrating on one keystone habit: IBM’s research and selling routines. At the consulting firm McKinsey & Company, a culture of continuous improvement is created through a keystone habit of wide-ranging internal critiques that are at the core of every assignment. Within Goldman Sachs, a keystone habit of risk assessment undergirds every decision.

And atAlcoa, O’Neill’s legacy lives on. Even in his absence, the injury rate has continued to decline. In 2010, 82 percent ofAlcoa locations didn’t lose one employee day due to injury, close to an all-time high. On average, workers are more likely to get injured at a software company, animating cartoons for movie studios, or doing taxes as an accountant than handling molten aluminum at Alcoa.

“When I was made a plant manager,” said Jeff Shockey, the Alcoa executive, “the first day I pulled into the parking lot I saw all these parking spaces near the front doors with people’s titles on them. The head guy for this or that. People who were important got the best parking spots. The first thing I did was tell a maintenance manager to paint over all the titles. I wanted whoever got to work earliest to get the best spot. Everyone understood the message: Every person matters. It was an extension of what Paul was doing around worker safety. It electrified the plant. Pretty soon, everyone was getting to work earlier each day.”

O’Neill’s tenure at Treasury was not as successful as his career at Alcoa. Almost immediately after taking office he began focusing on a couple of key issues, including worker safety, job creation, executive accountability, and fighting African poverty, among other initiatives.

However, O’Neill’s politics did not line up with those of President Bush, and he launched an internal fight opposing Bush’s proposed tax cuts. He was asked to resign at the end of 2002. “What I thought was the right thing for economic policy was the opposite of what the White House wanted,” O’Neill told me. “That’s not good for a treasury secretary, so I got fired.”

-Charles Duhigg

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