Jonathan Brach is an
EMT in Woburn, MA, and an aspiring medical student. He participated in the new
IHI Open School course, Leadership & Organizing to Improve Population Health, a 12-week field-based course that’s part
of the IHI Open School Change Agent Network, or I-CAN. Below, he
tells the story of how he confronted a major public health problem — texting
and driving — which is illegal in Massachusetts and many other states. (Learn more about population health in our course, TA 101: Introduction to Population Health.)
As an EMT, I spend a lot of time on the roads driving an
ambulance. While I see people doing a variety of unsafe things throughout the
day, there are few things that annoy me more than seeing another driver looking
at his or her cell phone instead of the road.
The reality is that texting and driving cannot be done
safely, no matter what the circumstances. The Virginia Tech Transportation
Institute released a study in 2009 that showed that drivers are 23 times more
likely to crash while texting and driving than when driving without distraction.
Thirty-nine states have passed laws forbidding texting and driving. But somehow,
texting and driving is still a very common practice on roads across the
Planning a project
So when I started planning a community-based project to do
for the I-CAN course Leadership & Organizing to Improve
Population Health, I
decided that I wanted to devote my time and energy to making sure that the
people in my community do not text and drive. The I-CAN faculty encouraged us to
do more than raise awareness with our projects, and to actually enlist people
to take action, so I decided to make a goal of encouraging 1,000 people to
pledge not to text and drive, and encourage their family and friends to do the
As it turned out, obtaining 1,000 signatures in a little
over a month proved to be more difficult than I anticipated. Based on my
experience collecting signatures for Dr. Don Berwick’s campaign for Governor of
Massachusetts, I decided to engage people in conversation outside of
supermarkets and ask them to pledge not to text and drive. But the majority of
people who I tried to engage with the simple question, “Do you have a minute to
help me with a public health project?” either gave me a flat-out “no” or walked
by me like I didn’t exist. And to make matters worse, I had a lot of trouble
recruiting my team members to stand outside of supermarkets with me. My family
and closest friends just don’t have as much fun engaging strangers in
conversation as I do.
It was at this point that I realized if I wanted to have a
successful project, I had to adjust my strategy to the challenging circumstances
I faced. I never was able to get the majority of people who walked by to talk
to me, but I did do my best to convince those who did stop and talk with me
that texting and driving was a really bad idea. In addition, I asked my family
and friends to collect pledges in the way that worked best for them. For my
parents, that meant bringing pledge sheets to work to have their colleagues
sign. My brother Joe asked all of his high school friends to pledge not to text
and drive. And my friends posted Facebook statuses in support of my project and
sent an online version of the pledge to everyone they knew.
As of May 22, my team has successfully collected 544 pledges!
Two pledges of note come from the chief financial officer of the Institute for
Healthcare Improvement and a local state representative, both of whom were nice
enough to stop and talk to me outside of the supermarket. While we did fall short
of our ambitious 1,000 pledge target, my team is nonetheless pleased with the
I think the biggest lesson I learned from the I-CAN course
is how to put a distributed leadership model into action. While we usually
think of a team as one leader with several passive followers, the reality is
that teams are much more effective when everyone takes ownership of the team’s
goals and brings their own creative ideas to the table.
In addition, I-CAN has made me a strong believer that all
clinicians should get more involved with tackling public health problems like
texting and driving. The challenges we face in population health today are too
important for health care providers to remain within the confines of the
clinic. By choosing to step outside of their comfort zones and confront the causes
of unhealthy behaviors in their communities, clinicians will not only help
improve the lives of their neighbors, but they will also undoubtedly receive a
boost in their own personal satisfaction in their work.
you can still pledge not to text and drive here!