12. Hypegiaphobia:
the fear factor of rules
‘We are 40 percent overcompliant; we have 40 percent too many rules.The whole organization
is riddled with them.’These were the words of the director of a large organization on the eve of
a process of change which liberally slashed the rules. Isn’t this risky? Rules prevent incidents,
don’t they? If an incident arises despite them, then at least one can appeal to the offender on
the basis of the rule? Or is there an optimum number of rules after which, as the director put
it, an organization becomes riddled with them?
Research by Tal Katz-Navon and colleagues shows that the director’s thinking is not so crazy
after all. In their research they scrutinized the level of detail of the rules in 47 departments in
different Israeli hospitals. They collected data for each department regarding the number of
incidents occurring in operations and other treatment procedures over a year. The focus was
on mistakes such as medication errors or mixing up test results.The incidents could cause the
patient considerable injury and even be life-threatening.
What did the researchers ind? In departments with few rules there were 13 incidents on
average. The more departmental rules, the fewer incidents there were, down to an average
of 9. This was the good news. Rules are useful. But what did the researchers ind when
they delved deeper? As the number of rules increased further, the number of incidents also
increased, to an average of 21.The relationship between rules and incidents was not linear but
curvilinear (a U-curve).
On the one hand, rules are useful; they ensure clarity and consistency. They allow people
to get a grip on what they should be doing. On the other hand, rules can also pass a tipping
point and be counterproductive. How does this come about? One possible explanation is
what is known as ‘hypegiaphobia’ (pronounced high-ped-jia-fobia), which means fear of taking
responsibility. In the irst instance rules lead to certainty, but too many rules have the opposite
effect. People become afraid of breaking them. The more rules, the greater the chance that
one will be forgotten, and the greater the chance of doing something wrong. People become
obsessed; the rules become a goal in themselves. As long as the rules are adhered to, all
12. Hypegiaphobia: the fear factor of rules
