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Accountable Leadership Practice

Julie's picture

Recently, I’ve worked with an organization to help reduce medication administration errors. Data show that staff are not consistently checking patients’ identification.    Bottom line, this is a critical step in safe medication administration, yet it is being overlooked and bypassed.  Why?  Three words – lack of accountability. So, what does it mean to be accountable?  It means that you accept responsibility for the outcomes expected of you—both good and bad. You don’t blame others or other external factors.  If you are a leader, know that accountability is bi-directional.  You are accountable to your followers as much as they are accountable to you.  Leadership and accountability go hand in hand.  Accountability starts with holding yourself accountable for your performance, owning your work, accepting responsibility for mistakes and missteps, learning from them, and then setting a plan to improve moving forward. 

When you’ve mastered holding yourself accountable, it’s time to look beyond yourself to your team, unit, division, etc.  Have you made performance expectations clear to your team?  Do you consistently measure performance? Do you require your team to report out on performance regularly?   Do you recognize and reward good performance?  How do you handle poor performance?

Returning to the earlier example, leadership must ultimately hold themselves accountable for staff checking patient identification.  Leadership inaction has enabled poor performance.   To change behavior, leadership must impose individual, frontline accountability.  What does this look like in practice?   It involves making plain your expectations around key behaviors, processes, and outcomes.  It means monitoring and measuring performance and giving timely and constructive feedback, both positive and negative. It means setting aside personal bias and evaluating performance as objectively as possible.  It means recognizing and rewarding desired behaviors and outcomes. Finally, it also means having a clear plan in place to consistently handle poor performance, which you consistently follow through on when the situation warrants.

Believe it or not, accountability creates a current of freedom and openness and provides structure and an equitable quality to work when it is consistently applied.  What’s expected becomes transparent.  Follow-through is certain.