1. Drake, Kirsten DNP, RN, OCN, NEA-BC

Article Content

Q There's a lot of conversation about accountability in my organization. Our leadership meetings specifically mention "being accountable and holding employees accountable." What's the best way to do this?

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

Accountability can be a confusing term-just use a popular search engine to find the definition and you'll end up with a variety of answers. If we break down accountability into two parts-the personal value and the action of holding others accountable-we can see how one affects the other.


It sounds simple, but taking responsibility for your actions or lack of actions, including taking ownership of a project, can be very difficult, especially when, as a leader, you have to say that you were the reason for a failure in your area of responsibility. How many times have you heard your leader say, "I messed up?" It takes courage to confess that you were at fault or didn't perform to the expectation. Accepting responsibility for your actions is an excellent way to role model for your direct reports. In contrast, pointing fingers at others, blaming, and excuses lead to a lack of trust in leaders; these are all ways of not being accountable for actions and outcomes.


By demonstrating answerability, you can assist in building a successful team and holding team members accountable. There are key components and steps that can guide staff members, starting with ensuring that they know the expectations. It's difficult to reach a goal if you don't know what the goal is; however, be sure that the goal is realistic. For instance, if you're trying to improve patient experience scores, start by evaluating the baseline and set a reasonable goal from that baseline. If your unit is at the 50th percentile, it isn't realistic to hit the 90th percentile in 1 month. Instead, set a goal to reach the 60th percentile in 3 months. It's easier to gain a commitment when goals appear attainable and have associated timeframes.


Improving commitment means including others in setting the goal. Utilize the individuals and groups doing the work when establishing your goal; they know what they can and can't do. Gaining a commitment also occurs when there's advertisement of the goal so that others are aware of the expectation. Post information in break rooms and newsletters. Also, make sure that you communicate the goal to your leader to solidify your own commitment and accountability.


Recently, I was working with a nurse leader who wanted to improve her unit's compliance with medication verification barcoding. She approached the goal in phases to increase staff involvement and commitment. During each phase, she posted the unit's compliance data, as well as each individual's compliance. This is a way to measure goal attainment and provide feedback to staff. Inspecting the outcomes allows you to acknowledge desired performance and stipulate a consequence for those who don't comply. In the barcoding example, the leader made public who was meeting the established goal. She also had a prize drawing as an added incentive. Focusing on good performance tends to reap increased performance from those involved and others around them.


The Business Dictionary defines accountability as "the obligation of an individual or organization to account for its activities, accept responsibility for them, and to disclose the results in a transparent manner."1 This definition decreases confusion by encompassing what it means for leaders to be accountable and the components needed to hold others accountable.




1. Business Dictionary. Accountability. [Context Link]