Replacing the word “accountability” with “responsibility” can change mindsets and behaviors. The former tends to be more punitive while the latter has more possibility to be mutual. We tend to get better, less defensive responses to the question “What are your responsibilities as..?” or “What are you responsible for in your role..?” as opposed to “What are you accountable for?”
Responsibility is given and accepted. Accountability is pressed upon others. I accept responsibility while I am held accountable. Nuances perhaps, but words affect thought, thought affects action, actions create artifacts which in turn create environments that create culture.
Great article. I think Paul is one of the only hospital CEO’s I’ve ever seen that understood what Deming taught- holding individuals personally responsible for errors in a complex system/process is ridiculous. Hospital leaders regularly make the fundamental attribution error- blaming the individual and not understanding the impact of the situation, process and system structure.
The other common problem I see with healthcare leaders and accountability is the problem of suboptimization in attempting to improve the value of patient outcomes. Improving the rate of hand hygiene or use of OR timeout protocols without measuring the value-based outcomes for the patient is a leadership failure. When protocols are instituted and followed, but patient outcomes are not improved, the solution is not to work harder at implementing the protocols, it is to recognize that suboptimization is occurring and to be accountable for improving the value of patient outcomes, not just documenting some process measures because they easy to quantify and/or are part of various reporting requirements.
I forgot to mention that the Wachter article quotes my friend Paul Levy (@paulflevy) from his book “Goal Play”:
“I assert instead that it is not only impossible to hold people accountable in an organization, but trying to do so is a misallocation of a leader’s attention”
I view the leader’s job as helping to create an environment in which people are given the right tools for doing their jobs and are so comfortable with their role in the organization that they hold themselves accountable.”
Safety is very important, and laughter is the best medicine indeed. Safety should be every companies number one priority, because once you have safety in the workplace and everything is running the way it should be you then get more productivity out of all your workers.
Sound like a good concept, just sort of confused with the Holiday Inn lobbies attempt at this. If they took the best idea’s, then they are not really listening to what the consumers want, all they are doing is taking the few ideas they like from 5,000 consumer ideas. At least 1 out of 5,000 is going to be what the hotel wants, not necessarily what most of the consumers want.
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