Creating a Culture of Accountability in Healthcare (2024)

Article highlights
  • Aligning your vision, strategy, and tactics.
  • Clear and open communication.
  • Ethics and compliance training.

In the healthcare industry, accountability is incredibly important.

A lack of accountability in healthcare can cause significant damage to your organization. It can erode quality of care, ruin your organization’s reputation, and increase the risk of lawsuits.

A lack of accountability can even put patients’ lives at risk. Astudy by the Journal of Patient Safetyfound that more than 210,000 hospital patients die each year from hospital-related infections or medical mistakes.

Many of those could have been avoided if staff followed proper policies and procedures.

A culture of accountability in healthcare can help prevent such mistakes. Accountability in healthcare includes clear policies and procedures, but it is about so much more than just telling employees to follow the rules.

Ethics and accountability should be an integral part of your organization’s culture.

When healthcare organizations hold themselves and their employees accountable, they can learn from mistakes and continuously improve operations. A culture of accountability in healthcare improves doctor-patient trust, reduces the misuse of resources, and helps organizations provide better quality care.

Here are a few ways to create a culture of accountability in healthcare:

Align Your Vision, Strategy, and Tactics

Workplace culture has everything to do with the organization’s underlying values. Therefore, it’s important for your healthcare organization to establish and regularly communicate core values.

Formalizing your values and mission can help you make sure your organization is moving in a positive direction. You can adapt your strategy and tactics to make sure your organization’s actions align with its mission and values.

It starts with leadership

A culture of accountability in healthcare has to start on a personal level. It has to start with you.

Personal accountability is important for staff on every level of the organization. But it’s especially important for leaders and managers to lead with honesty and integrity.

When leaders model accountability, transparency, and ethical behavior, lower-level employees often follow suit.

As Apple CEO Tim CooktoldFast Company, “Ultimately, it’s on the company leaders to set the tone. Not only the CEO but the leaders across the company. If you select them so carefully that they then hire the right people, it’s a nice self-fulfilling prophecy.”

Focus on a common purpose

People who choose a career in healthcare care about helping people. They want to deliver excellent patient care and help people improve their health.

Creating a culture of accountability in healthcare starts from those common values and motivations.

Creating a Culture of Accountability in Healthcare (1)

Rather than simply lecturing staff on following rules, talk about how accountability measures enable them to help patients more effectively. Stress your organization’s shared values, such as compassion, teamwork, and excellence.

Be aware of informal team norms

When attempting to create or strengthen a culture of accountability in healthcare, take note of the unspoken expectations and norms already in place in your organization.

For example, an article in theHarvard Business Reviewtells the story of how health insurance company Aetna shifted some of its unhealthy cultural norms.

In the early 2000s, Aetna was struggling, in large part because of a culture that “encouraged employees to be steadfast to the point that they’d become risk-averse, tolerant of mediocrity, and suspicious of outsiders.”

When John Rowe took over as CEO, he took the time to understand the underlying workplace culture. Then he set to work shifting unhealthy attitudes and reinforcing positive aspects of the culture.

TheBusiness Reviewexplains:

Without ever describing their efforts as “cultural change,” top management began with a few interventions. These interventions led to small but significant behavioral changes that, in turn, revitalized Aetna’s culture while preserving and championing its strengths.

By building on and shifting existing informal norms, Aetna leadership was able to move company in a more positive direction.

Encourage Clear and Open Communication

Transparency and clear communication is an essential aspect of creating a culture of accountability in healthcare.

Make culture a topic of conversation

In the above story about Aetna, the key to the company’s successful cultural shift involved employees in conversations about the strengths and weaknesses of the company culture.

As theHarvard Business Reviewtells it:

Rowe didn’t walk in with a new strategy and try to force a cultural shift to achieve it. Instead, right from the start, he … took time to visit the troops, understand their perspective, and involve them in the planning. With other members of the senior team, they sought out employees at all levels – those who were well connected, sensitive to the company culture, and widely respected – to get their input on the strategy as well as their views on both the design and execution of intended process changes.

This kind of honest discussion about culture makes employees feel respected and heard. It helps leaders identify ways to effectively improve accountability in healthcare and get staff buy-in to accountability measures.

Be willing to talk about errors and mistakes

Many healthcare organizations have an unspoken culture of fear and shame when it comes to medical errors.

For example,studies have shownthat doctors are often hesitant to admit mistakes for fear of litigation or job repercussions. In this kind of environment, staff members fear that they will get blamed for any mistakes, so they simply don’t report errors.

In the past few years, many healthcare organizations have begun trying to shift this culture of blame to a culture of safety.

Nurse Sherry Shaffer Ratajczak, theclinical editor at Elsevier, saysa deliberate cultural shift can improve accountability in healthcare.

“Many nurses fear that reporting a medication error will result in a loss of their job, or worse, a loss of their license,” she says. “However, in a culture of safety, institutions view errors as a systems issue and encourage nurses to report and discuss errors to improve patient care.”

Create Ethics Education and Training

Ethics are foundational to creating a culture of accountability in healthcare. And ethics education and training is especially important in the healthcare industry.

Ethics violations can not only damage your organization’s reputation, they can also put you at risk forlitigation. Cases of fraud and abuse cost healthcare organizations billions of dollars each year.

Ethics education and training can help employees hold themselves and others accountable, and know when to speak up if they see another staff member doing something unethical.

Code of conduct training

Most healthcare organizations have a formal code of conduct. A code of conduct puts your organization’s ethics into a more concrete form, helping staff members see what behaviors are acceptable and what is unacceptable.

Many organizations only train staff members on the code of conduct during the onboarding process. But the code of conduct should be included inrecurring staff training and testing. This helps ensure that staff follow best practices.

The code of conduct should cover things such as harassment, patient confidentiality, integrity with billing and finances, andmuch more.

Creating a Culture of Accountability in Healthcare (2)

Conflicts of interest

The Institute of Medicine defines a conflict of interest as“a set of circ*mstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest.”

Conflicts of interest can be complicated, but it’s best for healthcare organizations to work hard to avoid even the appearance of impropriety.

For example, it could be a conflict of interest for an employee in purchasing accepts a gift from a vendor, as the gift may be seen as swaying the employee’s decision on which vendor to buy from.

Asan earlier postpointed out, most ethics violations happen when employees are simply unaware of how the laws or rules apply in their position. So it is important to train employees on common ethical issues and provide them with concrete examples.

Establish Clear-Cut Expectations

In order for employees to be accountable, they must have clear guidelines and regulations to follow.

Healthcare organizations communicate these goals through an employee handbook outliningpolicies and procedures. Make sure every employee reads and signs off on policies and procedures.

But along with policies and procedures, a few other practices help ensure a culture of accountability in healthcare:

Goals, measuring, and tracking

In order to be held accountable, staff members need to know the standards they are being measured against. This includes tracking things like infection rates, patient satisfaction rates, and the timeliness of care.

Measuring processes and outcomes can help you identify what interventions work best for certain types of cases and see areas you can improve.

Be sure to make specific goals a part of your normal operations and regularly track and measure progress. Create incentives for staff to meet and surpass these goals.

Give everyone a sense of ownership/responsibility

A culture of accountability in healthcare works best when every staff member helps hold themselves and others accountable. In order for this to happen, your organization must make it clear that you value everyone’s opinion.

Employees are more likely to go above and beyond when they feel heard and empowered.

Create clear channels for employee feedback and reporting. This can help prevent a culture of silence where lower-level employees feel they are not allowed to question their superiors.

A study by Johns Hopkinsfound that patient safety dramatically improved when healthcare organizations allowed and encouraged nurses to question doctors who skipped a step or violated safety measures.

As you seek to create a culture of accountability in healthcare, remember to start by clearly articulating your organization’s vision and values.

Encourage transparency and open communication, train your staff on ethics issues and provide clear standards and expectations. These efforts will help your healthcare organization deliver better care to patients, avoid liability risks, and continually improve operations.

Creating a Culture of Accountability in Healthcare (2024)

FAQs

How do you create accountability in healthcare? ›

How to Improve Accountability in Healthcare
  1. Create Clear Expectations. Everyone on your healthcare staff should know their role and responsibility. ...
  2. Decide How You'll Measure Progress. Again, accountability can often feel like an abstract concept. ...
  3. Improve Communication. ...
  4. Provide the Necessary Tools. ...
  5. Offer Training.
Mar 15, 2023

How do you develop a culture of accountability? ›

How to create a culture of accountability
  1. Define workplace expectations. ...
  2. Set strong goals. ...
  3. Monitor progress. ...
  4. Encourage commitment. ...
  5. Communicate consequences. ...
  6. Show leadership. ...
  7. Take responsibility for mistakes. ...
  8. Gather feedback from employees.
Feb 24, 2023

What does a culture of accountability mean? ›

In a Culture of Accountability® people demonstrate high levels of ownership to think and act in the manner necessary to achieve organizational results. They feel attached to the purpose and results of the organization. Rather than having accountability mandated in an Employee Handbook, something happens internally.

What is accountability in healthcare? ›

As a behavioral health professional, accountability means putting the client's best interests first and always being able to justify your actions. It also means complying with privacy laws and ethical codes of conduct to protect your clients' confidentiality and safety.

What are the 4 pillars of accountability? ›

Summary of the 4 P's of Accountability™

You're responsible for holding yourself and employees accountable for meeting performance goals and objectives. To accomplish this, focus on the 4 P's of Accountability – people, purpose, performance, and progression.

What is an example of a culture of accountability? ›

In a culture of accountability, people take responsibility for their actions (or lack thereof) but are judged based on their decisions. For example, an employee might break an organization's rule to avoid escalating a dispute in the process.

How to develop a culture of accountability and collaboration? ›

7 steps to fostering accountability in the workplace
  1. Make accountability one of your company's core values. ...
  2. Lead by example, whether you're a manager or an executive. ...
  3. Assign clear ownership to projects and initiatives. ...
  4. Let accountability trickle down. ...
  5. Prioritize employee growth and development. ...
  6. Be trustworthy and trusting.
Jun 24, 2022

What is an example of creating accountability? ›

A great example of accountability is when you are focused on achieving your goals and tasks. If you're able to limit distractions and pressures, you're successful in achieving your goals efficiently. Moreover, when your team sees this, you're setting a good example for them. You build a strong work ethic for your team.

What are the three major elements of accountability? ›

Today there are three aspects of accountability: fiscal accountability, process accountability, and program accountability.

What are the three parts of accountability? ›

The three C's of accountability are:
  • Clarity.
  • Commitment.
  • Courage.
Mar 28, 2021

Why is creating a culture of accountability important? ›

Lacking a culture of accountability in the workplace can spell doom for companies, especially those in high growth and working on employee retention and engagement. A strong culture of accountability means your leadership team is able to trust your employees to bring their best work to the table.

What is the ethical principle of accountability in healthcare? ›

Accountability

Accountability is chief among the ethical principles in nursing. Each nurse must be responsible for his or her own choices and actions in the course of patient care. Nurses who hold themselves accountable often provide higher-quality patient care.

What is the main purpose of accountability? ›

Accountability eliminates the time and effort you spend on distracting activities and other unproductive behavior. When you make people accountable for their actions, you're effectively teaching them to value their work. When done right, accountability can increase your team members' skills and confidence.

What is the purpose of accountability? ›

Accountability makes you reliable by highlighting your goals and effectively enforcing you to best your past self. It teaches you to assume responsibility for your actions by putting you through personal challenges.

What are the 5 C's of accountability? ›

We call it the 5 Cs: Common Purpose, Clear Expectations, Communication and Alignment, Coaching and Collaboration, and Consequences and Results. On the surface, it's a simple framework but in practical application, it can really change the game for teams and leaders.

What are the five elements of accountability? ›

Elements of an Effective Accountability System
  • Formal standards of performance. ...
  • Adequate resources and support. ...
  • A system of performance measurement. ...
  • The application of effective consequences. ...
  • Regular monitoring and feedback. ...
  • Continuous evaluation of the accountability program.
Jun 2, 2023

What are the 2 types of accountability? ›

Political accountability is the accountability of the government, civil servants and politicians to the public and to legislative bodies such as a congress or a parliament. Political accountability is the vertical-downward variant of external accountability with relatively weak control.

What is a good example of accountability in the workplace? ›

For example, you can offer to stay late with a colleague to help them finish that last-minute project or take over a coworker's tasks while they're off sick for the day. Helping after completing your own responsibilities shows collaboration, empathy, and accountability for the team's success.

What behaviors demonstrate accountability? ›

Accountability is willingly accepting responsibility for your actions. An accountable staffer owns their work and doesn't try to make excuses for themself. If something goes wrong, they communicate honestly with their team about what happened rather than hiding the truth.

What is the just culture model of workplace accountability? ›

“Just Culture” refers to a system of shared accountability in which organizations are accountable for the systems they have designed and for responding to the behaviors of their employees in a fair and just manner.

What is the core value of accountability? ›

Accountability is about becoming aware of the situation, owning the problem, finding solutions, and making things happen. It is a recognition that you are valuable. That means you can be counted on. Accountability as a core value provides your company with a distinctive advantage.

How do you create a strong compliance culture? ›

7 Building Blocks for a Culture of Compliance
  1. Set the Tone from the Top. ...
  2. Engage Employees from the Start. ...
  3. Make the Compliance Team Real and Relatable. ...
  4. Embed Compliance, Integrity and Values in Everything You Do. ...
  5. Ensure Compliance Teams Guide But Don't Dictate. ...
  6. Clear Compliance Processes Are Vital. ...
  7. Make the Most of Technology.
Oct 14, 2021

How do you develop accountability and responsibility? ›

How to Develop Personal Accountability
  1. Know your role. You'll need to understand your responsibilities to be accountable for them. ...
  2. Be honest. Set pride aside. ...
  3. Say sorry. If something has gone wrong, and you're responsible, then apologize. ...
  4. Use your time wisely. ...
  5. Don't overcommit. ...
  6. Reflect.

What is an example of accountability in nursing? ›

One way to demonstrate accountability in nursing is to use resources for their intended purpose. Taking care of equipment, administering medications as prescribed, and documenting any supplies used in patient care also demonstrate accountability to your patients and employer.

What is a strong sense of accountability? ›

Accountability means showing up and setting out to accomplish the things you'd said you'd do. It's about taking personal responsibility for your work. It's also trusting in your teammates and knowing you can count on each other to get things done.

What is an example of accountability and responsibility? ›

For example, an ongoing task that just needs to be repeated only involves accountability if someone stops doing it. If your responsibility is to water a plant, you're only going to be held accountable if you stop watering it. Otherwise, your responsibility is simply being carried out continuously.

What are 3 positive results of accountability? ›

Positive results of accountability

increased feelings of competency, increased employee commitment to the work, more creativity and innovation, and. higher employee morale and satisfaction with the work.

What does creating accountability mean? ›

Accountability is when people take responsibility for their own actions. It's about taking initiative and recognizing not only that individuals have the power to cause problems, but also to fix them.

How can I improve my accountability skills? ›

8 ways to improve accountability in your team
  1. Set clear expectations, and document them.
  2. Make everyone responsible for team meeting agendas.
  3. Assign tasks to individuals.
  4. Follow-up.
  5. Adopt an “embrace mistakes” mantra.
  6. 6. … but make sure there are consequences.
  7. Reward wins.
  8. Practice what you preach.

What are the 4 ethical principles in healthcare? ›

The four principles of Beauchamp and Childress - autonomy, non-maleficence, beneficence and justice - have been extremely influential in the field of medical ethics, and are fundamental for understanding the current approach to ethical assessment in health care.

What are the top 5 ethical issues in healthcare? ›

5 Ethical Issues in Healthcare
  • Do-Not-Resuscitate Orders. ...
  • Doctor and Patient Confidentiality. ...
  • Malpractice and Negligence. ...
  • Access to Care. ...
  • Physician-Assisted Suicide.

What are the 4 guiding principles for ethical accountability in nursing? ›

Nursing ethical principles can be broadly categorized into four major ethical nursing principles:
  • Autonomy: The right to self-determination. ...
  • Beneficence: The promotion of good. ...
  • Justice: Fairness or an equal distribution of benefits. ...
  • Nonmaleficence: The avoidance or minimization of harm.

What are the four functions of accountability? ›

Roles of Accountability
  • Improve a company's governance. Accountability, alongside other key underpinnings, such as integrity and transparency, has proven to be the driving force behind a good governance arrangement. ...
  • Provide oversight. ...
  • Maintain and enhance legitimacy. ...
  • Improve performance.
Jul 28, 2020

Why is accountability important in ethics? ›

Ethics help officials make better decisions in the public interest and help people evaluate the decisions taken on their behalf by public officials. Public accountability ensures that officials are openly answerable for the decisions they are taking on behalf of the public.

What is accountability in professional ethics? ›

Accountability means the state of being responsible or answerable for a system, its behavior, and its potential impacts. Accountability is an acknowledgement of responsibility for actions, decisions, and products. Responsibility can be legal or moral (ethical).

What are 3 examples of accountability? ›

Here are some common examples of accountability:
  • Creating solutions to problems. ...
  • Showing focus. ...
  • Admitting your errors. ...
  • Speaking about issues. ...
  • Going to work. ...
  • Discuss your career goals with your supervisor. ...
  • Work independently. ...
  • Get involved in extracurricular activities.
Mar 8, 2023

What are the five steps of accountability? ›

Five Steps to Accountability
  • 100% Clarity & Authority. ...
  • 100% Agreement. ...
  • Track & Post. ...
  • Coach, Mentor and Train. ...
  • Reward Success Lavishly & Deal Decisively with Mediocrity.
Dec 17, 2021

What is a good example of accountable? ›

Examples of accountability include taking personal responsibility, showing evidence of what you have and haven't done, and regularly reporting on your progress. Accountability is a trait of being responsible and open to having your decisions and actions scrutinized.

How do you demonstrate accountability and responsibility in a workplace? ›

Examples of showing accountability in the workplace
  1. Finish tasks by the deadline you agreed on.
  2. Ask for support when you need it.
  3. Support your team when they need it.
  4. Attend team meetings on time and prepared.
  5. Acknowledge mistakes and come up with potential solutions.
May 5, 2023

What are the three C's of accountability? ›

So, there you have it, our 3 C's: Clarity, Commitment and Consequences. We believe that if you remember -- and apply -- them, you will find a cure to your organization's accountability problems.

What are the 3 pillars of accountability? ›

Pillar 1: Ethical Fundraising. Pillar 2: Strategic Risk Management. Pillar 3: Fiscal Integrity.

What are the core values of accountability? ›

Accountability is often seen as an individual obligation. The synonyms for accountability include terms like answerability, responsibility, liability, and culpability. It typically has punitive implications. When scandals or crimes take place there will often be an outcry to hold someone accountable.

What is the easiest way to show accountability? ›

Use these six steps to become more personally accountable.
  1. Know your role. You'll need to understand your responsibilities to be accountable for them. ...
  2. Be honest. Set pride aside. ...
  3. Say sorry. If something has gone wrong, and you're responsible, then apologize. ...
  4. Use your time wisely. ...
  5. Don't overcommit. ...
  6. Reflect.

What is key of accountability? ›

Accountability means accepting responsibility for your actions. It's also about making agreements with other people (an accountability partner) and establishing commitment with them to do something. By doing so you have a way of tracking your progress and ultimately increasing the likelihood of success.

What is principle 7 accountability? ›

The principle of accountability makes an organisation and it's leaders responsible for complying with the UK GDPR and says that it must be able to demonstrate compliance. In a charity this is one of the areas of governance for which trustees are responsible, even if work is delegated.

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