Leaders in todays health care environment must focus on rendering services along the continuum of care for the customers we serve. Simultaneously, leaders must include a strong focus on integrating and arranging an organization that fosters point-of-service accountability and decision-making. It is at point-of-service that most all of the decisions are made and this decision-making is what makes any organization successful. A strong customer focus is the foundation for all activities and job descriptions in the organization. Therefore in order to be successful, we must examine our workforce, structures and model of care delivery systems to enhance that foundation and build upon it. Leaders must focus on resources available to staff while supporting them in their efforts to get the work done.
Accountability is a core standard for leadership and it is imperative that leaders invoke that standard into the standards and expectations of their staff. There must be a shift from the locus of control to accountability and that shift should be directed towards those providing the care. Leaders must take a hard look at the partnership they share with their employees in terms of accountability and be flexible to change in order to partner and support. Staff cannot establish accountability for work that they do not share without direction, control and approval. If accountability and equity are not shared, the system will not support the efforts of the caregivers and staff will never experience ownership to their work. When staff is dependent on their managers to make decisions for them, creativity is stifled. This results in staff lacking motivation and ultimately lacking the most precious buy-in to the processes. It is a leaders responsibility to ensure that accountability is defined, refined and clear as this is critical for building accountability in any organization at each and every level. Accountability is not given or assigned but rather assumed. Performance expectations must be clear and understood as well as embedded in the job of the employee at the bedside. It is imperative for those delivering the services at the bedside to be aware of both rewards and consequences that are associated with accountability.
Service is so very important to the business of health care which makes it imperative that decision-making and accountability for those decisions is kept at the level they belong. It must not only be clearly understood but clearly owned by the staff or the service delivered will be lacking the substance it deserves. Staff needs empowerment and freedom to serve their customers while the organization should be right there to support their moves. The structures in place for care delivery must reflect the foundation of service as service delivery is built around the customer and not around departments and processes.
Leaders need to take the lead in acquiring new rules for their behaviors to ensure that staff is accountable. There should be no “mom and dad” type relationships, no codependency behaviors, no parental checking and no more taking on other peoples problems. Managers must be much more serving to their staff and less directing. Managers are challenged to become more relationship-oriented with their staff and less distant. And, in the end all of us are challenged to be accountable for what we say and do. Authors B.J. Gallagher and Steve Ventura (2004) wrote about success through personal accountability titled: Who Are “They” Anyway? Here are their ten most important words of personal responsibility that managers should take hold and be sure to share with their staff:
The 10 most important words:
I won’t wait for others to take the first step.
The 9 most important words:
If it is to be, it’s up to me.
The 8 most important words:
If not me, who? If not now, when?
The 7 most important words:
Let me take a shot at it.
The 6 most important words:
I will not pass the buck.
The 5 most important words:
You can count on me.
The 4 most important words:
It IS my job!
The 3 most important words:
Just do it!
The 2 most important words:
I will.
The most important word:
Me
I agree.
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