June 29, 2017

Leadership and Accountability

Clinician Leadership | Leadership Development

Reading Time: 2 minutes

Creating Healthy Organizational Discipline

When you hear the word Accountability, what comes to mind?  If you are like many people, the word provokes feelings of fear associated with negative consequences for failing to deliver the expected outcome.  One CEO described it as knowing “which throat to choke.”
At the same time, many organizations with that definition of accountability concurrently espouse a desire to create a “culture of innovation,” to not be “risk averse.”  Not surprisingly, the tension between these two cultural touchstones can be paralyzing to an organization’s employees as they try to walk the fine line between innovation and predictability.
Organizations with what we call “healthy accountability” maintain a timely, rigorous, candid and disciplined approach to analyzing and responding to unanticipated variance in performance. They do not presume that the root cause is the failure of a person but investigate vigorously to determine what broke down that led to an outcome different than what was expected:

  • Was adequate thought and analysis done in setting the performance goal or is there room for improvement in the forecasting process?
  • Was the tactical plan well derived and did it adequately account for all the “knowable” factors that could affect results?
  • Is there room for improvement in the execution of the plan, i.e., were the right resources in place and organized in the right way and did they perform as expected?
  • Were there uncontrollable factors that turned out differently than expected? Was adequate study done to predict the range of possible outcomes of those factors and plan for those contingencies?
  • Were appropriate, timely steps taken adjust to unanticipated events?

Based on the findings of that root cause analysis, the organization then implements corrective action.  In the end, the root cause may be that the leader did not take appropriate steps to set and drive achievement of their performance goals.  If so, steps should be taken to improve their competency if they are capable of acquiring those skills.  If not, it may be necessary to acknowledge the lack of fitness for the role and make a leadership change.  Putting that step at the end of the process rather than the start will help you strike the necessary balance between innovation and accountability and avoid the unintended consequences of an accountability system based in fear of failure.
MEDI Leadership: “The Catalyst for Great Healthcare Leaders and Teams” MEDI Leadership, founded in 2000, is the largest and most experienced executive coaching firm dedicated exclusively to the healthcare industry.  Our coaches use their professional experience in healthcare leadership to help our clients accelerate their drive for high-performance.  We believe healthcare cannot be transformed without effective executive, physician and other clinical leaders at the table working as teams.  We are the catalyst for creating Great Healthcare Leaders and Teams. We would love to talk with you about how we can help your organization.

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About the author

Robert "Bob" Porter, JD, MBA, PCC

Robert "Bob" Porter, JD, MBA, PCC is an accomplished organizational leader with over 30 years’ experience in health system leadership. Bob has extensive experience in working with senior leadership executives in complex organizational settings, with a proven track record for engaging diverse stakeholders in the redesign of organizational systems and processes to achieve breakthrough improvement in performance.

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