In a collaborative culture with an influential leader, accountability is a visible practice. All team members are clear about their specific responsibilities. They are aware of the organization's mission, vision, values and goals, and how they fit into this framework. They are given measures and tools to use in determining if they are moving forward or falling behind on their objectives. They are empowered to do their jobs, and they are rewarded for their efforts.

Accountability is indispensable in collaboration because the work is interrelated. For example, if one team member makes an error or falls behind schedule, he must report it to the rest of the team to stem the consequences; failure to disclose a problem in one part could potentially damage the entire work. In addition, taking responsibility for errors is easier in a collaborative setting, where the focus is on correction rather than on blame. Thus, fear of retribution is minimal, if it exists, allowing a more honest exchange among team members.

In a traditional culture with command-and-control leadership, however, the opposite is true. Although management demands and praises the value of accountability, it does not provide the resources and environment that enable accountability. This absence results in widespread confusion, distrust and underachievement. Influential leaders are aware of these pitfalls and thus behave, and urge others to behave, in a manner that promotes accountability.

Role Modeling

"Leaders lead," as an old saying goes. This is a simplistic view of what leaders actually do; it does not take into account the fact that not everything a leader does is worth following. So let's revise this saying to be more specific: "Leaders lead by modeling good behavior."

Influential leaders are role models of accountability. Their appropriate behavior comes from a conscious choice to live by their conviction, to change harmful mental models and to manage their emotions. This choice extends to the way they view their enormous responsibility for other people—from the internal senior management team to the governing board to employees to physicians and other clinical providers to the patient population to the community at large. Accountability is a practical instrument that influential leaders use to keep themselves and those around them honest, focused and productive. Influential leaders know that an organization devoid of accountability is nothing but a collection of people who shift blame, feel victimized, procrastinate and disguise their incompetence.

One way that a leader can model accountability is to admit mistakes and vulnerabilities in the face of various responsibilities. For example, a leader can share a story in which he "dropped the ball" on an important project. He can explain the steps he took to recover from this event. The story then can be turned into a teaching moment that may inspire others to change their approach to avoid the negative outcome experienced by the storyteller. The point of this exercise, which is called "power of story," is to show that a lack of accountability has the power to weaken even a strong performer and thus needs to be managed with vigilance. 

Another way a leader can serve as a role model for accountability is to always, in any challenging situation or conflict, ask: "How did I contribute to this problem?" This simple question must be followed by an actual evaluation of the leader's role, because just posing the question is as good as screaming, "I didn't do it!" This show of genuine concern indicates to others that the leader sees herself accountable not only for the problem, but also for the solution.

Stopping the Blame Game

More often than not, when we talk about white-collar crimes (e.g., embezzlement, fraud, Ponzi schemes), we ask: "Who's accountable for this mess?" The question indicates that we have a collective, if unconscious, negative reaction to the word accountability.

This perspective extends to the way we approach accountability in organizational life. Historically, and especially in health care, we associate accountability with blame and shame. We regard a director responsible for a certain service line as the "go-to"—the person who receives all the complaints and does all the explaining when a problem emerges in that department. This person, in turn, traces the problem to its origin and then transfers all the ire and miseries to the staff member who committed the actual error, compelling the employee to either resign or take the prolonged abuse.

An employee who does stay amid this stress feels humiliated and utterly incompetent, is fearful of getting fired, and too intimidated to perform the simplest tasks. At this point, the relationship between the director and the employee (and between the employee and the organization) is not just strained; it is broken. And this scenario plays out in front of other members of the department, creating the "us vs. them" mindset among the staff, which decreases their productivity and level of performance. Under the blame scenario, accountability becomes a countdown to doom, where everyone knows it is only a matter of time until the relative peace in the workplace is shattered.

You, as the organizational leader, have the ability to stop the loss of trust and damage to the relationship that this system of accountability perpetuates. Try the following strategies:

  1. Analyze the problem for the purpose of preventing recurrence and correcting the error, not for the purpose of shaming the responsible party. Even if this root-cause analysis points to one person, the discussion should remain professional, avoiding name-calling and threats that will trigger an emotional outburst.
  2. Provide help and support to the person who is accountable. Retraining, coaching or shadowing should be considered before firing, sanctioning or disciplining.  
  3. Turn around the negative perspective of accountability within the organization by celebrating and rewarding achievements.
  4. Clearly communicate the organization's policy of no (or low) tolerance for inappropriate behavior, regardless of who commits it. This behavior includes harassment of the responsible person following an adverse event.

Remember that human behaviors drive or stall execution of processes, policies and strategies. This concept should be considered when you transform accountability from a fault-finding approach to a fact-finding, rewarding system.

Michael Frisina, Ph.D., is founder of The Frisina Group, a leadership consulting and teaching consortium based in Columbia, S.C.  He is the author of Influential Leadership: Change Your Behavior, Change Your Organization, Change Health Care and a member of Speakers Express.