Getting accountability rightNursing Management: September 2018 - Volume 49 - Issue 9 - p 1 doi: 10.1097/01.NUMA.0000546157.74947.f4 CE Connection Free Article MetricsMetrics GENERAL PURPOSE: To provide information about ways of increasing commitment and accountability among staff members. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Review the importance of addressing employee accountability using the accountability building blocks. 2. Identify ways to create a nonpunitive disciplinary system of management. When addressing accountability with difficult people, a main concern of nurse managers is charges of harassment. losing staff. lack of organizational support. The urgency of needing to meet healthcare targets and deadlines often leads to an emphasis on using consequences for staff. a staff overwhelmed with disapproval and animosity. overshadowing the rationale of why meeting the targets is important. One of the three key building blocks of accountability described by the authors is identifying clear expectations. ensuring that staff members know the manager has full control. determining who should take the blame for a mistake. An example of a nurse manager action that can hinder conveying a clear expectation is using a sincere tone. rolling eyes while speaking. focusing on an issue instead of a person. An example of using the follow-through building block of accountability includes mentoring staff. providing rewards. ensuring that the directive is understood. Follow-through actions focus on rewards. behaviors. consequences. Which is an example of a follow-through question? “How's your project coming along?” “How should we get started on this project?” “What ideas do you have for addressing this issue?” Which is an example of a follow-through action? identifying resources deciding who'll work on a project determining when an assignment is due Which is a result of follow-through when it's done well? issue escalation reduced project engagement partnership development When providing employee rewards, the nurse manager should develop a complex reward system. create rewards that staff members are unlikely to achieve. have a clear connection between the reward and the behavior. Research has shown that more frequent praise for newly hired nurses significantly reduces job achievement. improves performance and retention. increases resentment from the other nurses. The nurse manager can create a positive approach to accountability by progressing from coaching to counseling. adopting a punitive disciplinary system. making excuses for marginal staff performance. If employees have a victim mentality, how should the nurse manager address accountability? praise even marginal performance refuse to rescue them set limits What's the best way for the nurse manager to foster staff accountability? Be a role model for accountability behaviors. Develop a controlling environment. Use the progressive negative discipline approach. A punitive disciplinary system places nurse managers in a policing mode. provides an opportunity for long-term change. fosters commitment instead of compliance. When disciplining an employee with a nonpunitive process, the nurse manager moves from being in a coaching role to a policing role. creates a written outline for changes that the employee needs to achieve. develops an approach with the employee that focuses on the past instead of the future. To attain a high-performing team, one goal is to create an accountability program based on coerced compliance. a single governance management system. peer-to-peer accountability. A progressive view on accountability includes a system that consistently enforces punitive policies. results in reduced fear and increased trust. is based on blaming employees for their mistakes. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.