LEADERSHIP & MANAGEMENT IN HEALTH

Accountability Part 3
Lecturer: Dr. Ann Downer, EdD
In this last lecture on accountability, I’m going to share some additional ideas for improving
accountability—getting it above the 85% mark, as Linda Galindo recommends—both for
yourself and for your team.
The first idea has to do with saying no. I’ve read that Bill Gates and Warren Buffet both say that
the ability to say no is one of the most important skills to have as a manager and leader. So,
what do you do when someone asks you to do something that you feel you or your team
cannot be truly accountable for? How do you say no? Let’s say, for example, that the head of
your unit wants a new project to start immediately while you already have three other projects
going that are high stakes with demanding schedules. You know your team cannot deliver on
another project. What do you do?
In some instances, you may just have to find a way to say yes and then deliver. In a case like
that, I would probably explain the workload and ask my boss which of the projects was of
highest and lowest priority since one was going to have to suffer. I’ve actually said before, “I’d
be happy to take that on. I have several competing priorities that I could use your help sorting
out, though. Can you review them with me and give me some input?”
In other instances, the most responsible thing you can do is say no. Obviously, saying no to a
boss is something you’d do only after a lot of consideration and after carefully thinking through
how you’ll say it.

• First, listen carefully again to what exactly is being asked of your team.
• Explain what you feel the team is able and willing to do (if anything) at this time.
• Explain what the team is not able to do at this time and why, but offer alternative or ask
for help re-prioritizing those projects.
• Resist the temptation to say yes if you truly know that you can’t be fully accountable.
• In the end, it’s often worse for everyone if you fail than it is to say no right at the start.
Another situation you might find yourself in is when you have to hold someone accountable for
the poor results of their work. This usually comes up when a member of a team doesn’t do
what they promised to do. In this situation, I recommend that you:

• Prepare in advance for the conversation. Either start by asking them how they feel they
performed or start by offering your opinion of their performance before asking them to
respond.
• Review the original agreement that you had with the person and try to understand
where and when the problems started to occur—was he timeframe a problem? Was the
task too hard? Did they have personal issues that got in the way? Why was the problem
not communicated sooner?
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 • Be clear about the impact that their performance had on the project before focusing on
problem-solving about how to mitigate the impact or get back on track.
• Also, as the team lead, consider accepting some of the responsibility yourself before
renegotiating the agreement or otherwise concluding the difficult conversation.
The end result of this conversation will either be a renegotiated agreement and some
discussion of lessons learned or, more drastically, letting the person go. These conversations,
while difficult, can build stronger working relationships and more effective teams.
Another idea that may find helpful in promoting responsibility and accountability is something
very simple. You don’t need to have a difficult conversation or use anything high-tech—the idea
is just to use a calendar! It doesn’t matter if it’s a paper calendar, a chalkboard calendar, a
computer or a mobile phone calendar.
Whatever type of calendar you use, note the start and end dates for the tasks that you’re
accountable for. Block time on the calendar to work on it. And review your calendar before you
actually commit to a task.
One final suggestion to increase accountability- get in the habit of looking back after you’ve
completed a task or a project. Don’t be afraid to examine your own performance in addition to
that of the team. What did you take responsibility for—just a small piece or for the outcome of
the whole effort? Did you follow through—did you accept at least 85% of the responsibility for
the outcome? What did you learn? What problems arose and what did you do to fix them?
What did you do that contributed to success? Were you willing to own failure as much as
success? What will you do differently next time?
In summary, we have talked about accountability in this unit—the personal willingness, after-
the-fact, to answer for outcomes produced, whether good or bad. Do work on that goal of 85%
or more!

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