Training is often a culprit of lack of accountability.  It is difficult to complete a task if we are uncertain how it is to be done.  Uncertainty lessens accountability!  Set standards for the practice by defining one way instead of multiple ways.  Standards create consistency and consistency escalates excellence.  The more consistent we are the more accountable we become resulting in a higher performing team and practice.  Provide personal training and cross training as well as entire team training to get everyone aligned on the same page.

Asking for help is being accountable.  Give your team permission to ask for help when needed.  Asking for help can often feel like a weakness when in essence it is being accountable to make sure the job gets done.  There are some team members who have OCD – Over Committers Dysfunction.  You will often here them say; “I got this!”  when they have so many plates already spinning, they can’t possibly get them all done.  Saying yes can sometimes be less accountable then delegating or asking another person for help.

Prioritize tasks as there will be days even the entire team can’t get everything done!  If we communicate and get the rocks done, we will be okay.  I utilize the rocks, pebbles, and sand analogy to help teams prioritize their responsibilities.  A rock is anything that is important and urgent (needs to be done that day) or there will be negative consequences for the practice.  The biggest rock is always the patient right in front of us.  Everyone helps everyone with their rocks (as long as it is legal, ethical and within their licensure) before going on to their own pebbles and sand.  Once all rocks are completed, the team member may move on to their pebbles.

Pebbles are also very important but not urgent.  Pebbles are never delegated because they can be done another day without affecting the practice negatively.  Everyone is responsible for their own pebbles.  A pebble can eventually become a rock if left undone based on change in urgency.  For example, ordering supplies might become a rock if you must order that day, or you will run out of necessary supplies before they arrive.  Even washing uniforms may become a rock if there are none available for the next day and it is close to closing.

Sand is the filler to fill in open time with cleaning and organizing.  Sand is also never delegated.  Everyone is responsible for their own sand.  This helps to prevent delegating the things that are less desirable.

Confirming by checking in when a task is completed is part of accountability.  It keeps everyone in the loop and ends the night wondering/worry of whether a certain task was completed.

Clearly defined consequences are necessary.  An accountable high performing team is dependent on supporting the patients, the team, and the practice standards.  Our job is whatever is legal, ethical, and within our licensure to help the team and practice thrive!   We must choose to support our patients, team, and practice if we want to be a part of the team!