Leadership, accountability, and safety in health care

摘要

Another impetus for this renewed thinking about leadership is that we have a new dean in our College of Nursing. She has challenged me in new ways to consider what leadership and accountability mean. In a book she has asked us to read, The Oz Principle (Connors, Smith, & Hickman, 2004), a sentence struck me that I cannot get out of my mind: "An attitude of accountability lies at the core of any effort to improve quality, ... build teams, ... and get results" (p. 16). The book's authors describe behavior that is below the line of accountability as "The Blame Game" consisting of the all-too-familiar behaviors of wait-and-see, confusion/tell me what to do, it's not my job, ignore and deny, finger pointing at others, and covering your tail. These behaviors result in a work culture where "no one acknowledges the truth and people don't speak up" (p. 11), and victims reside. Behaviors above the line of accountability are see it, own it, solve it, and do it. An accountable individual or work culture acknowledges the reality of a situation (sees it), accepts responsibility for the situation (owns it), finds and implements creative solutions to problems (solves it), and exhibits the commitment and courage needed to follow through (does it). Makes sense, doesn't it? Common sense.