By Stephanie Carnes
At large hospitals, when a patient dies unexpectedly, doctors conduct mortality and morbidity conferences, or M&Ms. All of the physicians in the hospital come to the M&M to both analyze the case and figure out what went wrong. This might sound like an excruciating situation for the doctor on the case: He’s lost a patient, and now a group of his peers is calling him to account for it. But, in fact, that’s not how most doctors experience an M&M. The conferences are confidential and do not lead to punishment, and their purposes are to prevent future mistakes and implement better service practices by learning from each other, which lead to improved patient care.
Imagine if every industry had its own version of M&Ms. At The LMC Group, we encourage our clients to maintain incident logs and perform a root cause analysis (RCA) after a service failure. Errors are going to happen, so why not turn negative situations into positives by treating them as problems to be solved? With your team, discuss how the service failure happened and what you can do to avoid it in the future without making excuses or expressing anger.
This level of accountability sounds ideal—but it may be hard to picture in reality. It’s not exclusively a chauffeured ground transportation issue; most people in the workplace are not eager to discuss their mistakes with their colleagues, and some will come up with excuses to deflect attention from their errors. Also, many managers find it difficult to address failings without getting personal or punishing. It all comes down to culture—a culture of accountability.
Many managers find it difficult to address failings without getting personal or punishing. It all comes down to culture—a culture of accountability.
Obviously, the hospitals with M&M conferences have cultures of accountability, but why? First, we all want employees who “own” their jobs instead of “renting” them—we want employees who are engaged. Since becoming a doctor costs hundreds of thousands of dollars and requires at least four years of college, four years of medical school, and three to seven years of residency, we can safely say most doctors “own” their careers. Second, quite obviously, the stakes are higher for doctors. As tough as losing a sale or a contract can be, it’s nothing compared to losing a life. Doctors are supremely motivated to keep their patients alive. Finally, no one is exempt from the M&M conference, from the first-year intern to the seasoned surgeon. The culture of accountability in medicine is wide and deep.
So how can we create a culture of accountability in our workplaces? Our employees haven’t devoted a dozen years to train for their positions, and we generally aren’t making life-or-death decisions. The answer lies in the final element of the medical culture: accountability for all. If you want your employees to be accountable, it starts at the top, with you.
Here are some steps you can take to foster a culture of accountability in your company.
Hold yourself accountable. Be a person of your word. If you make a mistake, own up to it. When things go wrong, focus on solving the problem rather than assigning blame or shame. You can only manage to the level of your own abilities, so improve yourself through executive coaching, therapy, religious practice—whatever it takes.
2. Find the Right People.
When you are interviewing candidates, you can ask questions to see if they are the types of people who will integrate well into your culture of accountability. One question we like to ask is this: “Tell me about a time you made a mistake at work and how you handled it.” You’ll know from the answer if your candidate is a teachable problem-solver based on the thoughtfulness of their answer. You can also ask interviewees to tell you about a time they overcame a hardship at work. Listen to see if the candidates blame others or talk about their ability to succeed in face of difficulty.
If candidates have held positions of leadership, this is often a good sign. Willingly accepting leadership roles usually means that a person will work hard and make sacrifices for a greater good. You can see this even in the resume of a recent graduate who held such positions in their extracurricular activities.
3. Manage Out the Wrong People.
Many small business owners expend a lot of stress worrying about personnel issues. I asked several human resources professionals what percent of the employees at most reasonably successful companies are “problem” employees (i.e., ones that should be managed out). Each person I asked told me the same answer: 10-15 percent. Your personnel problems may feel bigger than they are.
At the same time, if 10-15 percent of your employees have ongoing performance issues or toxic personalities, they will take a toll on the other 85-90 percent. Part of the culture of accountability is imposing real consequences on people who continue to be detrimental to your business. If you don’t follow through on stated consequences, you will undermine the rest of your team’s confidence in you. If 10-15 percent are allowed to go on unchecked, the high-performing team players will do one of two things: They will leave for a company with a better culture of accountability, or they will start sinking down to the level of the poor performers.
One question we like to ask is this: ‘Tell me about a time you made a mistake at work and how you handled it.’ You’ll know from the answer if your candidate is a teachable problem-solver.
4. Welcome Feedback.
Make it clear to your employees that you truly desire their feedback. It’s one thing to say it, but they will know you mean it by the way you react when they give you criticism you may not like. If you act defensively or dismiss their ideas outright, chances are that they won’t be offering feedback in the future. You don’t have to implement all of their suggestions, but if you take them seriously, ask questions, and engage, they will feel heard.
5. Project Management Approach.
Take a project management approach to the major tasks of your business:
a. Put one capable person in charge of each task.
b. When you start something new—a new service offering, a new shuttle contract—have a kickoff meeting and be sure every required piece of the project is clearly spelled out and assigned to someone. Gain commitment from each of the people involved.
c. Set measurable goals.
d. Don’t wait until the end to see how things are going: Check in regularly and make adjustments if necessary.
e. Evaluate how things went soon after the rollout and at its conclusion. Decide what you will do differently next time.
6. Coach Employees Regularly.
Having regular check-ins with employees is a reoccurring theme in HR Coach. Once a week is ideal, but definitely don’t go longer than once a month. These do not have to be formal reviews—go over what was accomplished last week, what is due this week, and what the employee needs to be successful using positive reinforcement to keep them motivated.
Believe it or not, a number of personality types will be more motivated by these meetings than they would be by a bonus!
7. Delegation + Empowerment.
There’s no question about it: Delegation is tough. Turning over critical parts of your business to someone who doesn’t sign the paychecks or whose name isn’t on the door feels scary. But you will never grow if you don’t delegate, and there’s a limit to how much you can hold people accountable if they aren’t in charge of anything.
When you delegate responsibilities, it’s crucial that you empower your employees to get their jobs done. Give them the information, the resources, and the power to meet their goals. Don’t micromanage them.
You can create a culture of accountability in your business, even if you are not saving lives. Just remember it starts and ends with you.
Stephanie Carnes is the client solutions provider for The LMC Group. She can be reached at firstname.lastname@example.org.