[reposted from DCCS Consulting] 
Today’s healthcare leaders are pressed on every front to provide quality healthcare with ever shrinking funding and ever expanding regulation. They are challenged to create a win-win situation for all stakeholders in what often feels like a management-by-numbers-only culture. Most agree accountability is paramount and yet the struggle to make it happen is real. This article looks at accountability as four basic actionable steps carried out in relationship- Promise, Do, Self, Results (PDSR).

Promise: Promise is the foundation of accountability. From the overall job duties to specific tasks, accountable people make a commitment to carry out an action(s). People take personal responsibility to engage in an obligation. The accountable manager makes sure there is shared meaning about the expectations, before accepting the “I do.”

Do: Doing what one promises to do is the heart of accountability. Accountable people do and accountable managers support doing with integrity. An accountable manager hones their capacity to recognize, to encourage, to support, and to celebrate diversity.

Self: People are the energy of accountability. People have unique ways of making meaning of life in the present based on their life experience and internal frames of reference – culture, gender, socio-economic status, etc. Accountable managers pay attention to ways self may or may not be standing in the way of achievement. They are aware of trust, communication and other interactions that are promoting or limiting success.

Results: Results are the soul of accountability. Results are an extension of action, an extension of promise, an extension of people. Accountable people commit themselves to accomplish expected results.

An accountable manager celebrates expected results when met and recognizes the elements of achievement for replication. Conversely, an accountable manager also holds crucial conversations when expected results are not met and renegotiates a new promise and supports actions to achieve the expected results.

In summary, accountable people make promises, do actions, are responsible for themselves, and deliver results. Accountable managers negotiate the content of the promise, provide resources necessary for the promise to be completed within the timeframe agreed upon and expect the promise to be fulfilled. Accountable managers also respect themselves, the relationship and the process enough to achieve the agreed upon results.