Staff Accountability Reveals New Pathways to Real Business Results. Here’s How!

  • drbob
  • December 13, 2017

Out of all the leadership trainings I have delivered in the last 20 years – Accountability has clearly been my #1 draw. And my guess is that it will continue to be.

More often than I can count, department leaders have asked me the question: What is the top issue you deal with when you work with managers?

My Answer:  They do not effectively hold their staff accountable. They don’t. They simply don’t.

And no doubt there are various reasons why:  they’re really bad at it; they view it as conflict; they’re reluctant; they think they don’t have time; they’re lazy; or they just don’t follow through.

What’s interesting to me is that many leaders agree on the importance of accountability but very few people either do it or do it well at all. In my trainings I teach them precisely how to do it by following 5 easy steps that, if done well and consistently over a period of time, will yield great results.

The 5 steps for attaining and managing employee accountability are:

  1. Determine the Accountability Goal
  2. Identify the Roadblock(s)
  3. Turn Roadblocks into Actions
  4. Obtain Buy In from employees
  5. Set a 7-Day Accountability Goal and Follow Up, Follow Up Again, and Again Follow Up

To provide a clearer perspective, I want to share with you how I helped turn a company around – from one that was previously losing revenue to one now consistently generating revenue.

I was hired to deliver a set of trainings for a Home Health Care company. The CEO hired me to work with her and her management team. The main problem she (the CEO) was facing was that her nurses and staff were not hitting their productivity numbers. And as such, they were losing revenue and the quality of patient care was becoming a big concern. Although there were various reasons why they were not hitting their productivity (i.e., staff was spending too much time in patients’ homes, not efficiently planning their days, etc.), the problem still remained: the company was losing revenue.

My Question: On whose direct shoulders does this problem rest?

Answer: The managers of these people, of course.

The real problem is they are not holding their people accountable. Here’s how the five step process worked and how I helped them both understand and implement it.


Since revenue and quality patient care are the ultimate drivers, the 1st step is to determine a realistic goal for each nurse to achieve on a daily basis. After a series of brainstorming and leadership input, it was determined that each nurse must make 5 patient visits per day, for a total of 20 visits per week. There’s the goal.


The next step is to brainstorm all of the roadblocks that prevent them from achieving the goal of making 5 patient visits per day. With any new goal or any new change, there will inevitably be roadblocks, reasons, and sometimes excuses why the goal you introduce is unachievable. It is very important that managers and the nurses brainstorm and then prioritize all of the top roadblocks.

Suggested Statement for Managers:

  • It seems to me that the major roadblocks you are facing are that you’re spending too much time in patients’ homes or you’re not planning your day in advance as efficiently as you could.


After the manager and the nurse prioritized the top roadblock, the 3rd step is to identify ways how to overcome that roadblock and turn it into an action.

Suggested Questions & Statements for Managers:

  1. What are some ways how you can be more efficient in patients’ homes while at the same time deliver quality care? Brainstorm all of the answers with them and then prioritize them in the order of importance
  2. How about if you and I spent the day together and we could look at some ways how you can be more efficient? Would you like to do that?
  3. It seems to me that one action you could take is ____ . What do you think?


The next step is to consistently obtain buy in. One way to do this is to discuss the rewards and benefits for the nurses once the goal is achieved and, as we did above, continue to make suggestive statements and pose questions.

Suggested 1, 2, 3 Word Track:

  1. Ask: How might you benefit if you consistently hit your productivity goals? And then wait for their answer
  2. Then make a follow up statement such as: it seems to me that one big benefit (or an additional benefit) for you once we tackle this problem is _____
  3. Then say: How about you and I work together in this area? This, by the way, is a great non-threatening, closing question.


The 5th step is to ‘lock it in’ by reiterating the goal, the main roadblock, how the roadblock will be addressed, and what is expected the next time you meet – which is in 7 days.

Statements and Questions

  • Your goal is to make 5 patient visits per day
  • The main roadblock we determined is that you spend too much time in patients’ homes
  • So you agree that two ways how to overcome this roadblock is that you’ll (1) more efficiently schedule your ‘planning for the day time’ either the day before or before the day begins and (2) that you’ll not complete your paperwork in patents’ homes.
  • We also agreed that if you do this, you will consistently achieve your productivity goal of making 5 patient visits per day.
  • Can you do this?
  • Will you do this?
  • Great we are – as you know – going to meet in 7 days. I look forward to congratulating you upon hitting your daily and weekly productivity goal of 5 visits and by more creatively and efficiently planning your day.
  • OK – Let me write down what we agreed on in my calendar
  • Again, I look forward to seeing you next week at our scheduled meeting

So many times and in so many ways, I have implemented this process with my clients. With this particular company, the results were astounding. The managers incorporated these steps within their own repertoire and did it.

As a result, the staff consistently achieved their productivity goals and the company revenue increased.

The Word “Accountability” Has a Bad Rap

There are those who view it as inducing conflict, being too micromanaging, and aggressive. A better perspective for managers and leaders is that it’s a professional development incentive. If this five-step process is administered tactfully, assertively, and in a way where the manager and the employee are working together, the results will take care of themselves as they did with this company.