Part 2 in a 3-part series
What does it mean to have accountability? As we observed in an earlier post, piggybacking off of Mark Graban, if a hospital manager expect nurses to be responsible for filling foam canisters to increase the odds of hand washing to protect patients, there needs to be an explicit promise between that manager and the nurses. Such a promise requires both a clear request (or offer) and an acceptance. Promise = Request + Acceptance.
Now, what can we say about the components of an effective request or offer? Let’s make explicit what was partly implicit in the above example. An effective request or offer consists of the following:
- Clear conditions for satisfaction. There needs to be a shared understanding of what it means to restock a canister.
- Clear timeframe or deadline. What days and what times of day will the nurse restock the canister—or at least check to see if it needs restocking?
- A specific speaker. What do we mean by this? If a vague pronouncement comes out from “management” about who is responsible for restocking the canisters, there is not a specific speaker. The nurse doesn’t have anybody to respond to (by accepting, declining, counter-offering, or promising to promise). Another way that a speaker can be “missing” is if a manager holds uncommunicated expectations; they want the nurses to refill the canisters, and maybe even mention it in passing, but never actually make a request.
- A specific listener. On the other hand, let’s say a particular manager makes the request but communicates it vaguely to a full team of nurses. Now, we have a specific speaker but not a specific listener.
- A shared “background of obviousness.” This is a fancy way of saying that when the manager says “restock the canisters in the middle hallway”, both the manager and the nurse understand which canisters these are and which hallway is the middle hallway.