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Veterinary Forum August 2007 (Vol 24, No 8)

Business Skills: Improving Employee Accountability

by Amanda L. Donnelly, DVM, MBA

    Editor's Note

    In our everyday practice of veterinary medicine, an important component of practice teams is staff accountability to each other, clients, patients and the practice owner. In this article, Dr. Donnelly reviews the management steps to take when holding staff accountable for their performance. This article is one to save, as you can use it every day in your practice. — Stephen Fisher, DVM, Column Editor

    One of the most challenging management frustrations for veterinary practice owners and managers is inconsistent employee performance. Why do some employees excel while others lack initiative in the workplace and demonstrate poor attention to detail? Employers and managers often think these employees lack motivation or have a poor attitude, which is not always true. The real issue in many practices is lack of willingness to accept responsibility — that is, lack of accountability. All too often, employees are not held accountable for their inadequate job performance.


    Lack of accountability can surface in many ways. Employees who consistently demonstrate an inferior job performance in multiple areas may lack accountability and need to be terminated. Other employees may have lapses in accountability but an average or above-average job performance most of the time. This type of employee represents what typically occurs in veterinary practices. Examples of accountability lapses include:

    • Tasks completed inconsistently
    • Lapses in client service
    • Failure to complete assignments on time
    • Excuses made for inconsistent job performance
    • Chronic tardiness

    When accountability is lacking, employees may make such excuses as, "It's good enough," "It's not my job," "I didn't have time," "I didn't know" or "I just work here."

    Underlying origins and components

    Because lack of accountability lack of accountability can surface in a variety of forms, managers need to ascertain the reason certain employees are unaccountable before corrective measures can be taken.

    Employees who lack integrity are often dishonest or immoral and, therefore, unaccountable not only to other staff members but to the practice in general. For example, a receptionist who steals money from the cash drawer may excel at client service but is certainly not accountable to the veterinary practice owner. Employees who are chronically tardy or steal drugs because of a substance abuse problem are other extreme examples of being unaccountable.

    Staff members who have a poor attitude regularly demonstrate lack of accountability. They tend to ask, "What's in it for me?" and are quick to find the demands of clients annoying. These employees are easy to identify because they may be cynical, constantly complaining or disruptive to the work environment.

    If an employee has an inconsistent job performance, it is important to determine whether lack of training is the reason. For example, if a receptionist does not consistently collect deposits or offer clients third-party payment plans, it may be because she or he has not been adequately trained to talk with clients about fees. In addition, the employee may not fully understand the value of client services and may not be comfortable reacting to clients who express anger about treatment plan fees.

    Without effective leadership, staff may be confused about the direction of the practice or the importance of their role. Employees may exhibit lack of accountability because they do not feel their job performance makes a difference in the daily practice operations and overall success of the practice. To deal with these concerns, practice leaders need to set a positive example for employees to follow.

    When managers are asked how they believe accountability can be improved, the typical response is to enforce a disciplinary policy. Yet most veterinary practices that have disciplinary policies continue to experience lack of accountability. Disciplinary policies may work well when addressing some employee performance issues, such as excessive absenteeism, co-worker conflict and incompetence. But discipline is not a positive approach when dealing with inconsistent job performance. Most managers agree that firing employees for occasional tardiness, forgetting to complete certain tasks or having minor lapses in client service is not a productive answer. Unfortunately, however, many practice owners who must deal with an employee's lack of accountability become frustrated but do not know how to solve the problem.

    Steps to increase accountability

    Lack of accountability often occurs in practices because owners or managers do not know how to effectively communicate with employees about how to be accountable. It is easier to ignore minor job inconsistencies than to confront employees. The steps outlined below can assist in your efforts to improve accountability and provide a foundation for better employee motivation. (See 6 Steps That Improve Staff Accountability .)

    Assess your health care team's productivity — To establish accountability in your practice, begin with an assessment of your entire health care team. You can begin by listing specific examples of tasks that are not done consistently and areas in which job performance is inconsistent. Once you have compiled your list, identify which employees are involved with the execution of a particular task as well as the underlying reason job performance is inconsistent.

    Provide effective leadership — The leadership of a practice needs to ensure that employees understand the mission of the practice and their role in achieving practice goals. Owners and managers also should examine their management style to make sure they are not inadvertently sabotaging accountability.

    Accountability is best established with a participative management style that fosters employee feedback and empowerment. If management is overly autocratic, accountability suffers because morale is low and employees resent the owners or managers. If the management style is too hands-off, employees may lack the direction needed to be accountable for their actions. If the practice has multiple owners, the practice management team must convey the same message to staff regarding core values and policies. Otherwise, employees can become confused and do not know which owner or manager they should listen to.

    Establish and follow core values — Core values represent how veterinary practices will conduct business and, as such, serve as a foundation for talking to staff about accountability. For example, when discussing tardiness, managers might indicate that "respect" is a core value of the practice, and when employees are tardy, they demonstrate a lack of respect for their co-workers. Employees are much more receptive to dialogue that is focused on core values. A discussion of inconsistent job performance no longer sounds like nagging but instead focuses on the importance of adhering to core values.

    Give employees the tools to do their job — Employees need job standards and adequate training to be accountable. This starts with written job descriptions that outline roles and responsibilities. Staff also should be given job expectations that detail how individuals are supposed to do their job and how they are to behave while at work.

    Practices must provide sufficient training for newly hired employees and invest in ongoing training for all employees to ensure proficiency at work. Employees also need equipment that functions properly. Staff may become stressed and adopt an attitude of negativity if they must struggle with equipment that is inadequate or constantly breaking down.

    Promote effective communication — The best way to increase accountability is direct and straightforward communication with employees and to establish deadlines for the completion of tasks. Employees are not always clear about the appropriate prioritization of assignments or management's sense of urgency for completing tasks if this is not clearly articulated.

    Another key is to enhance the effectiveness of staff meetings. To accomplish this, managers should follow guidelines, such as: Set an agenda before starting the meeting, start and end meetings on time, solicit employee feedback and facilitate interactive dialogue, allow employees to do 80% of the talking, develop action plans with deadlines to address issues and make assignments for completion of action items.

    Be willing to terminate employees for lack of accountability — The last step in establishing accountability for your practice is to be willing to terminate employees who demonstrate a lack of accountability despite your efforts. Otherwise, accountability will slip because employees realize there is no consequence for failing to be accountable.

    Blanchard K, O'Connor M: Managing by Values. San Francisco, Berrett-Koehler Publishers, 1997.

    Blanchard K, Oncken W Jr, Burrows H: The One Minute Manager Meets the Monkey. New York, Quill William Morrow, 1989.

    Web source: humanresources.about.com.

    NEXT: Clinical Report: "Methicillin-Resistant Staphylococcus aureus"


    Did you know... Effective communication can ease stress for the entire health care team. Establish open lines of communication with staff members so their concerns can be addressed. Read More

    These Care Guides are written to help your clients understand common conditions. They are formatted to print and give to your clients for their information.

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