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Crucial Accountability QA

Crucial Applications: Three Keys to Holding Coworkers Accountable

According to our recent poll, three in four employees quickly attribute their coworkers’ bad behavior to lack of motivation while only one in ten consider ability deficits. As a result, they avoid holding problem colleagues accountable, engage in costly workarounds, and perpetuate the very problems they detest.

Those who think more generously and carefully about the cause for others’ misbehavior are far more likely to speak up. They are also more disposed to explore potential motivation and ability barriers to their coworkers’ performance, and often report success in resolving the issue. Here are three tips for holding coworkers accountable by correctly diagnosing their bad behavior:

1. Identify the right problem. When approaching your coworker, think “CPR” (Content, Pattern, Relationship). Our natural inclination is to talk content—the immediate offense. But if and when your coworker continues to behave poorly, it’s time to talk about the pattern of bad behavior. If the infraction continues, talk about the long-term damage the pattern is having on your relationship of trust and dependability.
2. Make it motivating. If the other person is able to do what’s been asked, but chooses not to, start by making the invisible visible. Talk about the natural consequences—both good and bad—he or she cares about. What are the effects of his or her behavior on other employees, customers, share owners, etc.?
3. Make it easy. If you find out the problem is not due to motivation, then it’s likely due to an ability barrier. Maybe your expectations aren’t realistic. Maybe you didn’t provide him or her with the right tools. Maybe he or she is constrained because of bureaucracy. Whatever the constraints, discover them and make changes. The goal is to make it as easy as possible for your coworker to meet the expectation.

To view an entertaining video about unaccountable coworkers, access an online game to test your accountability skills, and learn more about our new Crucial Accountability Training, visit

Special Announcement

Special Announcement: Introducing Crucial Accountability Training

In every organization, you’ll find renegades who break rules or fail to live up to their end of the bargain. We call these troublemakers “The UnAccountables.” They create problems that are so stubborn they require extra vigilance. Watch our new video to see a showdown between one manager and his unaccountable direct report.

To prevent showdowns like this from happening in organizations across the world, we’re pleased to announce the release of Crucial Accountability Training, the update of our popular Crucial Confrontations Training course. New features include:

  • New and updated video-based instruction
  • Streamlined content in a new flow that’s easier to learn and train
  • Updated Crucial Accountability model

Learn more about the course, watch more videos, and play our game to see how well you do when it comes to holding others accountable.

Sucess Story

Success Story: VitalSmarts Training Helps Canadian Hospital Transform Its Culture

The Challenge
The staff at St. Joseph’s Health Care London didn’t talk to each other. Yes, they exchanged words, but when problems were serious and emotions were involved, many side-stepped core issues. Not only was this behavior unproductive and disrespectful for employees, it was potentially dangerous for patients.

The organizational development staff identified a training course that might help, especially in the interests of their main concern, patient safety. They also knew they needed an executive champion who could persuade busy physicians and nurses to participate. So they approached Dr. Gillian Kernaghan, a veteran family practice physician who was then the hospital’s Chief Medical Officer. She agreed something needed to be done.

“Only 50 percent of meetings were productive,” remembers Kernaghan, who is now the hospital’s President and CEO. “We had a lot of ‘Groundhog Days,’ where we talked about the same thing and didn’t find common purpose or get to actions that were agreeable.”

Kernaghan describes an environment where people wouldn’t speak up and sabotaged decisions that were made in the real “meeting” that happened in the hallway after.

“People pushed through their agenda by using power words like ‘patient safety,’ ‘evidence-based,’ and ‘family-centered,'” she says. “The implication was, ‘If you disagree with me you’re obviously not patient centered.’ Essentially, others couldn’t speak up because they felt shutdown.”

She also observed the initiatives that grew out of those limited discussions were less effective, leading to “rework” and “I told you so” comments even though people hadn’t spoken up in the first place.

“We needed to not only teach people to be nice to each other, but we also needed to get results by teaching them how to follow up and follow through,” she says. “We knew that if we could transform the way we communicated, our staff would be happier and more productive, and ultimately, our patients would be safer.”

So when she was asked to champion physician training that purported to address those needs, she agreed, knowing that in order to be an effective voice, she had to be “integrally involved.” So she registered to become a certified trainer of Crucial Conversations.

The Results: Read our case study to learn how Dr. Gillian Kernaghan used Crucial Conversations and Crucial Accountability Training to earn accreditation with exemplary standing, improve employee satisfaction scores, and see a significant improvement in holding others accountable.

What St. Joseph’s employees have to say: Read this guest post to see other ways employees at St. Joseph’s Health Care London have used Crucial Conversations and Crucial Accountability Training to change their culture.

Crucial Conversations QA

Guest Post: The Vital Behaviors of Practice Change

Cathy Parsons

Cathy Parsons is a nursing practice consultant at St. Joseph’s Health Care London, and a Master of Applied Positive Psychology graduate, University of Pennsylvania, Philadelphia.

Practice changes are an everyday reality in the life of a healthcare provider. Clients, patients, and residents are more knowledgeable and expect care that is evidence-informed. All change creates some kind of emotional response. If the recommended change challenges staff members’ long-held assumptions and cherished beliefs, it may create frustration and moral distress. It may feel like the research negates years of tradition. For example, one of our units recently reflected on best practices for reducing patient falls and use of restraints, and practice changes have required a significant shift in staff behaviors and attitudes.

Don Ewert, Coordinator, Veterans Care, and I recently collaborated on ways to enhance the success of practice change by using an approach grounded in principles from VitalSmarts’ training. We used the skills from Crucial Conversations to achieve the organization’s vital behaviors of speaking up, holding each other accountable, and asking for help whenever concerned about safety, quality of care or service, and/or quality of work life.

Getting unstuck begins with our awareness of discomfort with the practice change. Our emotional response helps us to gauge whether we have a difference of opinion about the desired change, or whether we fear the stakes are high (maybe I won’t be able to do it). Starting with Heart reminds us that those promoting the practice change and those who put the change into practice usually have good intentions. By suspending judgment, admitting our biases, being open to new possibilities, and recognizing the role of Villain, Victim, or Helpless behavior, we Master Our Stories so that we can be fully engaged in the change process.

Stating Our Path requires us to share our views while also staying open to hear and consider others’ stories. During this step, Learning to Look for behaviors of Silence or Violence ensures that everyone continues to contribute to the Pool of Shared Meaning which is key to successful change. As we discover the Mutual Purpose of the change, we are more likely to show Mutual Respect when there are differences of opinion. This, in turn, makes it safe for dialogue to continue.

The term evidence-informed practice requires us to Explore Others’ Paths—including research on the subject, experience of the healthcare provider, and especially patient, client, and resident preference—this does not have to be an either/or choice! It also means that we prepare care providers with the skills and tools to successfully adopt the change. This is how we strengthen a person-centered approach to care in body, mind, and spirit.

Our Move to Action includes implementing and evaluating the change. The success of the change is assessed from the perspective of the patient, the care provider, and the care environment processes. Our vital behaviors help us to evolve the implementation process as we speak up about problematic aspects of the change, hold each other accountable when we see members of the team not modeling new behaviors, and ask for help when we feel unable to support the new practice. Ultimately, the way to enhance quality of patient care, build positive team relationships, and foster a shared and inclusive approach to practice change is grounded in the outcomes of these conversations.

Crucial Conversations QA

Crucial Applications: Antisocial Networks? How to Hold Effective Crucial Conversations on Social Media

According to our recent poll, social networks are becoming increasingly hostile, with 78 percent of users reporting rising incivility online and two in five blocking, unsubscribing, or “unfriending” someone over an argument on social media.

Specific findings include:

  • 76 percent have witnessed an argument over social media
  • 19 percent have decreased in-person contact with someone because of something they said online
  • 88 percent believe people are less polite on social media than in person
  • 81 percent say the difficult or emotionally charged conversations they have held over social media remain unresolved

Social media platforms aren’t the problem, it’s how people are using them that is causing a degradation of dialogue that has potential to destroy our most meaningful personal relationships.

Here are five tips for communicating both candidly and respectfully on social media:

  1. Check your motives. Social media hasn’t only changed the way we communicate, it has modified our motives. Ask yourself, “Is my goal to get lots of ‘likes’ (or even provoke controversy)?” or “Do I want healthy dialogue?”
  2. Replace hot words. If your goal is to make a point rather than score a point, replace “hot” words that provoke offense with words that help others understand your position. For example, replace “that is idiotic” with “I disagree for the following reasons . . .”
  3. Pause to put emotions in check. Never post a comment when you’re feeling emotionally triggered. Never! If you wait four hours you’re likely to respond differently.
  4. Agree before you disagree. It’s fine to disagree, but don’t point out your disagreement until you acknowledge areas where you agree. Often, arguers agree on 80 percent of the topic but create a false sense of conflict when they spend all their time arguing over the other 20 percent.
  5. Trust your gut. When reading a response to your post and you feel the conversation is getting too emotional for an online exchange—you’re right! Stop. Take it offline. Or better yet, face-to-face.

For additional advice, including ten things NOT to do when communicating via social media, download our free e-book, “When Crucial Conversations Go Social: How to Handle Heated Discussions via Social Media.”

Influencer Institute

Influencer Institute: Finding Meaning in the Mundane

Andrew MaxfieldAndrew Maxfield is director of the Influencer Institute, a private operating foundation that seeks to increase humanity’s capacity to change for good.

Influencer Institute

Atilano, a new friend of mine in Mexico, smiles while he delivers bottled water from his bicycle to nearby homes and businesses. His is a small business by nearly every standard, yet it is a powerful component of his escape route from poverty. And it’s working.

But that’s only half of the story. It turns out that there are several behaviors besides increasing income that lead a person to the outcome of a reliable financial surplus, and, eventually, to permanently improved economic conditions.

Can you imagine what one of those behaviors is?

You probably already know the answer—and it isn’t an exciting one. The behavior is: regularly write down every amount of money you take in and spend. People who make a habit (the intersection of ability and reliability) of regular financial record keeping know exactly how much they earn, exactly how much they spend, and can therefore take action if there is an imbalance between the two.

Our work with small business mentoring organizations in Latin America verifies this fact: their very poor clients who start small businesses and keep daily financial records manage to escape poverty over time, sometimes rapidly. Those who start businesses but are sloppy with record keeping or neglect it entirely, may never get ahead—and often don’t.

So here’s the rub, and it’s probably familiar: what if an all-important behavior is mundane? What if it’s dull, inconvenient, or psychologically painful?

This is where we can all learn from Atilano. It’s true that the act of record keeping might be tiresome if you view it as taking away from income-generating work, family time, or whatever you’d rather be doing. But Atilano thinks of his kids and the example he’s setting. He reminds himself of the “why” behind the task. Believe it or not, he considers his ledgers a personal diary—evidence of his hard work and dedication to his family. Taken in that light, record keeping can be a celebration of sorts, a happy daily ritual.

Can you think of a way to reconnect the task you routinely avoid to what you care about most? Can you link it to your values and vision and to people you care about?

Finding the thread that links what you must do to the grander vision of why you do it can help drum up the motivation you need to do an unpleasant task. Of course, your personal motivation isn’t everything; you also need skills, tools, and social support—and those factors unquestionably contribute to Atilano’s successes.

However, you and I can take a big step forward in our efforts to influence ourselves and others when we deliberately find meaning in life’s mundane but vital tasks.