Every leader wants his team to reach state of no blame and progress positively.  But how do we do it?

It is natural for us mortals to lay blames onto another person when something goes wrong.  It is not that we are bad, aggressive, or we want to make unnecessary enemy / prey.  We simply put up psychological defense that we are not part of a bad outcome (itself a bad news).  We also mean good when we spell who the last one to touch the ball was, because it is an oversimplified way of root cause analysis – we seem to have done our part even in prevention!

For the leader to change this culture, he may teach his subordinates a new code of conduct in response to an adverse outcome.

  1. Change the name: describe adverse outcome intellectually: a negative deviation in performance or some other academic description.  Do not use the names such as error, mistakes.

  2. Divide unfavorable outcome from deliberate bleaches in code of performance.  While the former may occur despite everything being done carefully under the best knowledge and occasionally unavoidable, the latter is something of a different nature and must be changed.

  3. Approach every difficult discussion positively as a chance of learning.  It may be disclosure of negative outcomes, or discussion after root cause analysis even with human performance factors being implied.  Start with asking ‘what are we going to learn from this observation’.

  4. To be empathetic to involved colleagues.  It is easy to point fingers to another person, but if we are not given information, we ourselves are as prone to the same errors.

  5. Establish an error registry and make everyone aware of duty to report.  Preach that it is a matter of loyalty to the team to report negative outcomes.  Conduct meetings to identify roots of problems, and solve them one by one.  Treat everyone alike, including seniors and juniors, in meetings.

  6. It is important to protect major stakeholders such as supervisors in the exercise, because they must not feel threatened with the exercise or become ineffective in leadership.  Therefore some buy-in and reassurance is important.  Make everyone understand that it is a collective accountability.  In addition, the head always assumes responsibility for any negative performance within the team.  This maintains cohesiveness and improves performance.\

  7. Teach the important principle that clients and sometimes staffs blame, yell or even behave outside of accepted manners, not because they do not like the provider involved.  They do so because they are scared of the bad news and consequences.  It is prevalent (not just common) in history that people blame messengers who bring about bad news.  Health care is full of bad news, and it stresses recipients.  When staffs understand this, they face blames with intention to dissolve hard feelings, instead of absorbing the blame, and then internalize or relay allegations &/or feelings.

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