The culture of an organization is of paramount concern for its leaders, as it ultimately guides the strategic direction and all decisions. Tsai (2011), tells us that culture is an element both learned and transmitted, beginning with leadership and spreading across the organization by leaders that clearly establish and foster their organizational culture. How that looks, will depend on what types of culture are built by these leaders. Certainly, organizations must demand accountability, especially in healthcare with the critical nature of its business. However, it is important to note that organizations must demand accountability not only of their employees, but of the leaders and organization itself as well. This creates some nuances in how that is accomplished. In an accountability culture, individuals are pinned directly for their mistakes, and punished accordingly. While this satisfies the personal accountability, it feels to teach lessons learned, or to identify procedural problems that may create similar individual mistakes in the future. A just culture style delivers a more balanced accountability for individuals in the organization that are responsible for designing and improving workplace systems and processes (Boysen, 2013).
This is advantageous when compared to simply accountability culture, which doles out individual punishment and punitive measures but ultimately fails to solve problems. Organizations design systems that individuals operate in. That is to say, aside from gross negligence, while an individual may be at fault the system likely is as well and failing to acknowledge and address punitive measures with such an approach worsens problems rather than rectifying them (Boysen, 2013). While discipline and accountability may be well-intentioned regardless of the style of cultural accountability, capitalizing upon mistakes as opportunities for learning and systemic change is likely to offer a far greater future benefit than individual punishment measures that do not address grander issues.
Boysen P. G., 2nd (2013). Just culture: a foundation for balanced accountability and patient safety. The Ochsner journal, 13(3), 400–406.
Tsai Y. (2011). Relationship between organizational culture, leadership behavior and job satisfaction. BMC Health Services Research, 11, 98. https://doi.org/10.1186/1472-6963-11-98