Content Dam Rdh Print Articles Volume37 Issue5 1705rdh C1

Accountability for your actions: Building a dental team culture that matures from its mistakes

May 1, 2017
Dorothy Garlough, RDH, explains how to weave accountability into a dental team in a positive way.

By Dorothy Garlough, RDH, MPA

A hugely popular book published in the mid-1840s, “The Mysteries of Russia,” tells a lurid tale of a peasant fleeing a pack of wolves on a sled. Unable to outrun the hungry beasts, she saved her own life by hurling her children, one by one at the ravenous pack.1

Many of us have seen such action in our workplace, where team members don’t take accountability for their actions. They either avoid the responsibility or point fingers, blaming others and then throwing them under the bus. Lack of personal accountability, not to mention team accountability, can be as rampant as caries in a patient who is addicted to methamphetamine. And, it is just as destructive. When there is a lack of accountability people hide behind others, close down, and stop bringing their mistakes forward. This creates escalating problems and will perpetuate a culture where no one answers for mistakes, screwups, and failures.

According to a survey2 conducted by AMA Enterprise, a division of the American Management Association, 21% of business leaders believed the percentage of unaccountable employees ranged from 30% to 50%. Assessments measuring different skills of teams show that team accountability consistently is the lowest competency. Even team members believe team effectiveness would rise by 89% if peers held one another accountable.3 Yet, people are not good at holding one another accountable for their actions.

The Value of Accountability

The value of accountability is recognized as vital to the team’s success. Everything from performance, creativity, innovation, and even morale and satisfaction is improved with accountability. Although accountability cannot be dictated, it can become part of the culture.

A person-centered team creates the conditions where accountability can thrive. It does this by all team members adhering to an accountability strategy statement within its constitution. This statement outlines the parameters of both the leader and the team members around not only owning their own performance and standards of behaviors, but also holding others to commitments. It is the measure of a team’s intense desire to not let each other down, because in letting them down, the whole team is let down.

Peer accountability recognizes that a well functioning team can accomplish something none of the team members can accomplish on their own. It acknowledges the impact of one’s actions (or lack thereof) on the team and demands follow-through. The strategy statement does not allow teammates to skirt ownership of their behavior. It recognizes that someone who is consistently falling short has a low commitment to the team.

In a dental office, one person’s failure in their tasks or behaviors has an effect on the whole, often with exponential results. The work the office had planned gets impacted and the failure has effects further downstream.4 It is recognized that the individual’s delay becomes the team’s delay.

We can easily see how failure to be accountable for even seemingly innocuous behaviours can create dysfunction in our dental offices. For instance, when a team member fails to sterilize a laser tip, it can affect another clinicians’ appointment, and this can have a snowball effect, throwing off the schedule for the day. Another example is tolerating a staff member coming in consistently 10 minutes late and missing the day’s overview morning meeting. This sends the message that low commitment to the team is an option and often leads to sub-par work being accepted.

Creating a culture of accountability means developing a climate in which people can speak openly about their vulnerabilities, admit to mistakes without fear, engage in debate respectfully, and focus on serving the patient instead of looking better than a co-worker. A team’s constitution fosters guidelines in its strategy statements to establish this culture. It also lends the team the ability to infuse their personalized ideas on how to achieve accountability.

Many issues can be avoided through creating a feedback loop by regularly checking in on progress, asking team members to share their current status, successes, and need for help. Lack of regular feedback reveals mistakes too late.5 Talking openly about responsibilities, performance standards, deadlines, potential consequences, or implications of actions will support an environment of accountability. Providing resources, knowledge, and needed assistance increases team members’ skills, confidence, and ownership.

A leader’s role in accountability

The leader naturally has an impact on accountability of the team. The culture of accountability comes from the top. If the leader is hesitant to address substandard performances and behavior, then others will be hesitant as well. Peers will mirror accountability as the leader models it. Although not the primary source of accountability in a person-centered team, the leader will always be the ultimate arbitrator.

Some people are hard to hold accountable, because they are so helpful. Others get defensive, and yet others are intimidating.7 Having to confront someone about their deficiencies and then stand in the moment and deal with the reaction requires a belief that the good of the whole is more important than the interests of the individual.

It takes resolution to open difficult conversations. But coming at it from a place of curiosity, wanting to learn where and why the breakdown occurred makes it easier. It is also the right thing to do. Catching behaviors early will save frustration and cost.

Establishing peer-to-peer accountability as the standard will also reduce politics within offices. If members of a team go to their leader when they see lack of commitment by a fellow team member, a perfect storm is created for distraction and politics. Team members get caught up in who ratted on them, creating distrust and resentment. Leaders find themselves constantly being pulled into unpleasant situations that could be more productively solved between peers.8

One might think that addressing failed accountability should be done in private. But in a person-centered team, if leaders need to address broken commitments, it needs to be done, in most instances, with the entire team present for the following reasons:

  • It ensures everyone receives the same message
  • It informs everyone on the team that the leader is holding their colleague accountable
  • It drives home the culture of accountability9

Of course, there are times when serious issues should be resolved in private, but generally speaking, transparency is better within a person-centered team.

A Lived Value

Make accountability a part of your team’s normal way of operating. Talk about it, share ideas, come to a common consensus about what accountability means in the workplace, and then use that as a foundation everyone works from. The saying, “Success has many parents, but failure is an orphan,” needs to be the antithesis.

Creating accountability recognizes the vested interest in the performance success of others. Demanding more of teammates results in greater accuracy of work, better response to role obligations, more vigilant problem solving, better decision-making, more cooperation with co-workers, and higher team satisfaction. Solutions are delivered and confidence and responsibility rises. Unlike the Russian peasant who sacrifices her children for the good of one, the team views accountability as a means of achieving the good for the whole. RDH

The eight C’s of shared accountability

  1. Create trust - Be authentic and lose the ego
  2. Craft organizational purpose - Address why the work is important
  3. Commitment - Buying into actions that serve “the whole” vs. the individual
  4. Communicate - Inform, debate, offer feedback
  5. Clear focus - Specific expectations, goals, values, and vision
  6. Clarify - Mistakes are part of a learning environment
  7. Conscious reparation - Set mistakes straight in a timely manner
  8. Consequences - Both positive and negative implications


1 The Economist. Feb. 4-10, 2016 NATO: Leaders worry that Donald Trump seems to see allies as a burden. Lexington/Strength in numbers, page 28.


3 The Wiley Workplace Learning Solutions for Cohesive Teams




7 Lencioni P. The Five Dysfunctions of Teams ISBN: 0-7879-6075-6, John Wiley & Sons, Inc., New York, NY, 2002

8 Lencioni P. The Advantage, ISBN: 978-1-118-26673,2012, John Wiley & Sons, Hoboken, NJ.

Dorothy Garlough, RDH, MPA, is an innovation architect, facilitating strategy sessions and forums to orchestrate change within dentistry. As an international speaker and writer, Dorothy trains others to broaden their skill-set to include creativity, collaborative innovation, and forward thinking. She recognizes that engagement is the outcome when the mechanisms are put in place to drive new innovations. Connect with her at [email protected] or visit