Accountability and Fostering Trust in Healthcare Teams

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Introduction   

Leadership in the healthcare setting is necessary for overall success of the healthcare organization. Nurse leaders help improve patient outcomes by enhancing team collaborations, encouraging proper use and advocacy for necessary resources, as well as empowering their staff to take accountability for and fostering trust within the team (11). Through guiding teams to a supportive environment and making strategic decisions there, staff can achieve their best work (7). 

Understanding Leadership in Healthcare 

Leadership in healthcare goes beyond the patient’s care. It involves guiding individuals and teams to achieve specific goals – typically related to clients’ care and overall performance. Effective leaders help build a vision for the team, as well as seek opportunities to motivate and inspire both team members on an individual and departmental level. Through a blended vision, motivational strategies, and strategic decision-making, nurse leaders can inspire their employees to practice at the top of their scope, be creative in addressing the challenges they face within the healthcare arena, and ultimately improve overall patient care (4). 

Within the healthcare setting a variety of leadership roles may be appointed. Often used interchangeably, management and leadership are not one in the same. In fact, one can exist without the other. However, for the best success of the team and in the best interest of the patient, the two must combine. 

Leadership focuses on inspiring and motivating staff, fostering a vision for the future, and driving change. Management keeps stability, implements processes, and ensures day-to-day operations run smoothly. Key leadership qualities that allow for effective healthcare leadership include emotional intelligence, communication skills, decision-making abilities, and adaptability. While these four are not the only key qualities for outstanding leaders, these four set a sturdy foundation which the leader can build upon (4). 

Emotional Intelligence is the ability to understand and manage one’s own emotions and those of others. Communication skills include clear, empathetic, and effective communication is essential for team success and patient care. Decision-making ability includes making informed and prompt decisions that affect clients’ care. Adaptability of the nurse leader includes responding to changing circumstances and challenges in a dynamic healthcare environment (5). 

There are several types of leadership styles. These include servant, transformation, identity, autocratic, democratic, laissez-faire, and coaching leadership styles. Each style has its strengths and can be used based on the team dynamic and situation the team is facing (1). 

Assessment of Leadership Skills 

To understand which style of leadership is best to build accountability and foster trust in one’s team, a leader must first understand the current leadership style. Assessing leadership skills allows for personal and professional growth. To accurately assess for this, a combination of self-assessment, peer review and team feedback, as well as regular reflective activities must be completed. Through these steps, a leader can develop a comprehensive understanding of strengths and weaknesses, as well as the ability to create a leadership growth plan (13). 

There are a variety of ways to assess leadership style. The Multifactor Leadership Questionnaire (MLQ) and the Leadership Practices Inventory (LPI) are commonly used assessments. These offer a framework for understanding how the current style impacts team accountability and trust (13). 

Journaling, self-reflective exercises, or the 360-degree feedback tool are all ways for a leader to assess their current performance, understand the impact on others, and seek areas for growths. These tools are particularly helpful as if used regularly, they can provide ongoing assessment and adaptation to the current needs of the team that is being lead (3). 

Peer reviews, team feedback surveys, and performance evaluations gather insights from colleagues and team members. Regular feedback from peers and team members shows the feeling of a leader’s strengths and weaknesses. Both formal and informal feedback can be used to provide a culture of openness and continuous improvement – starting with the leader being open to such feedback and using it as a tool for refinement of skills (13). 

Fostering Accountability and Trust 

Fostering accountability and trust starts with the nurse leader. The nurse leaders can help build accountability by setting expectations and holding team members accountable. Clear, measurable goals enable employees to meet, even exceed, the expectations that are set forth.  

The nurse leader must also provide regular feedback and performance evaluations. Both formal and informal check-ins allow leaders to communicate how an employee is doing, encouraging a continuation of proper skills and actions, and coaching unfavorable efforts or areas of weakness (8). Through transparent tracking, recognition, and coaching, employees will be empowered to take accountability for themselves and their contributions to the team. 

Building and keeping trust in the healthcare setting can make or break the team’s ability to conduct goals. Having trust within a team can profoundly affect the team dynamic and quality of patient care. Open communication, collaboration, and teamwork improve problem-solving and innovation. These lead to reduced cost, reduction in safety events, better coordination of resources, and greater patient satisfaction. 

Both accountability and trust have a synergetic relationship. With trust, accountability is properly encouraged. With accountability, greater trust is formed. The nurse leader should be aware of their team’s status in both areas and look to improve either that is lacking. Elevated levels of trust and accountability are associated with reduced errors, enhanced clients’ satisfaction, and team cohesion (8). 

Communication Skills for Leaders 

Improving accountability and trust starts by communicating clear, measurable expectations of the nurse leader’s team. Effective communication is needed for team cohesion. Effective communication involves active listening, clear messaging, and non-verbal communication. Active listening involved being fully engaged with the speaker, proving attentiveness through verbal and non-verbal communication (6). Clear messaging used straightforward, unambiguous manner allows for leaders to clearly convey their ideas and instructions. Non-verbal communication includes body language, facial expressions, and other nonverbal signals reinforce on contradict spoken messages (6). 

Conflict resolution is also a crucial skill for leaders. Conflict resolution also involves active listening, as well as empathy, and problem-solving. Leaders should look to understand the perspectives of their employees through active listening and acknowledgement of their views. Empathy allows leaders to relate to team members viewpoints, emotions, and beliefs, while easing a constructive dialogue. Problem-Solving helps engage team members in finding mutually beneficial solutions to conflicts, encouraging open communication and team building (6). 

Feedback and Performance Reviews offer constructive opportunities for improvement. These should be specific, actionable, and delivered on time. Leaders should focus on behaviors and outcomes rather than personal attributes, providing balances feedback that highlights both strengths and weaknesses (6). 

Navigating Change and Challenges 

Leading through change can be a tough time for both the leader and employees. Helping employees navigating change smoothly includes communicating a clear and compelling vision for the future that requires the change. Also, discussing the benefits, steps to achieve the change, and the purpose of the changes helps employees feel more comfortable with implementing changes. Including team members in the change process instills a sense of empowerment and commitment to the change. Providing feedback, addressing concerns, and incorporating suggestions help with the change strategy (2). 

Beyond the change itself, stress and work challenges can impede a team’s ability to make changes successfully occur. To help mitigate these concerns, stress management is helpful. Leaders should focus on finding the root cause of challenges and stressors that affect the ability to move forward appropriately (2). Once this information is set up, the use of problem-solving and resilience can help address both stress and challenges to change.  

Self-Management and Personal Development 

Effective time management and organization are necessary to keep leadership effectiveness. A variety of tools can be used including digital planners, task management apps, and time-tracking software. Similarly, employing techniques such as time blocking can enhance focus and efficiency by breaking work into manageable intervals (14). 

The nurse leader must set an example to their employees in both accountability and trust. Continual learning and professional growth help the leader improve their example to employee. The nurse leader should focus on attending formal courses, certifications, or informal learning opportunities. By engaging in professional networking and conferences, the nurse leader can contribute their own valuable insights and increase opportunities for growth (14). 

Lastly, work-life balance is a challenge in the healthcare setting. The nurse leader must have their own work-life balance to keep stress levels, improve stress recovery, and set the same example for their employees (12). Through setting clear boundaries between work and personal life, prioritizing family and friends, and engaging in regular self-care, the nurse leader and their team are more efficient, better involved, and motivated to improve patient outcomes (14). 

Research Findings and Evidence-Based Practices 

Recent studies in nursing leadership find strategies and practices that enhance leadership in the healthcare setting find the impact of transformation leadership. It also shows that leaders who inspire and motivate their teams through a shared vision and personal example counteract team and individual burnout among nurses. Similarly, the role of emotional intelligence is significant in the nursing leadership role (9). Leaders who focus on self-awareness, empathy, and effective communication are better equipped to manage complex and stressful situations in the healthcare environment (10). 

Conclusion

Healthcare is a fast paced and highly impactful field related to the ever–changing healthcare technology and patient lives at stake. Because of this, nurse leaders must be aware of and look to implement improvements in both accountability and trust in their healthcare teams. Through proper leadership, patient outcomes and team dynamics can be improved for the better. Utilizing evidence-based practice, leaders can promote a culture of continuous improvement and teamwork. Additionally, nurse leaders can help by setting examples of managing change and resilience. Through proper leadership skills and approaches, the nurse leader can promote accountability and foster trust in the workplace for better patient outcomes, improvements in healthcare, and happier employees.  

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