Take risks as long as you don’t take risks! This is a message in organizations that many employees will swear they hear alongside continuous improvement initiatives. In healthcare, continually improving processes can literally be a life-saving endeavor. Discovering sources of infections, improving the reliability of testing, and speeding up laboratory processes are examples.



So what does leadership mean when they communicate, “Take risks as long as you don’t take risks”?

When trying to discover the source of a problem, you can focus on one of two things: individual error or process error. (tweet this)

Focusing on individual error can create a climate that discourages creative risk-taking.  As in the case of Jenny who determined that the quality checking process she was using could be sped up but she needed help from a coworker. She checked with her manager to ensure it was fine to pull that coworker off their job to help. The collaboration failed. The manager reprimanded Jenny for using up valuable time and resources “on a hunch” and told her to go back to the way they had always done it. Jenny decided that despite the constant reminders to look for opportunities to improve and streamline processes it was expected that you stick to the book. She gave up.

When employees give up, the loss to the organization is hard to calculate. If you don’t want to suffer that kind of loss, consider rethinking failure as an invitation to learn from experience. If her manager facilitated Jenny to talk in terms of  “This is what I did, this is what I learned, here is what I would do differently in the future, and here is how I will be accountable for the improvement” – continuous learning would be unstoppable. Leaders who want continuous improvement and employees to take risks must acknowledge that stopping to learn takes time.


In healthcare, the pace of work is intense, and when a crisis emerges (the right drug is not available during surgery, beds haven’t been turned around quickly enough for new patients, the laboratory report is late and the patient goes into a seizure) a quick “workaround” is thrown into place instead of taking the time to explore the problem and learn from it. Often the person who implements the workaround is praised for quick thinking and “saving the day.” But the praise needs to go to the person, or the team, that says after-the-fact, “Wait a minute, why did this crisis occur in the first place? How can each of us make sure that it doesn’t happen again?”

Process intense organizations can benefit from a continuous improvement culture that spells out “workarounds are not allowed”, and more importantly, are not rewarded. Reward discovering the source of the problem and challenge your people to come up with creative solutions. Demonstrate how problem solving can focus on the process, not on individuals. It feels safe to explore ownership for problems when blame doesn’t enter the picture.

In organizations that have adopted the importance of individual accountability as a positive and productive character trait, the focus is on the process and an “owner” rather than as a person to blame for failed outcomes.


  • Believe that people are capable, because they are.
  • Allow people to make mistakes as long as they learn from them.
  • When mistakes are made, or the outcome does not meet expectations, analyze what happened with an honest account of who did what, and agree on the needed changes in the proccess to get it right the next time.


1. Define the issue. Develop a clear written issue statement. The key in this step is clarity. Everyone agrees on what the problem is.

“An outmoded piece of equipment gives too many false positive readings, resulting in much rework”.

2. Identify the root cause of the problem. The key to this step is candor. People have to trust each other enough to keep asking “why” and be willing to tell the truth. If the root cause is not clearly identified, the problem will not be solved.

What prevents having newer equipment? Is it financial? Or have statistics on false positives not been kept? Is the decision maker not aware of the problem? Are employees not properly trained on how to use it?

3. Brainstorm a list of solutions. The key here is creativity.

4. Act! Develop an action plan. Be specific about who will do what by when. Write it down.


When really digging into problems, leaders create an environment of excellence by promoting individual and collective accountability at the same time.  Open, honest conversations to problem solve are risky because owning up could mean someone will remember your admission at performance evaluation time. It’s understandable if you don’t want to risk it. You are accountable either way and it’s powerful to know that. Not being accountable is a choice. Cultures change and problems are solved much faster when being accountable is chosen more often. Risk it. Try being accountable more often.

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