ACCOUNTABILITY: What Motivates Employees. firstname.lastname@example.org. Session Objectives. This session will consider Accountability :. What it is . What we want . How to get it. Accountability: Is this it?. 1. Accountability: What it is.
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This session will consider Accountability:
A definition of “accountability”:
“Personal choice and willingness to contribute to an expressed or implied outcome.”
“How do you make people accountable for their health?”
Potential problems with this question:
A better question:
“What motivates employee ‘personal choice and willingness to contribute’ to health?”
Specifically, what is the evidence and are we applying it in our programs?
Two Worldviews on How to Get It
1. The Deficit Worldview
The problem is (an empty glass):
Thus, the solution is (to fill the glass) by giving them:
Just published study (BMJ, May 26): Salter and colleagues analyzed pharmacist-patient discourse during medication review consultations.
What they found: Advice giving without being asked was common and “was often resisted or rejected (by patients) and created interactional difficulties…”.
What about accountability: Advice giving occurred “despite deliberate displays of competence and knowledge by patients.”
2. The Competence Worldview
The solution is (to draw water from the well) by:
What do Competence Worldview
programs look like?
A clinical example:
Rubak and colleagues (2005) in the British Journal of General Practice concluded from a review of 72 RCTs:
“(Motivational interviewing) outperforms traditional advice giving in approximately 80% studies…The meta-analysis shows significant effects of motivational interviewing for combined effect estimates of body mass index, total blood cholesterol, systolic blood pressure, blood alcohol concentration and standard ethanol content…on many different areas of intervention. The review has shown that motivational interviewing can be effective even in brief encounters of only 15 minutes and that more than one encounter with a patient increases the likelihood of effect.
Aliotta, S. L., Vlasnik, J. J., & Delor, B. (2004). Enhancing adherence to long-term medical therapy: A new approach to assessing and treating patients. Advances in Therapy, 21, 214-231.
Bennett, J. A., Perrin, N. A., & Hanson, G. (2005). Healthy aging demonstration project: Nurse coaching for behavior change in older adults. Research in Nursing and Health, 28, 187-197.
Berger, B. A., Liang, H., & Hudmon, K. S. (2005). Evaluation of software-based telephone counseling to enhance medication persistency among patients with multiple sclerosis. Journal of the American Pharmacists Association, 45, 466-472.
Broers, S., Smets, E. M. A., Bindels, P., Evertsz, F. B., Calff, M., & DeHaes, H. (2005). Training general practitioners in behavior change counseling to improve asthma medication adherence. Patient Education and Counseling, 58, 279-287.
Hayward, P., Chan, N., Kemp, R., & Youle, S. (1995). Medication self-management: A preliminary report on an intervention to improve medication compliance. Journal of Mental Health, 4, 511-518.
Kreman, R., Yates, B. C., Agrawal, S., Fiandt, K., Briner, W., & Shurmur, S. (2006). The effects of motivational interviewing on physiological outcomes. Applied Nursing Research, 19, 167-170.
Robles, R. R., Reyes, J. C., Colon, H. M., Sahai, H., Marrero, C. A., Matos, T. D., et al. (2004). Effects of combined counseling and case management to reduce HIV risk behaviors among Hispanic drug injectors in Puerto Rico: A randomized controlled trial. Journal of Substance Abuse Treatment, 27, 145-152.
Rose, J., & Walker, S. (2000). Working with a man who has Prader-Willi syndrome and his support staff using motivational principles. Behavioural and Cognitive Psychotherapy, 28, 293-302.
Other programs that can be “competence” based:
The Principles of ChangeTM
1. The Principle of Social InvestmentTM
2. The Principle of DiscrepancyTM
3. The Principle of AccessibilityTM
4. The Principle of ExpectancyTM
What You can Do: Communicate this…
Accountability programs (whether to motivate patient adherence or a healthy lifestyle) work, not because they demand or instil accountability, but because they value and evoke employee competence and commitment.
Behavior Change Solutions, Inc.
52 Cherie Road
St. Catharines, ON
CANADA L2M 6L7